In this article a selection of notable peer-reviewed publications from 2024 are provided.
Article Selection by: Bassam Ghanem, Pharm.D., MS, BCPS, BCIDP
Article Construction by: Timothy P. Gauthier, Pharm.D., BCPS, BCIDP
2024 has been an interesting year for infectious disease literature dissemination. For years many of us were using #IDtwitter to get our journal article identification and discussion fix. With Twitter changing to X in mid-2023 and subsequently in the end of 2024 many folks from the IDtwitter community moving over to Bluesky, the game is certainly ever-changing. I wonder if this will cause us to be more fragmented as a group in 2025 and if Bluesky will really have sticking power. Mastodon sure did not. Threads sure does not look like a viable other option for us either!
As 2024 comes to a close, my friend Dr. Ghanem (who you can follow on X and Bluesky @ABsteward) has done our community the favor of composing a list of some of the most interesting articles that emerged during our latest trip around the sun. Naturally, many of these were circulated widely on social media, however perhaps there are some items that you missed. This is not an all-inclusive list and certainly there will be many excellent articles that came out which are not included here.
We hope you find this list helpful, maybe it will even inspire a journal club or two!
RANDOMIZED CONTROLLED TRIALS
1. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM
BALANCE RCT: Among hospitalized patients with bloodstream infection, antibiotic treatment for 7 days was non-inferior to treatment for 14 days.
2. Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis | JAMA
The ADAPT-Sepsis RCT: In critically ill adult patients hospitalized for suspected sepsis, daily PCT-guided protocol reduced total antibiotic duration and had non-inferior all-cause mortality compared with standard care. No difference was found in total antibiotic duration between standard care and daily CRP-guided protocol, and CRP showed inconclusive results for all-cause mortality.
3. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women | NEJM
PURPOSE 1 RCT: No participants receiving twice-yearly lenacapavir acquired HIV infection. HIV incidence with lenacapavir was significantly lower than background HIV incidence and HIV incidence with daily oral F/TDF.
SABATO RCT: Oral switch antimicrobial therapy was non-inferior to intravenous standard therapy in participants with low-risk S. aureus bloodstream infection.
BLING III RCT: In critically ill patients with sepsis, continuous vs intermittent β-lactam antibiotic infusions did not significantly reduce 90-day mortality in the primary analysis.
SIMPLIFY RCT: De-escalation from an anti-pseudomonal β-lactam in Enterobacterales bacteraemia following a predefined rule was non-inferior to continuing the empiric antipseudomonal drug.
PROPHY-VAP RCT: In patients with acute brain injury, a single ceftriaxone dose decreased the risk of early ventilator-associated pneumonia.
ACCESS RCT: Addition of clarithromycin to standard of care enhances early clinical response and attenuates the inflammatory burden of community-acquired pneumonia.
REGARD-VAP RCT: Individualized shortened antibiotic duration guided by clinical response was non-inferior to longer treatment durations in terms of 60-day mortality and pneumonia recurrence, and associated with substantially reduced antibiotic use and side-effects.
Trep-AB Study RCT: The efficacy of linezolid at a daily dose of 600 mg for 5 days did not meet the non-inferiority criteria compared with benzathine penicillin G and, as a result, this treatment regimen should not be used to treat patients with early syphilis.
11. Stewardship Prompts to Improve Antibiotic Selection for Pneumonia | JAMA
The INSPIRE RCT: Real-time electronic health record–generated recommendations for standard-spectrum antibiotics using patient-specific risk for MDRO-associated infections can substantially and safely reduce empiric extended-spectrum antibiotic use in patients hospitalized for pneumonia.
MOBILE2 RCT: Mechanical and oral antibiotic bowel preparation reduced overall postoperative complications as well as rates of SSIs and anastomotic dehiscences in patients undergoing elective rectal resection compared with mechanical bowel preparation plus placebo.
