Read & Download your Issue of Thursday – January 14 FNN News

Using antibiotics wisely for respiratory tract infection in the era of covid-19

• Most acute respiratory tract infections (RTIs) are viral and can be managed through virtual care
• For patients with RTI symptoms who test negative for covid-19, a diagnosis of viral RTI remains most likely, and supportive management can continue to be offered virtually in most cases
• Virtual assessments limit diagnostic capabilities and can lead to overprescribing of unnecessary antibiotics. For those RTIs that may be bacterial, arrange an in-person assessment where possible to confirm the diagnosis

Source: BMJ

Update to living systematic review on drug treatments for covid-19

• The latest version of this living systematic review includes results for new interventions azithromycin, colchicine, interferon beta, interferon gamma, interferon kappa plus trefoil factor 2, rhG-CSF, tocilizumab (but certainty is low or very low).
• Evidence that remdesivir may not reduce mortality (low certainty) or time to symptom resolution (moderate certainty); evidence that glucocorticoids probably reduce length of ICU stay (low certainty) and increase ventilator-free days (moderate certainty).

Source: BMJ

Dose Optimization of Hydroxychloroquine for Coronavirus Infection 2019: Do Blood Concentrations Matter?

• Clinical trials of hydroxychloroquine (HCQ) for the treatment of coronavirus infection 2019 (COVID-19) are moving forward on the heels of conflicting, and sometimes controversial.
• Applying pharmacokinetic methods to optimize drug dosing is the preferred approach for most drugs.
• The alternative approach, predating the advent of clinical pharmacokinetics is allometric and empirical.
• In this article they present results of pharmacokinetic studies of HCQ with the intent of informing optimal dosing strategies for COVID-19.

Source: Oxford Academic

Intermittent Fasting Improves Cardiometabolic Risk Factors and Alters Gut Microbiota in Metabolic Syndrome Patients

• Intermittent fasting (IF) is an effective strategy to improve cardiometabolic health.
• The objective of this work is to examine the effects of IF on cardiometabolic risk factors and the gut microbiota in patients with metabolic syndrome (MS).
• IF induces a significant alteration of the gut microbial community and functional pathways in a manner closely associated with the mitigation of cardiometabolic risk factors.
• The study provides potential mechanistic insights into the prevention of adverse outcomes associated with MS.

Source: Oxford Academic

Combination of empagliflozin and linagliptin improves blood pressure and vascular function in type 2 diabetes

• Preserved vascular function represents a key prognostic factor in type 2 diabetes mellitus (T2DM), but data on vascular parameters in this patient cohort are scarce. Patients with T2DM often need more than one drug to achieve optimal glucose control.
• The aim of this study was to analyse the efficacy of two combination therapies on vascular function in subjects with T2DM.
• Beyond the effects on glycaemic control, the combination therapy of empagliflozin and linagliptin significantly improved central BP and vascular function.

Source: Oxford Academic

Smoking and antiplatelet therapy after acute coronary syndromes

• Dual antiplatelet therapy (DAPT) with aspirin plus P2Y12 inhibitors such as ticagrelor or prasugrel for 1 year remains the standard of care for most patients with acute coronary syndromes (ACS).
• Improved clinical outcomes with this strategy, in particular myocardial infarction, comes with increased risk of minor and major bleeding which can be associated with adverse clinical outcomes.

Source: Oxford Academic

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Read & Download FNN Issue 8 of April 2020 FNN News