1- Monday Infectious Disease News – 10th May

1 – Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

• In this study, they aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation.
• In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes.
• These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids.

Source: The Lancet

2 – Exclusion of bacterial co-infection in COVID-19 using baseline inflammatory markers and their response to antibiotics

• COVID-19 is infrequently complicated by bacterial co-infection, but antibiotic prescriptions are common.
• This study used community-acquired pneumonia (CAP) as a benchmark to define the processes that occur in bacterial pulmonary infections, testing the hypothesis that baseline inflammatory markers and their response to antibiotic therapy could distinguish bacterial co-infection from COVID-19.
• This study proposes that in COVID-19, absence of both elevated baseline WCC and antibiotic-related decrease in CRP can exclude bacterial co-infection and facilitate antibiotic stewardship efforts.

Source: Oxford Academy

3 – Seroprevalence of anti-SARS-CoV-2 antibodies after the second pandemic peak

• After the first pandemic wave in Europe, seroprevalence surveys revealed that roughly one in ten individuals had been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
• Since autumn, 2020, Europe has experienced a rapid increase in reported infections, with SARS-CoV-2 incidence in some countries largely surpassing that of the first wave.
• Due to changes in test availability, policy, and care-seeking behaviours, it is unclear how to compare current case reports with the first wave and how these relate to undetected infection rates.

Source: The Lancet

4- Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine, BBV152: a double-blind, randomised, phase 1 trial

• To mitigate the effects of COVID-19, a vaccine is urgently needed.
• BBV152 is a whole-virion inactivated SARS-CoV-2 vaccine formulated with a toll-like receptor 7/8 agonist molecule adsorbed to alum (Algel-IMDG) or alum (Algel).
• BBV152 led to tolerable safety outcomes and enhanced immune responses. Both Algel-IMDG formulations were selected for phase 2 immunogenicity trials.
• Further efficacy trials are warranted.

Source: The Lancet

5 – What are the most effective community-based antimicrobial stewardship interventions in low- and middle-income countries? A narrative review

• Antimicrobial resistance (AMR) is a major global issue and antimicrobial stewardship is central to tackling its emergence.
• The burden of AMR disproportionately impacts low- and middle-income countries (LMICs), where capacity for surveillance and management of resistant pathogens is least developed.
• This study reviewed the evidence available to researchers and policymakers testing or implementing community-based antimicrobial stewardship strategies in LMICs.
• They find that multifaceted, education-focused interventions are likely most effective in our setting. We also confirm that the quality and quantity of community-based stewardship intervention research is limited, with research on microbiological, clinical and economic sustainability most urgently needed.

Source: Oxford Academic

6 – Delayed antibiotic prescribing for respiratory tract infections: individual patient data meta-analysis

• This study aims to assess the overall effect of delayed antibiotic prescribing on average symptom severity for patients with respiratory tract infections in the community, and to identify any factors modifying this effect.
• Delayed antibiotic prescribing is a safe and effective strategy for most patients, including those in higher risk subgroups.
• Delayed prescribing was associated with similar symptom duration as no antibiotic prescribing and is unlikely to lead to poorer symptom control than immediate antibiotic prescribing.
• Delayed prescribing could reduce reconsultation rates and is unlikely to be associated with an increase in symptoms or illness duration, except in young children. 

Source: The BMJ

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