Expert Review of Anti-infective Therapy最新文献

{"title":"Structural determinants of communicable disease risk in asylum reception centres.","authors":"Giancarlo Ceccarelli, Francesco Branda, Cecilia Ceccarelli, Luca Bortolani, Helen Linda Morrone, Marta Giovanetti, Fabio Scarpa, Alessandro Russo, Massimo Ciccozzi, Gabriella d'Ettorre","doi":"10.1080/14787210.2026.2751993","DOIUrl":"https://doi.org/10.1080/14787210.2026.2751993","url":null,"abstract":"<p><strong>Introduction: </strong>With over 120 million people forcibly displaced globally, asylum reception systems represent critical epidemiological interfaces. This synthesis is not confined to a single geographic region: evidence was drawn from reception systems across high-income host countries in Europe and, where available, comparable settings elsewhere, reflecting the substantial heterogeneity of reception models worldwide. Within a One Health framework, these socio-spatial environments shape communicable disease dynamics through accommodation density, sanitation capacity, and governance continuity.</p><p><strong>Areas covered: </strong>Synthesizing evidence from 2015-2026, we examine transmission patterns of respiratory infections, fecal-oral diseases, ectoparasitic and dermatological conditions, tuberculosis, and vaccine-preventable diseases in reception infrastructures. Outbreaks cluster around occupancy density, ventilation constraints, sanitation integrity, mobility, and discontinuity of care. Transmission dynamics are structurally produced by interactions between built environments, organizational processes, and health system integration.</p><p><strong>Expert opinion: </strong>Reception systems are conditionally amplifying environments: outbreak magnitude depends on spatial configuration, occupancy governance, surveillance interoperability, and clinical continuity. Reframing centers as epidemiological infrastructures enables a shift from reactive containment to structural calibration. Modular design, density thresholds, and integrated preventive-clinical pathways enhance epidemiological predictability and reduce transmission risk. Amplification is not intrinsic to populations but to the environments accommodating them, with implications for broader collective housing and public health system design.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the potential of treatment options for chronic hepatitis B.","authors":"Shang-Chin Huang, Jia-Horng Kao","doi":"10.1080/14787210.2026.2749497","DOIUrl":"10.1080/14787210.2026.2749497","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic hepatitis B (CHB) remains a leading cause of cirrhosis and hepatocellular carcinoma worldwide, but long-term or even lifelong viral suppression with nucleos(t)ide analogues (NAs) seldom clears hepatitis B surface antigen (HBsAg), so-called 'functional cure.' In recent years, a shift in treatment strategy from viral suppression toward cure has emerged, catalyzed by three revised international hepatitis B guidelines (2025-2026) and the first-in-class phase 3 evidence that a finite antiviral therapy, the antisense oligonucleotide bepirovirsen, can achieve a functional cure in about one in five NA-suppressed CHB patients with baseline HBsAg below 3000 IU/mL.</p><p><strong>Areas covered: </strong>We evaluated the spectrum of established and emerging treatment options for CHB, organized around quantitative HBsAg (qHBsAg) as the axis for selecting and sequencing therapy. Coverage spans backbone NAs and pegylated interferon-α, an HBsAg-guided roadmap, finite NA therapy and off-treatment outcomes, bepirovirsen, other virus-targeting and immunomodulatory agents, and genome-directed covalently closed circular DNA silencing and editing.</p><p><strong>Expert opinion: </strong>Bepirovirsen's approaching approval is an inflection point. qHBsAg should guide personalized, sequential therapy, with partial cure (HBsAg <100 IU/mL) as a potential intermediate target when functional cure is unlikely. Durability, standardized biomarkers, rational combination design, metabolic co-management and equitable access are the priorities; a sterilizing cure remains distant.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-10"},"PeriodicalIF":4.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic prophylaxis and empirical therapy for intra-abdominal infections: a systematic review and network meta-analysis.","authors":"Pooja Singh, Malvika Sharma, Khyati Gupta, Vikas Dhiman, Ajay Verma, Amarinder Singh Malhi, Sachit Anand","doi":"10.1080/14787210.2026.2746348","DOIUrl":"10.1080/14787210.2026.2746348","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal choice of antibiotic prophylaxis and empirical therapy for suspected acute intra-abdominal infections (IAIs) remains uncertain, especially in light of increasing antimicrobial resistance. This systematic review and network meta-analysis (NMA) compared the efficacy and safety of antibiotic classes for empirical treatment of suspected IAIs and for prophylaxis in at-risk populations.