Though antimicrobial stewardship programs (ASPs) are required for hospitals, the involvement of transplant recipients in programmatic interventions, protocols, and metrics has historically been limited. Though there is a growing interest in studying stewardship practices in transplant patients, optimal practices have not been clearly established. A component of ASPs, antiviral stewardship (AVS), specifically targeting cytomegalovirus (CMV), has been more recently described. Understanding AVS opportunities and interventions is particularly important for transplant recipients, given the morbidity and mortality associated with viral infections, challenging clinical syndromes, ultrasensitive molecular diagnostic assays, antiviral resistance, and costs of viral disease and medications, as well as antiviral drug toxicities. This review highlights opportunities for AVS for CMV, EBV, HSV, VZV, SARS-CoV-2, respiratory syncytial virus, and BK polyomavirus in transplant patients.
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http://dx.doi.org/10.3390/v16121884 | DOI Listing |
Infect Drug Resist
January 2025
Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu, 210000, People's Republic of China.
Background: tNGS and mNGS are valuable tools for diagnosing pathogens in lower respiratory tract infections (LRTIs), which subsequently influence treatment strategies. However, the impact of tNGS and mNGS on antimicrobial stewardship in patients with LRTIs remains unclear.
Methods: Patients diagnosed with LRTIs who underwent tNGS or mNGS between June 2021 and January 2024 were included.
Viruses
December 2024
Department of Infectious Diseases, Ochsner Medical Center, New Orleans, LA 70115, USA.
Though antimicrobial stewardship programs (ASPs) are required for hospitals, the involvement of transplant recipients in programmatic interventions, protocols, and metrics has historically been limited. Though there is a growing interest in studying stewardship practices in transplant patients, optimal practices have not been clearly established. A component of ASPs, antiviral stewardship (AVS), specifically targeting cytomegalovirus (CMV), has been more recently described.
View Article and Find Full Text PDFEBioMedicine
January 2025
Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Section for Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway. Electronic address:
Background: The Bari-SolidAct randomized controlled trial compared baricitinib with placebo in patients with severe COVID-19. A post hoc analysis revealed a higher incidence of serious adverse events (SAEs) among SARS-CoV-2-vaccinated participants who had received baricitinib. This sub-study aimed to investigate whether vaccination influences the safety profile of baricitinib in patients with severe COVID-19.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Markos University, 269, Debre Markos, Ethiopia.
Background: Antibiotic resistance (AMR) remains a global public health threat with a high burden in sub-Saharan countries. The overuse of antimicrobials in the clinical setting is the main factor for the spread of antibiotic resistance. Diagnostic uncertainty in differentiating between bacterial and viral infections is the major contributor to antimicrobial overuse.
View Article and Find Full Text PDFDrugs Aging
January 2025
Department of Infectious Diseases, Alfred Hospital and Monash University, 55 Commercial Rd, Melbourne, VIC, 3004, Australia.
Owing to widespread availability of potent and tolerable antiretroviral therapy, life expectancy of people with human immunodeficiency virus (HIV) has significantly increased. Consequently, the population of people with HIV are ageing, with over 50% over the age of 50 years, and it is expected that 25% will be over the age of 65 years by 2030. People diagnosed with HIV at older age tend to have more advanced disease, and may already be experiencing comorbidities that will influence the choice of initial antiretroviral treatment.
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