Open Forum Infectious Diseases最新文献

{"title":"Developing a Simple Scoring System on CT Findings for Predicting Treatment Failure in <i>Mycobacterium avium</i> Complex Pulmonary Disease: The BCD (Bronchiectasis and Cavity Distribution) Score.","authors":"Makoto Hayashi, Hiroyasu Takishima, Hidekazu Cho, Fumihiro Yamaguchi, Takuya Yokoe, Satoshi Matsukura","doi":"10.1093/ofid/ofaf565","DOIUrl":"10.1093/ofid/ofaf565","url":null,"abstract":"<p><strong>Background: </strong>Optimal timing for treatment initiation in <i>Mycobacterium avium</i> complex pulmonary disease (MAC-PD) remains unclear due to lack of established rules for predicting treatment response.</p><p><strong>Methods: </strong>A retrospective observational study was conducted to develop a prediction model for treatment failure at 2 Japanese university hospitals between 2012 and 2023. Participants were 135 patients with MAC-PD who received macrolides and ethambutol-containing regimens over 1 year. Treatment failure was defined as nonachievement culture conversion at 1 year. We selected model components as cavity (categorized by diameter) and bronchiectasis (categorized by modified Reiff score) on pretreatment computed tomography. Their combinations of each category were scored based on number of lobes involved and compared by average areas under the curve calculated using k-fold cross-validation.</p><p><strong>Results: </strong>Forty-three (31.9%) of the 135 patients failed in treatment. Number of lobes with cavities > 2cm or bronchiectasis with varicose or cystic changes was designated as the prediction model, with an average area under the curve of 0.798, and was named the Bronchiectasis and Cavity Distribution score. The representative metrics were sensitivity of 0.907 at the cutoff of 2 and specificity of 0.913 at the cutoff of 4 points. The patients were stratified into low-risk (0-1 points), intermediate-risk (2-3 points), and high-risk (4-6 points) groups. The treatment failure rates were 8.0%, 35.6%, and 69.2% in the respective groups.</p><p><strong>Conclusions: </strong>With simple assessment of computed tomography findings, the Bronchiectasis and Cavity Distribution score predicted treatment failure. Although validation studies are warranted, this score may provide guidance for treatment of MAC-PD.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf565"},"PeriodicalIF":3.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Elimination of Culturable SARS-CoV-2 With Intramuscular or Intravenous Administration of Antiviral Monoclonal Antibody Therapy.","authors":"Rinki Deo, Manish C Choudhary, Owen T Glover, Rachel Bender Ignacio, Julie Boucau, Kara W Chew, Carlee Moser, Judith S Currier, Joseph J Eron, Arzhang Cyrus Javan, Mark J Giganti, Evgenia Aga, Michael Gibbs, Taylor Cohen, Katie Streicher, Karina Soboleva, Courtney V Fletcher, Eric S Daar, Alexander L Greninger, Robert W Coombs, William Fischer, Michael D Hughes, Davey Smith, David Alain Wohl, Amy K Barczak, Jonathan Z Li","doi":"10.1093/ofid/ofaf542","DOIUrl":"10.1093/ofid/ofaf542","url":null,"abstract":"<p><p>We evaluated intramuscular (IM) versus intravenous (IV) administration of tixagevimab/cilgavimab in early COVID-19. Both routes achieved rapid elimination of culturable virus and minimal emergence of resistance. These results support IM delivery as a viable alternative to IV, with important implications for scalable deployment in future viral pandemics.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf542"},"PeriodicalIF":3.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Take 5 Campaign: Effects of an Intervention to Promote Five-Day Durations of Antibiotic Therapy for Common Infections in Urgent Care.","authors":"Timothy C Jenkins, Axel A Vazquez Deida, Lindsey E Fish, Michael J Breyer, Amy Quinones, Melody Zwakenberg, Cory K Hussain, Allison L Sabel, Katherine C Shihadeh","doi":"10.1093/ofid/ofaf564","DOIUrl":"10.1093/ofid/ofaf564","url":null,"abstract":"<p><strong>Background: </strong>We implemented an intervention to promote 5-day durations of antibiotic therapy for common infections in urgent care. The objectives of this study were to evaluate the effects of this intervention on prescribed durations and clinical outcomes.