</p><p><strong>Methods: </strong>PubMed, Embase, SCOPUS, Web of Science, and CENTRAL were searched until 24 January 2026 (PROSPERO-CRD420251106514). Eligible studies assessed empiric antibiotic therapy or prophylaxis for IAI. Outcomes included treatment success, intra-abdominal and wound infection rates, morbidity, mortality, and adverse events. Treatment and prophylaxis data were analyzed as separate networks per outcome using frequentist random-effects NMA, with certainty graded via GRADE.</p><p><strong>Results: </strong>19 studies (2,910 patients) on treatment and 9 studies (3,014 patients) on prophylaxis, across eight antibiotic classes, were included. In the treatment setting, carbapenems were associated with significantly higher treatment success than β-lactam/β-lactamase inhibitor [RR(95%CI)=1.06 (1.01-1.62)] and ranked highest by SUCRA for treatment success and adverse events. In the prophylaxis setting, cephalosporin was associated with a lower risk of wound infection than carbapenem [RR(95%CI)=0.79 (0.70-0.88)] and β-lactam/β-lactamase inhibitor [RR(95%CI)=0.38 (0.16-0.91)]. Sensitivity analyses confirmed robustness; certainty ranged from moderate to very low, mainly due to imprecision.</p><p><strong>Conclusion: </strong>Carbapenems provide the highest efficacy for empirical IAI treatment but require judicious use given resistance concerns. This benefit does not extend to prophylaxis, where narrower-spectrum agents such as cephalosporins performed well. Further high-quality trials incorporating newer agents and resistance outcomes are needed.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-15"},"PeriodicalIF":4.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Remdesivir in individuals with confirmed Omicron variant: a meta-analysis of cohort studies.","authors":"Hila Asham, Kosar Kouchari, Hossein Bannazadeh Baghi, Samaneh Dousti, Maryam Mehrpooya, Taher Entezari-Maleki","doi":"10.1080/14787210.2026.2749496","DOIUrl":"https://doi.org/10.1080/14787210.2026.2749496","url":null,"abstract":"<p><strong>Introduction: </strong>The emergence of the Omicron variant (B.1.1.529) of SARS-CoV-2 represents a new challenge due to its high transmissibility and potential resistance to existing treatments. While Remdesivir, an FDA-approved antiviral, has been widely used in managing COVID-19 cases, its efficacy against the Omicron variant remains uncertain and warrants further investigation. This systematic review and meta-analysis evaluates the effectiveness of remdesivir in individuals infected with the Omicron variant.</p><p><strong>Method: </strong>A systematic search of MEDLINE (PubMed), Embase, Cochrane Library, Google Scholar, and ClinicalTrials.gov identified relevant cohort studies. Data extraction and risk of bias assessment followed PRISMA guidelines, with statistical analysis conducted by random-effects model using the RevMan. In addition, subgroup analysis and sensitivity analysis were applied as necessary.</p><p><strong>Results: </strong>Fourteen cohort studies with 964,156 participants were included. Remdesivir significantly reduced all-cause death among hospitalized individuals (OR: 0.70, 95% CI [0.60-0.81]), all-cause hospitalization (OR: 0.27, 95% CI [0.14-0.54]), and COVID-19-related death (OR: 0.13, 95% CI [0.03-0.58]). However, its effect on oxygen supplementation was not significant (OR: 0.52, 95% CI [0.08-3.52]).</p><p><strong>Conclusion: </strong>These findings reinforce the role of Remdesivir in preventing severe COVID-19 outcomes among patients infected with the Omicron variant.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances needed for improving leprosy diagnosis in Brazil.","authors":"Sálvia Cely Cerqueira Carvalho, Leonardo Lopes-Luz, Victor Santana Santos","doi":"10.1080/14787210.2026.2744223","DOIUrl":"10.1080/14787210.2026.2744223","url":null,"abstract":"<p><strong>Introduction: </strong>Leprosy remains a major public health challenge in Brazil, where delayed diagnosis sustains transmission and disability. Despite advances in diagnostic research, slit-skin smear microscopy remains the only laboratory diagnostic criterion recommended by WHO among the cardinal signs, despite its limited effectiveness. This diagnostic gap underscores the need to evaluate emerging and complementary approaches. Early and accurate case detection is central to the Global Leprosy Strategy and Sustainable Development Goals.