13. Diagnostic Stewardship in Community-Acquired Pneumonia With Syndromic Molecular Testing| JAMA
CAPNOR RCT: Routine deployment of PCR testing for lower respiratory tract pathogens enables faster and more targeted microbial treatment for patients with suspected community acquired pneumonia, suggesting that this tool could replace selected standard, time-consuming, laboratory-based diagnostics.
BEATLE RCT: Extended infusion of anti-pseudomonal β-lactams did not achieve a higher treatment success at day 5 than II in haematological patients with febrile neutoprnia.
SURE 3 RCT: Sulopenem IV followed by oral sulopenem etzadroxil/probenecid was not non-inferior to ertapenem followed by oral step-down in treating cIAI in the micro-MITT population.
S31/A5349 RCT: Flat dosing of pyrazinamide at 1,000 mg per day would be readily implementable and could optimize treatment outcomes in drug-susceptible tuberculosis.
SYSTEMATIC REVIEW & META-ANALYSIS
The meta-analysis suggests that transitioning from intravenous to oral therapy is likely effective in a subgroup of carefully selected patients.
The meta-analysis suggests that early transition to oral antibiotics was non-inferior to continued intravenous antibiotic treatment for bacteraemia and sepsis.
The systematic review concluded that there is paucity of overall evidence, and especially a lack of high-quality data that may support any decision on treatment duration in proven uncomplicated SAB, including the current recommendation of an unconditional two-week treatment schedule.
The systematic review and meta-analysis which identified 8 observational studies found that vancomycin secondary prophylaxis was significantly associated with a reduced odds of recurrent C. difficile infection during antibiotic re-exposure.
The systematic review and meta-analysis found that penicillin monotherapy did not out-perform ceftriaxone or doxycycline. Epidemiologic data have shown a growing spread of azithromycin resistance worldwide.
The systematic review and meta-analysis concluded that short duration of antimicrobial therapy may have similar efficacy to prolonged treatment for Pseudomonas aeruginosa BSI.
The systematic review and meta-analysis concluded that among adults in the intensive care unit who had sepsis or septic shock, the use of prolonged β-lactam antibiotic infusions was associated with a reduced risk of 90-day mortality compared with intermittent infusions.
Findings show that specific bacteriostatic agents, such as linezolid and tigecycline, are clinically non-inferior to bactericidals in multiple infections, including pneumonia, intra-abdominal infections, and skin and soft tissue infections. Studies also support using several bacteriostatic agents as salvage therapies in severe infections, such as neutropenic fever and endocarditis. Not all combinations of bacteriostatic and bactericidal agents appear to be antagonistic, with many combinations, such as linezolid and rifampicin, already being used.
ADDITIONAL NOTABLE ARTICLES
1. IDSA 2024 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections
Last updated 7/12/2024.
Published November 2024.
Published August 2024.
BONUS: NEW ANTIMICROBIAL APPROVALS IN 2024
1. Cefepime-enmetazobactam (Exblifep)
FDA-approved on 22 February 2024 for treatment of adult patients with complicated urinary tract infection including pyelonephritis caused by designated susceptible organisms
FDA approved 24 April 2024 for treatment of female adults with uncomplicated urinary tract infections caused by susceptible isolates of Escherichia coli, Proteus mirabilis and Staphylococcus saprophyticus.
3. Sulopenem etzadroxil and Probenecid (Orlynvah)
FDA-approved 25 October 2024 for treatment of uncomplicated urinary tract infections caused by the designated microorganisms Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis in adult women who have limited or no alternative oral antibacterial treatment options.
4. Ceftobiprole medocaril (Zevtera)
Ceftobiprole was FDA approved on April 3, 2024 (provided by Basilea Pharma) for the treatment of adults with (1) Staphylococcus aureus bloodstream infections (bacteremia), including those with right-sided infective endocarditis, (2) adults with acute bacterial skin and skin structure infections, and (3) adult and pediatric patients three months to less than 18 years old with community-acquired bacterial pneumonia.
Closing Comments
Did not see an article that you think should have been listed? Shoot me a message @IDstewardship! I hope you have found this post helpful!!
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