</p><p><strong>Methods: </strong>This was a quasi-experimental study involving 2 urgent care centers in an integrated health care system. The Take 5 campaign was a multifaceted intervention to promote adherence to institutional guidance for 5-day durations of therapy for skin infections, urinary tract infections, sinusitis, otitis media, pneumonia, and chronic obstructive pulmonary disease exacerbations. Patients ≥18 years of age with an urgent care visit between January 2017 and December 2023 for 1 of the target infections were included. The primary outcome was the proportion of antibiotic prescriptions for ≤5 days before and after the intervention, as assessed by interrupted time-series analysis (ITS).</p><p><strong>Results: </strong>Before the intervention, there was a significant increasing trend in the proportion of prescriptions for ≤5 days. The intervention was associated with an immediate 10.7% increase in the proportion of prescriptions for ≤5 days (<i>P</i> < .001), with a subsequent sustained upward trend of 0.18% per month (<i>P</i> < .001). The aggregate proportion of prescriptions for ≤5 days increased from 57.5% before the intervention to 82.9% after implementation (<i>P</i> < .001). Rates of new antibiotic prescriptions and hospitalizations within 14 days were similar between the periods.</p><p><strong>Conclusions: </strong>The Take 5 campaign was associated with increased adoption of 5-day antibiotic durations. Shortening durations of therapy appears to be an effective strategy to reduce unnecessary antibiotic exposure in the urgent care setting.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf564"},"PeriodicalIF":3.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to Minimize Time From HIV Acquisition to ART Initiation: The Barcelona Early-cART Program.","authors":"Lucia Bailón, Yovaninna Alarcón-Soto, Angel Rivero, Pep Coll, Jorge Saz, Michael Meulbroek, Irene Gonzalez-Navarro, Maria Salgado, Victor Urrea, Patricia Cobarsi, Eugenia Negredo, Roger Paredes, Javier Martinez-Picado, Christian Brander, José Moltó, Beatriz Mothe","doi":"10.1093/ofid/ofaf545","DOIUrl":"10.1093/ofid/ofaf545","url":null,"abstract":"<p><strong>Background: </strong>Targeted referral systems for individuals at highest risk of HIV transmission can accelerate linkage to care and antiretroviral treatment (ART) initiation, potentially reducing onward transmission.</p><p><strong>Methods: </strong>In 2014, we established the Early-cART cohort of adults newly diagnosed with HIV who started ART within 6 months of estimated HIV acquisition (etPWH), in collaboration with community centers and via a fast-referral system to our HIV unit. Clinical data and biological samples were collected before and after initiation of ART. Total HIV-1 DNA in peripheral blood mononuclear cells was measured in a subset of participants virologically suppressed for >3 years. Link-to-care was defined as days from first positive HIV test to first appointment at the HIV unit. HIV-to-ART was defined as days from estimated acquisition to ART start.</p><p><strong>Results: </strong>From 2014 to 2022, 340 etPWH (90% men having sex with men, mean age 34 years) were included from ∼900 new referrals. Two years after ART initiation, 48% of etPWH achieved a CD4/CD8 ratio of >1, whereas only 5% remained <0.5. In the reservoir subset, levels of HIV-1 DNA correlated with time from HIV to ART only when ART was initiated within 60 days after HIV acquisition, with 55% of participants showing <50 HIV-1 DNA copies/10⁶ peripheral blood mononuclear cells. Median link-to-care time decreased from 11 to 3 days (<i>P</i> = .0011), and HIV-to-ART time from 73 to 27 days (<i>P</i> = .0014) over the study period.