</p><p><strong>Areas covered: </strong>This narrative review examines Brazil's leprosy diagnostic landscape, highlighting the strengths and limitations of the existing diagnostic pathway, including reliance on clinical expertise, limited access to complementary laboratory methods, and the impact of socioeconomic inequalities on timely case detection. It discusses emerging diagnostic technologies, including point-of-care tests, molecular assays, digital health, artificial intelligence, and precision public health, and their potential to improve early detection, particularly of paucibacillary disease and household contacts. It also emphasizes strengthening Primary Health Care, workforce training, contact surveillance, research, and stigma reduction to advance leprosy control.</p><p><strong>Expert opinion: </strong>Integrating innovative diagnostics with stronger Primary Health Care, workforce training, contact surveillance, research, and stigma reduction is essential. Equitable, evidence-based implementation can accelerate early diagnosis, reduce disability, and interrupt transmission in Brazil.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":4.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the clinical pharmacokinetics of fluconazole in healthy and diseased populations.","authors":"Tahir Saleem, Khadija Ameen, Muhammad Fawad Rasool, Faleh Alqahtani","doi":"10.1080/14787210.2026.2744221","DOIUrl":"https://doi.org/10.1080/14787210.2026.2744221","url":null,"abstract":"<p><strong>Introduction: </strong>Fluconazole is a triazole antifungal agent commonly used to treat both systemic and superficial fungal infections. This comprehensive review aims to collate all published pharmacokinetic (PK) data on fluconazole in healthy and diseased subjects.</p><p><strong>Methods: </strong>A systematic search of Google Scholar, PubMed, and the Cochrane Library identified 40 clinical PK studies of fluconazole that met inclusion criteria.</p><p><strong>Results: </strong>In healthy volunteers, oral fluconazole (100 mg) achieved a maximum plasma concentration (C_max) of 2.184 ± 0.427 µg/mL and peak time (T_max) of 2.6 ± 1.4 h, while IV administration produced a steady-state area under curve from 0 to t (AUC_0-t) of 608 ± 115.4 µg.h/mL. In diseased populations, fluconazole PK varied according to the underlying clinical condition, including renal and hepatic impairment, peritoneal dialysis, and neoplastic disease. Patients with moderate renal impairment following IV administration exhibited a higher C_max (15.7 ± 2 ug/mL) than those with severe renal impairment (12.5 ± 1.24 ug/mL). Following a 150 mg oral dose, AUC_0-t was higher under fasting than fed conditions (123.600 ± 16.760 vs. 113.000 ± 15.339 µg.h/mL).</p><p><strong>Conclusions: </strong>This systematic review compiles fluconazole PK data to support dose optimization in renal impairment and minimize toxicity and drug-drug interactions.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-13"},"PeriodicalIF":4.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Better incorporating real world evidence into anti-infective therapy development.","authors":"Milo Gatti, Federico Pea","doi":"10.1080/14787210.2026.2744572","DOIUrl":"https://doi.org/10.1080/14787210.2026.2744572","url":null,"abstract":"","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-6"},"PeriodicalIF":4.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-medication with antibiotics and knowledge and attitudes toward rational antibiotic use among women of reproductive age.","authors":"Sevgül Dönmez, Yılmaz Güneş, Emine Aslan","doi":"10.1080/14787210.2026.2701360","DOIUrl":"10.1080/14787210.2026.2701360","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess self-medication with antibiotics and evaluate knowledge and attitudes toward rational antibiotic use among women of reproductive age.</p><p><strong>Method: </strong>This descriptive study was conducted among 1002 women who attended a state hospital in the southern region of Türkiye. Data were collected using a Personal Information Form, the Antibiotic Use Scale (AUS) and the Knowledge-Attitude Scale for Rational Antibiotic Use (RAUKAS).