Key Takeaways on Managing Antimicrobial Resistant Gram-Negative Infections

New data from the PETERPEN trial suggest that piperacillintazobactam may be noninferior to meropenem for early clinical outcomes in select patients with ESBL bloodstream infections, but carbapenems remain the standard of care until final mortality results are available and fully analyzed.

Outcomes from treating orthopedic infection with debridement and implanted antibiotic were similar whether followed by short or standard duration of systemic antibiotic.

In this week's top infectious disease stories, a Pennsylvania teen became the state's fourth measles death in weeks, the CDC reported a 17% summer surge in rabies exposure calls, new research revisited whether cefepime raises mortality risk, a multihospital review examined ceftriaxone's safety after state alerts, and examining Legionella pneumonia diagnostics.

A retrospective multihospital study found that severe adverse events occurred at similarly low rates with ceftriaxone and other IV cephalosporins suggesting there is no evidence to support avoiding ceftriaxone despite recent health department safety alerts.

New gyrA testing guides ciprofloxacin use for gonorrhea, cutting ceftriaxone reliance while tackling resistance, access, and FDA hurdles.

A retrospective study of 225 patients across Cook County Department of Health clinics found that the novel 1-month 1HP regimen (isoniazid plus rifapentine) for latent TB infection had a completion rate comparable to standard longer regimens and was well tolerated, suggesting it may be a viable shorter alternative.

Resistance-guided testing targeting a single gene mutation could let clinicians safely reintroduce ciprofloxacin for the majority of gonorrhea cases still susceptible to it, sparing ceftriaxone as resistance climbs worldwide. Lao-Tzu Allan-Blitz, MD, MPH, offers insights into his work in this area.

Adding bismuth to amoxicillin-vonoprazan increased efficacy of the combination for H pylori, and exceeded that of clarithromycin-based triple therapy without contributing to clarithromycin resistance.