JAMMI最新文献

{"title":"AMMI Canada seasonal influenza guideline update 2025-26: Some questions answered.","authors":"Robyn Harrison, Emma K Reid, Upton D Allen, Jesse Papenburg, Danuta M Skowronski, Samira Mubareka, Todd Hatchette, Gerald A Evans","doi":"10.3138/jammi-2026-0105","DOIUrl":"10.3138/jammi-2026-0105","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"11 1","pages":"1-17"},"PeriodicalIF":1.1,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-label use of dalbavancin to improve treatment outcomes and reduce health care costs in people who use drugs: A Canadian single-centre quality improvement initiative.","authors":"Adrianna N Gunton, Mara Pavan, Victor Leung, Melanie Cm Murray, William J Connors","doi":"10.3138/jammi-2024-0036","DOIUrl":"10.3138/jammi-2024-0036","url":null,"abstract":"<p><strong>Background: </strong>Dalbavancin is approved in Canada for the treatment of acute bacterial skin and skin structure infections (ABSSSIs). We present a single-centre quality improvement case series of dalbavancin use in serious bacterial infections in people who use drugs (PWUD). Our goal was to facilitate access to dalbavancin to improve treatment outcomes and identify potential health system savings.</p><p><strong>Methods: </strong>We established an unrestricted, hospital-specific, rapid-access compassionate provision program for dalbavancin. Patients were considered for treatment with dalbavancin at the discretion of an infectious diseases physician if they had serious gram-positive infections. Patients provided informed verbal consent. Data were collected via retrospective chart review. We compared costs savings using a practitioner modifiable cost calculator developed by Paladin Labs Inc.</p><p><strong>Results: </strong>Between September 2022 and November 2023, seven patients received dalbavancin. The most common indications for use included early discharge from hospital and improved treatment adherence. Three patients were considered to have infection cure at last follow-up, three patients were presumed to have infection cure but were lost to follow-up, and one patient had infection relapse. Two patients died from causes unrelated to the dalbavancin-treated condition. There were no reported adverse events. Dalbavancin resulted in cost savings compared with standard-of-care (SoC) treatment, and this was primarily driven by reduced inpatient hospital days.</p><p><strong>Conclusions: </strong>Dalbavancin may improve treatment adherence and outcomes for PWUD with serious gram-positive infections while saving health care costs by facilitating earlier discharge from hospital. Our preliminary experience highlights the need for additional controlled studies to evaluate expanded indications for dalbavancin as well as innovative approaches to increase access to novel antimicrobial agents in a single-payer health care system such as Canada.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"11 1","pages":"18-27"},"PeriodicalIF":1.1,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penicillin allergies and community antibiotic prescriptions: A secondary analysis of prescribing choices in six family medicine clinics in southern Ontario, 2018-2019.","authors":"Sahana Kukan, Warren McIsaac","doi":"10.3138/jammi-2025-0007","DOIUrl":"10.3138/jammi-2025-0007","url":null,"abstract":"<p><strong>Background: </strong>While 10% of the population has a reported penicillin allergy, 90% of these allergy labels may not be accurate. However, the impact of penicillin allergy de-labelling on antibiotic use in primary care is not clear. We aimed to determine the effect of penicillin allergy labels on antibiotic use in the community for common infections.</p><p><strong>Methods: </strong>A secondary analysis of cross-sectional data from a previous stewardship intervention study in six family medicine clinics in southern Ontario was conducted. Antibiotic prescriptions to 914 adult patients presenting with common respiratory and urinary tract infections from 2018 to 2019, with and without a penicillin allergy in their electronic medical record, were examined. The primary outcome was what antibiotics were prescribed to patients with and without a penicillin allergy.</p><p><strong>Results: </strong>Of 914 patients included, 84 (9.2%) had a penicillin allergy listed in their medical record. Penicillin allergy labels affected prescribing for acute respiratory infections, with patients more commonly prescribed macrolides (<i>p</i> < 0.0001), tetracyclines (<i>p</i> < 0.0001), and fluoroquinolones (<i>p</i> = 0.01) compared with patients without a penicillin allergy label. If all penicillin allergy patients underwent testing and were successfully de-labelled, we estimated that 40.3/914 (4.4%) of antibiotic prescriptions to adults in this study would change.