The Latest in Critical Care, 10/23/23 (Issue #17)

ACORN trial (cefepime vs. pip-tazo), Paxlovid for Omicron, MDROs on the rise

PulmCCM

Oct 23, 2023

∙ Paid

Piperacillin-Tazobactam vs. Cefepime for Kidney Injury and Neurologic Dysfunction (ACORN Trial)

PulmCCM

December 10, 2023

Piperacillin-Tazobactam vs. Cefepime for Kidney Injury and Neurologic Dysfunction (ACORN Trial)

Piperacillin-tazobactam, marketed as Zosyn, has been one of the most-prescribed broad spectrum antibiotics for many years, used for its bactericidal activity against most gram-negative and anaerobic bacteria, including Pseudomonas. Cefepime has similar antibacterial activity, and both are widely used in the ICU as empiric coverage in patients with potentially serious gram-negative infections.

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Does Paxlovid Improve Covid-19 Outcomes in the Omicron Era?

PulmCCM

Feb 25

Does Paxlovid Improve Covid-19 Outcomes in the Omicron Era?

Nirmatrelvir and ritonavir, marketed as Paxlovid by Pfizer, are antiviral drugs that inhibit a protease vital to the viral replication of SARS-CoV-2. Paxlovid was FDA-approved based on the EPIC-HR trial, conducted during the Delta variant’s dominance. Patients taking nirmatrelvir-ritonavir had a significantly lower risk of progression to severe Covid-19 or death (5.8% absolute risk reduction; 89% relative risk reduction). All enrolled patients were unvaccinated and considered high risk for progression to severe disease (with one or more risk factors including overweight, smoking, hypertension, etc).

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Acinetobacter baumannii and Candida auris Are Becoming Common in Mechanically Ventilated Patients

PulmCCM

Apr 30

Acinetobacter baumannii and Candida auris are two emerging multidrug-resistant pathogens that are primarily found in health care settings, particularly in mechanically ventilated patients. Both organisms have limited treatment options and have been identified as urgent health concerns by CDC and the WHO.

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