</p><p><strong>Conclusions: </strong>The Early-cART program achieved rapid linkage to care and ART initiation with robust immunovirological responses, indicating its potential to reduce HIV transmission.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf545"},"PeriodicalIF":3.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Family at War-Against <i>Tropheryma whipplei</i>: A Case Series.","authors":"Daina Lasaitiene, Marie Kebke, Anna Grankvist, Ahmed Abdi, Niels Wagner, Karin Bergman, Thomas Beck-Friis, Anders Lundqvist","doi":"10.1093/ofid/ofaf535","DOIUrl":"10.1093/ofid/ofaf535","url":null,"abstract":"<p><p>A 29-year-old woman (case 1) with a 2-year history of arthralgia, pericarditis, fever, weight loss, and elevated inflammatory parameters was admitted to Södra Älvsborg Hospital in Borås, Sweden, in January 2023. Severe thrombocytopenia and anemia were remarkable findings at admission. Transthoracic echocardiography showed vegetations on the aortic valve indicating endocarditis. Initial blood cultures were negative. Diagnostics were expanded with polymerase chain reaction (PCR) testing in blood for <i>Tropheryma whipplei</i> and other unusual pathogens. The PCR in blood was positive for <i>T. whipplei</i>, warranting further investigation. Both positive periodic acid-Schiff (PAS) staining and positive PCR of duodenal biopsy confirmed a diagnosis of Whipple's disease (WD). In addition to WD-associated endocarditis/pericarditis, the patient was diagnosed with bilateral multifocal chorioretinitis, which is a possible manifestation of the disease. WD became suspected even in close relatives, the patient's father and her homozygotic twin, who both had similar manifestations such as pericarditis, arthritis/arthralgia, and gastrointestinal symptoms. Another relative, a sister to the father, presented with gastrointestinal symptoms and arthralgia. \"Definitive\" WD was confirmed in case 2 and case 3 and \"possible\" WD in case 4.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf535"},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Bacterial Vaginosis Pathogenesis Using Peptide Nucleic Acid-Fluorescence <i>In Situ</i> Hybridization With a Focus on the Roles of <i>Gardnerella</i> Species, <i>Prevotella bivia</i>, and <i>Fannyhessea vaginae</i>.","authors":"Sheridan D George, Megan H Amerson-Brown, Lúcia G V Sousa, Tyler M Carter, Alexa H Rinehart, Ashleigh N Riegler, Sixto M Leal, Kristal J Aaron, Jiaying Hao, Ashutosh Tamhane, Chaoling Dong, John W Lammons, Jacob H Elnaggar, Keonte J Graves, Paweł Łaniewski, Melissa M Herbst-Kralovetz, Christopher M Taylor, Nuno Cerca, Christina A Muzny","doi":"10.1093/ofid/ofaf556","DOIUrl":"10.1093/ofid/ofaf556","url":null,"abstract":"<p><strong>Background: </strong>Bacterial vaginosis (BV) is a vaginal dysbiosis characterized by polymicrobial communities of BV-associated bacteria (BVAB) adhered to the vaginal epithelium. Despite decades of research, its etiology remains unknown. We aimed to investigate BV biofilm formation over time among women who developed incident BV (iBV) using peptide nucleic acid-fluorescence <i>in situ</i> hybridization (PNA-FISH), focusing on 3 key BVAB (<i>Gardnerella</i> species, <i>Prevotella bivia</i>, and <i>Fannyhessea vaginae</i>).</p><p><strong>Methods: </strong>Heterosexual, nonpregnant women ages 18-45 with optimal vaginal microbiota were enrolled to self-collect twice-daily vaginal specimens for 60 days. iBV was defined as a Nugent score of 7-10 on ≥4 consecutive specimens. For women who developed iBV (cases), <i>Gardnerella</i> spp., <i>P. bivia</i>, and <i>F. vaginae</i> were visualized and quantified by PNA-FISH for up to 14 days prior to iBV, the day of iBV, and 3 days post-iBV. Cases were matched to women maintaining optimal vaginal microbiota (controls) based on age, race, and contraceptive method. Control specimens were matched to case specimens by day of menses.