</p><p><strong>Conclusions: </strong>Antibiotic prescribing choices were affected by penicillin allergy labels, with more frequent prescribing of broad-spectrum antibiotics, particularly in acute respiratory infections. However, the proportion of all antibiotic prescriptions that would be changed by penicillin de-labelling was small. Other antimicrobial stewardship approaches in addition to penicillin allergy de-labelling may be needed to reduce antibiotic overuse in primary care.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"11 1","pages":"28-36"},"PeriodicalIF":1.1,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of COVID-19 universal screening in obstetrical units in Quebec, Canada.","authors":"Elisabeth McClymont, France Leduc, Isabelle Vachon, Marie-Claude Tanguay, Laurent H Tordjman, Bi Lan Wo, Anne-Julie Dubé, Suzanne Taillefer, Isabelle Boucoiran","doi":"10.3138/jammi-2025-0012","DOIUrl":"10.3138/jammi-2025-0012","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, some jurisdictions used universal screening for SARS-CoV-2 infection at obstetrical units. This study evaluated the utility of this screening strategy.</p><p><strong>Methods: </strong>We assessed the asymptomatic infection rate and test positivity rate at six obstetrical units in Quebec, Canada.</p><p><strong>Results: </strong>32,663 parturients were admitted to the six obstetrical units, of which 77.5% were tested for SARS-CoV-2 on admission. Among all six sites, 388 parturients (1.2% [95% CI 1.07% to 1.31%]) tested positive for SARS-CoV-2. Of these, 74.2% were asymptomatic. Rates of positive asymptomatic admissions were similar across sites, ranging from 0.5% to 1.3%. Test positivity rates among parturients varied across the pandemic, ranging from 0.0% to 9.0%. Three nosocomial SARS-CoV-2 infections occurred, with two occurring at the same site.</p><p><strong>Conclusions: </strong>Non-universal strategies such as symptom-based screening and personal protective equipment may be more practical and cost effective for future respiratory pandemics.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"11 1","pages":"82-85"},"PeriodicalIF":1.1,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrow spectrum, broad utility: Reassessing cephalexin and cefazolin beyond cellulitis.","authors":"Carsten Krueger, Waleed Alqurashi, Eric Eckbo, Jennifer Grant, Nicole Le Saux","doi":"10.3138/jammi-2025-0929","DOIUrl":"10.3138/jammi-2025-0929","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 4","pages":"276-280"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can emulated trials in antimicrobial therapy replace randomized trials?","authors":"Thomas C Scheier, Dominik Mertz, John W Eikelboom","doi":"10.3138/jammi-2025-1015","DOIUrl":"10.3138/jammi-2025-1015","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 4","pages":"269-270"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a paper-based checklist for promoting increased access to long-acting injectable cabotegravir/rilpivirine among people living with HIV in Toronto: Lessons learned from a quality improvement initiative.","authors":"Myo Min Oo, Archchana Arulananthan, Ashan Wijesinghe, Monica Sanh, Darrell Hs Tan","doi":"10.3138/jammi-2025-0017","DOIUrl":"10.3138/jammi-2025-0017","url":null,"abstract":"<p><p>Long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) offers a promising alternative to daily oral antiretroviral therapy for individuals with HIV, potentially addressing adherence challenges and pill fatigue. However, its implementation may inadvertently widen health disparities. We conducted a qualitative improvement project at a large hospital-based HIV clinic in Toronto to promote equitable access to CAB/RPV LAI. A one-page paper-based checklist was developed and piloted from September 2023 to June 2024 to streamline eligibility screening and guide discussions. Of 232 patients screened, 152 records included the checklist. Among those, 10% were ineligible, 33% eligible, and 5% had uncertain eligibility, with 52% lacking eligibility information. CAB/RPV was discussed in 48% of eligible cases, leading to a 6% initiation rate among those discussions (4/66), plus two additional initiations. This compares to a 2.5% initiation rate among other clinic patients without the intervention. Interviews with clinicians and pharmacists revealed the checklist integrated well, aiding systematic assessment and patient discussions, despite time constraints limiting full documentation. Clinicians cited patient preference for oral pills, needle aversion, and logistical concerns as reasons for declining LAI. Our findings suggest that a structured paper-based tool, while imperfect, can facilitate discussions and improve uptake of LAI HIV treatment, highlighting the potential for electronic medical records to further optimize this process and ensure equitable access.