Q fever endocarditis duration of treatment

The duration of treatment for endocarditis caused by coxiella burnetti should be 18 months (or 24 for prosthetic valves) based on a recently published large 20-year cohort. Treatment with doxycycline and hydroxychloroquine are recommended (abstract) with 5 years of follow up to assess for relapse.

Risk of hyperkalemia with trimethoprim-sulfamethoxazole

In this population-based case-control study of elderly patients on an ACE or ARB, the risk of hyperkalemia-associated hospitalization was 7 times higher for patients with a recent prescription for trimethoprim-sulfamethoxazole, compared to amoxicillin (with no increased risk with other comparator antibiotics), even after matching for age, sex, renal insufficiency, and diabetes. For elderly patients on an ACE or ARB, the risk of hyperkalemia should be considered before being prescribed trimethoprim-sulfamethoxazole (abstract)

ID consultation associated with lower mortality in staph aureus bacteremia

In this large retrospective cohort of 341 patients with staph aureus bacteremia, only 1/3 of them had an ID specialist consulted. Overall, 16% of the patients died within 4 weeks, and having an ID consult was associated with a 56% reduction in the risk of dying. Routine use of ID consults should be considered in patients with staph aureas bacteremia (abstract)

Stool transplant for recurrent Cdiff

Stool transplants have been successful in a few case series of patients with recurrent or refractory Cdiff. This case series describes self-administered (by enema) stool transplants (from family members) in 7 patients with refractory Cdiff. They report 100% clinical success with 14 months of follow up. The donor was extensively tested for infectious agents before donating the fecal specimen. Although cumbersome, this may be a feasible option in patients with ongoing Cdiff that is refractory to other treatments (abstract).

Study confirms antibiotic benefit in COPD exacerbations

This large retrospective analysis of >84,000 patients hospitalized with COPD confirms the benefits of antibiotics; antibiotic treated patients had lower risks of mechanical ventilation, inpatient mortality, and COPD readmissions (although higher Cdiff readmission rates). This large analysis confirms guideline recommendations for antibiotic therapy in patients hospitalized with COPD exacerbations (abstract)