</p><p><strong>Results: </strong>The mean AUS score was 40.4 ± 17.9, while the RAUKAS knowledge and attitude scores were 27.7 ± 8.9 and 30.6 ± 12.6, respectively. Overall, 24.5% of women reported self-medication with antibiotics within the last 6 months. The most common indications were cold or influenza (62.4%), toothache or dental swelling (58.0%), sore throat (51.8%), fever (31.4%), cough (25.3%), urinary burning (23.3%), headache (19.2%), abdominal pain (16.7%), fatigue (15.9%), and skin infection (11.8%). In addition, 30.0% kept antibiotics at home, 64.0% had never heard of antibiotic resistance, and attitude toward rational antibiotic use was the strongest predictor of self-medication (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Self-medication with antibiotics is practiced and represents a significant public health concern, with insufficient awareness of rational antibiotic use, highlighting the need for targeted educational interventions and public health strategies.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1001-1008"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of invasive fungal infections in the intensive care unit.","authors":"Dara Chean, Alice Friol, Elie Azoulay, Alexis Maillard","doi":"10.1080/14787210.2026.2710718","DOIUrl":"10.1080/14787210.2026.2710718","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive fungal infections (IFI) are becoming more and more frequent in the intensive care unit (ICU), affecting not only immunocompromised patients. Invasive pulmonary aspergillosis, invasive candidiasis, and mucormycosis are associated with substantial mortality. Management of these patients remains challenging because the histopathological confirmation is often unfeasible. Consequently, clinicians must rely on a probabilistic approach integrating host factors, clinical and radiological features, and mycological evidence.</p><p><strong>Areas covered: </strong>This narrative review summarizes current evidence on the epidemiology, risk factors, definitions, diagnostic strategies, and management of critically ill patients with IFI. We discuss adaptations of diagnostic criteria for critically ill patients, with a special focus on performance and limitations of non-culture-based tools. Diagnostic work-up and therapeutic strategies are discussed with a focus on ICU-specific considerations.</p><p><strong>Expert opinion: </strong>Management of IFI in the ICU requires an individualized approach combining early clinical suspicion based on clinical risk stratification, targeted use of culture and non-culture-based tests, and timely initiation of antifungal therapy. Refining risk stratification, validation of molecular diagnostics in large ICU cohorts, and multidisciplinary collaboration are warranted to improve outcomes in this highly vulnerable population.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"907-925"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical site infections after vascular surgery - current strategies and future directions.","authors":"Julien Hasselmann, Stefan Acosta","doi":"10.1080/14787210.2026.2706709","DOIUrl":"10.1080/14787210.2026.2706709","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical site infections (SSIs) in vascular surgery remain a major source of morbidity, mortality, graft failure, limb loss, and healthcare costs. Although many vascular procedures are classified as clean surgery, the frequent use of prosthetic material, high-risk anatomical sites such as the groin, and comorbid patient populations make infections particularly consequential.</p><p><strong>Areas covered: </strong>This review summarizes the epidemiology, risk factors, microbiology, classification, diagnosis, prevention, and treatment of SSIs in vascular surgery. It discusses procedure-specific infection risks, including those associated with open and endovascular interventions, and examines current preventive strategies such as patient optimization, perioperative antibiotic prophylaxis, skin antisepsis, intraoperative measures, and incisional negative pressure wound therapy. Treatment approaches, including antimicrobial therapy, surgical debridement, graft explantation, reconstruction, and multidisciplinary care, are reviewed. Key challenges include antimicrobial resistance, inconsistent surveillance definitions, underreporting after discharge, diagnostic uncertainty, and limited evidence on cost-effectiveness and endovascular SSI management.</p><p><strong>Expert opinion: </strong>Future progress requires vascular-specific risk stratification, standardized and objective surveillance systems, stronger post-discharge follow-up, and high-quality randomized trials on antibiotic prophylaxis duration and advanced wound therapies. Transparent reporting and interdisciplinary collaboration are essential to reduce SSI-related complications and improve patient outcomes.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"965-979"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}