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 4","pages":"310-314"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canada's \"American-style\" dental health system.","authors":"Kevin B Laupland, Daniel Dagasso, Yoav Keynan","doi":"10.3138/jammi-2025-1017","DOIUrl":"10.3138/jammi-2025-1017","url":null,"abstract":"","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 4","pages":"271-275"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Salmonella Typhi</i> mimicking Pott's disease: A case report and review of the literature.","authors":"Nikesh Pandey, Philip W Lam","doi":"10.3138/jammi-2025-0026","DOIUrl":"10.3138/jammi-2025-0026","url":null,"abstract":"<p><strong>Background: </strong>Infectious spondylodiscitis, an infection that involves the intervertebral disc and adjacent vertebral body, often manifests as back pain, fever, and malaise. Although <i>Staphylococcus aureus</i> is the most commonly reported cause of infectious spondylodiscitis, other atypical organisms can also cause spinal infections. <i>Salmonella enterica</i> serovar <i>Typhi</i> has been rarely reported to cause spondylodiscitis.</p><p><strong>Method: </strong>Retrospective single-record review with informed written consent from the patient.</p><p><strong>Results: </strong>We present the case of an immunocompetent 67-year-old female patient with subacute intermittent back pain, weight loss, and a history of prolonged travel to India. MRI showed destructive T7-T8 spondylodiscitis with vertebral collapse, kyphotic deformity, and severe canal stenosis. Given the patient's presentation, epidemiology, and radiologic features, spinal tuberculosis was initially suspected. A biopsy of the spinal tissue grew <i>S. Typhi</i> by the third day of incubation. The patient was treated with a 6-week course of intravenous ceftriaxone. The patient's symptoms resolved over the course of treatment, and she remained clinically well with no signs of recurrent infection at 12-month follow-up.</p><p><strong>Conclusion: </strong>This case highlights <i>S. Typhi</i> as a rare cause of spondylodiscitis in immunocompetent individuals that can mimic Pott's disease clinically and radiographically. This case exemplifies the importance of maintaining a broad differential when evaluating spondylodiscitis, especially in patients who travel to regions that are endemic for atypical pathogens.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 4","pages":"319-324"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rhinoscleroma and chronic rhinosinusitis- an insidious presentation.","authors":"Babak Pourmomenarabi, Leigh J Sowerby, Keith Kwan, Lise Bondy","doi":"10.3138/jammi-2025-0006","DOIUrl":"10.3138/jammi-2025-0006","url":null,"abstract":"<p><strong>Background: </strong>Rhinoscleroma is a chronic granulomatous infectious disease of the respiratory mucosa, endemic in some countries of Central America, Southeast Asia, and parts of Africa, but rare in North America.</p><p><strong>Methods: </strong>We report the case of a 35-year-old man who immigrated to Canada from El Salvador at 10 years of age who was diagnosed with rhinoscleroma 25 years after his immigration.</p><p><strong>Results: </strong>He presented with chronic rhinosinusitis (CRS), rhinorrhea, and nasal congestion for 14 years that did not respond to standard CRS treatment. His symptoms resolved with the administration of appropriate antibiotic therapy following the diagnosis of rhinoscleroma based on histopathological examination and nasal culture.</p><p><strong>Conclusion: </strong>This case report highlights the importance of recognizing non-endemic diseases in the era of mass global migration. Clinicians should consider epidemiology and non-endemic infections when evaluating patients with CRS and refer those who are refractory to standard therapy to an otolaryngologist for further assessment.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"10 4","pages":"315-318"},"PeriodicalIF":1.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}