</p><p><strong>Results: </strong>Among 135 women enrolled, 18 developed iBV and were matched to 18 controls. Pooled median <i>Gardnerella</i> spp. counts significantly increased starting 5 days before iBV, while pooled median <i>F. vaginae</i> counts significantly increased on the day of iBV diagnosis. In contrast, pooled median <i>P. bivia</i> counts were not significantly different between groups.</p><p><strong>Conclusions: </strong>These data suggest that <i>Gardnerella</i> spp. are early colonizers of the BV biofilm while <i>F. vaginae</i> is a secondary colonizer. <i>P. bivia</i> was not found to be significantly different between iBV case and control specimens.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf556"},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal Adverse Event After VLA1553 Chikungunya Vaccination in an Elderly Patient: A Case Report From Reunion Island.","authors":"Emilie Mosnier, Marie-Christine Jaffar-Bandjee, Radj Cally, Lotfi Dahmane, Etienne Frumence, Liem Binh Luong Nguyen, Rodolphe Manaquin, Muriel Vincent, Marie Pierre Moiton, Patrick Gérardin, Xavier de Lamballerie, Julien Jabot","doi":"10.1093/ofid/ofaf550","DOIUrl":"10.1093/ofid/ofaf550","url":null,"abstract":"<p><p>We report a fatal case of febrile encephalopathy in an 84-year-old man following administration of the live-attenuated chikungunya vaccine IXCHIQ® (VLA1553, Valneva SE) during the 2025 outbreak in Réunion Island. The patient, previously autonomous with stable comorbidities, developed fever, asthenia, and polyarthralgia 3 days post-vaccination. His condition rapidly deteriorated, with confusion, acute kidney injury, and hemodynamic instability requiring intensive care. Chikungunya virus RNA was detected in both serum and cerebrospinal fluid, with sequencing confirming the presence of the vaccine strain in both compartments. Despite broad-spectrum antimicrobials, antiviral therapy targeting herpesviruses, and hemodialysis, his neurological status worsened and he died 14 days after symptom onset. This case is the first fatal adverse event officially recognized by French health authorities as plausibly related to VLA1553 vaccine. It raises concerns regarding potential neuroinvasive disease following vaccination in elderly individuals and highlights the importance of close clinical and virological evaluation in post-vaccination adverse events during outbreak settings.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf550"},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Contributing to Pneumococcal, COVID-19, and Influenza Vaccine Uptake Among People Living With HIV in Belgium: A Retrospective Study.","authors":"Li-Cécile Destordeur, Victoria Lopez Delhoulle, Iraklis Papadopoulos, Nathalie Maes, Karine Fombellida, Majdouline El Moussaoui, Gilles Darcis","doi":"10.1093/ofid/ofaf513","DOIUrl":"10.1093/ofid/ofaf513","url":null,"abstract":"<p><strong>Background: </strong>Despite antiretroviral therapy, people living with HIV (PLWH) remain vulnerable to vaccine-preventable diseases. Although vaccination is strongly recommended, data on vaccine uptake among PLWH in Belgium remain scarce. This study aims to assess pneumococcal, COVID-19, and influenza vaccine coverage in PLWH in Belgium and identify factors associated with vaccine uptake.</p><p><strong>Methods: </strong>We conducted a retrospective study using the data from the HIV database of the Liege University Hospital in Belgium from 2017 to 2022. We evaluated vaccine coverage and collected demographic, clinical, and biological data to assess factors associated with vaccine uptake. Vaccine adherence was characterized as follows: partial adherence: receipt of at least one of the recommended vaccines during the study period and complete vaccination: pneumococcal vaccination, full COVID-19 primary vaccination, and annual influenza vaccination throughout the study period.