Carbapenem de-escalation as an antimicrobial stewardship strategy: a narrative review.

Increased carbapenem prescribing has contributed to rising rates of carbapenem-resistant bacterial pathogens. Although antimicrobial stewardship efforts that facilitate de-escalation of carbapenems to alternative agents can minimize unnecessary exposure, clinicians may be hesitant to de-escalate therapy due to concerns for potentially compromising patient outcomes. A literature search was performed to characterize carbapenem de-escalation strategies and assess associated patient outcomes.

Aldehyde-Induced DNA and Protein Adducts as Biomarker Tools for Alcohol Use Disorder.

Alcohol use disorder (AUD) screening frequently involves questionnaires complemented by laboratory work to monitor alcohol use and/or evaluate AUD-associated complications. Here we suggest that measuring aldehyde-induced DNA and protein adducts produced during alcohol metabolism may lead to earlier detection of AUD and AUD-associated complications compared with existing biomarkers. Use of aldehyde-induced adducts to monitor AUD may also be important when considering that approximately 540 million people bear a genetic variant of aldehyde dehydrogenase 2 (ALDH2) predisposing this population to aldehyde-induced toxicity with alcohol use.