</p><p><strong>Results: </strong>Among 791 participants, 89.1% received at least 1 dose of COVID-19 vaccine. Sixty-eight percent received at least 1 dose of influenza vaccine, but only 10.1% were vaccinated annually. Pneumococcal vaccine coverage was only 37.8%. Complete vaccine adherence was correlated with age (adjusted odds ratio [aOR]: 1.02, <i>P</i> = .024). Partial vaccine adherence was associated with age (aOR: 2.66, <i>P</i> = .026) and number of consultations (aOR: 1.23, <i>P</i> = .0002) and negatively associated with intravenous drug use (aOR: 0.15, <i>P</i> = .015).</p><p><strong>Conclusions: </strong>While COVID-19 vaccine uptake was high, vaccination coverage for influenza and pneumococcal disease remains insufficient. Age, healthcare encounters, and drug use were key factors influencing vaccine uptake. Targeted interventions and vaccine reminders should be conducted to increase vaccination rates.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf513"},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Enterosignatures Predict Surgical Site Infections After Abdominal Surgery.","authors":"Simone N Zwicky, Daniel Spari, Daniel Rodjakovic, Hugo Guillen-Ramirez, Bahtiyar Yilmaz, Guido Beldi","doi":"10.1093/ofid/ofaf549","DOIUrl":"10.1093/ofid/ofaf549","url":null,"abstract":"<p><strong>Background: </strong>The relationship between preoperative intestinal microbiota composition and the development of surgical site infections (SSIs) following abdominal surgery is not well understood. The aim of this study was to characterize the preoperative rectal microbiota using the novel concept of enterosignatures (ESs) in patients undergoing abdominal surgery and assess their association with SSIs.</p><p><strong>Methods: </strong>In this prospective cohort study, preoperative rectal microbiota from 133 patients undergoing elective abdominal surgery was profiled using 16S rRNA sequencing. ESs were calculated using high-quality genus-level taxonomy, simplifying complex microbial compositions into 5 generalizable patterns: <i>Bacteroides-, Firmicutes-, Prevotella-, Bifidobacterium-,</i> or <i>Escherichia</i>-dominated profiles.</p><p><strong>Results: </strong>A total of 519 bacterial species were identified within the 133 patients. The <i>Firmicutes</i> ES was found to be a significant risk factor for SSIs, while the <i>Prevotella</i> ES was associated with a reduced risk of SSIs. Combining these into the <i>Firmicutes</i>-to-<i>Prevotella</i> ES ratio (ES-Firm-Prev ratio) yielded a stronger association with SSIs (noSSI: median [interquartile range {IQR}] log ES-Firm-Prev ratio, 0.21 [-0.43 to 1.33]; vs SSI: median [IQR] log ES-Firm-Prev ratio, 8.24 [2.17 to 8.5]; <i>P</i> = .001). Machine learning and logistic regression models confirmed the ES-Firm-Prev ratio to be a significant, independant predictor of SSIs (odds ratio, 1.35; 95% CI, 1.09-1.66; <i>P</i> = .005).</p><p><strong>Conclusions: </strong>The ES-Firm-Prev ratio is a robust, independent predictor of SSIs in patients undergoing abdominal surgery and may serve as a novel biomarker to identify high-risk patients preoperatively.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf549"},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Muddled Middle: A Case-Based Exploration of Oral β-Lactams for Systemic Gram-Negative Infections.","authors":"Jennifer Shif, Hawi Tasissa, Conan MacDougall, Emily L Heil, Jason C Gallagher","doi":"10.1093/ofid/ofaf435","DOIUrl":"10.1093/ofid/ofaf435","url":null,"abstract":"<p><p>Oral β-lactams are frequently referred to as low bioavailability agents that are inferior in the treatment of systemic gram-negative infections. This notion limits their utility beyond their use. The pharmacokinetic/pharmacodynamic profiles of oral β-lactams differ among agents, and each agent must be considered individually in the context of the patient. In this review, we describe 3 scenarios where oral β-lactams may play a role in the treatment of systemic gram-negative infections and the decision process to select or avoid these agents. Each case represents a risk-vs-benefit scenario in which the degree of confidence in using an oral β-lactam varies.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf435"},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}