4- Thursday Pharmacotherapy News – 6th May

1 – Covid-19: What do we know about airborne transmission of SARS-CoV-2?

• How covid-19 spreads is one of the most debated questions of the pandemic.
• Scientists distinguish between respiratory infectious diseases classed as “airborne”—which spread by aerosols suspended in the air—and infections that spread through other routes, including larger “droplets.”
• Some scientists have doubted the aerosol route because covid-19 does not appear as transmissible
• Sneezing and coughing generally produce larger particles of fluid. But evidence shows large quantities of SARS-CoV-2 are also expelled in small aerosols emitted when someone is speaking at a normal volume, or merely breathing.
• Several case studies suggest airborne transmission has spread SARS-CoV-2 to distances beyond two metres from the infectious person.

Source: The BMJ

2 – Simulated Identification of Silent COVID-19 Infections Among Children and Estimated Future Infection Rates With Vaccination

• A significant proportion of COVID-19 transmission occurs silently during the presymptomatic and asymptomatic stages of infection. Children, although important drivers of silent transmission, are not included in the current COVID-19 vaccination campaigns.
• This study aims to estimate the benefits of identifying silent infections among children as a proxy for their vaccination.
• In the absence of vaccine availability for children, a targeted approach to rapidly identify silent COVID-19 infections in this age group was estimated to significantly mitigate disease burden.

Source: JAMA Network

3 – Azithromycin has no benefit for patients with severe COVID-19, RECOVERY trial data suggest

• The antibiotic azithromycin has no meaningful clinical benefit for patients who are hospitalised with severe COVID-19, a preliminary analysis of data from the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial has found.
• Azithromycin is known for its anti-inflammatory properties and because inflammation, caused by an overly active immune response, is a feature of severe COVID-19, the antibiotic was considered as a potential treatment for COVID-19.
• However, preliminary analysis of the data revealed no significant difference in 28-day mortality rates between the azithromycin arm (19%) and the usual care arm (19%).

Source: Pharmaceutical Journal

4- How to address vaccine hesitancy

• Despite the proven efficacy of vaccines, vaccine hesitancy is a growing problem.
• This article aims to provide an overview of vaccine hesitancy and its determinants to help pharmacists and pharmacy teams understand why some individuals are vaccine-hesitant — particularly in the context of COVID-19 vaccines — and how addressing the concerns of patients will increase confidence in, and uptake of, vaccines.

Source: Pharmaceutical Journal

5 – Uncontrolled asthma: assessment and management

• Asthma is a common chronic condition that affects around 5.4 million people in the UK, including 1.1 million children, and 1 in 5 of these people will suffer from severe asthma
• Two guidelines are used in the UK: the British Thoracic Society and Scottish Intercollegiate Guidelines Network (BTS/SIGN) and National Institute for Health and Care Excellence (NICE) guidelines.
• This article will mainly consider the BTS/SIGN guideline, as it is the more established UK guideline, and will outline how pharmacists can review and manage these patients and adjust their regimen to control their symptoms.

Source: Pharmaceutical Journal

6 – Do long-term antibiotics for acne fuel antimicrobial resistance?

• Intra‐abdominal infections (IAIs) are a common reason for intensive care unit (ICU) admissions, and methicillin‐resistant Staphylococcus aureus (MRSA) is an uncommon pathogen in IAIs.
• Although more data are available in the setting of non‐abdominal sources, there are limited data on the performance of nasal MRSA screening for MRSA IAIs.
• The primary objective of this study was to evaluate the performance of nasal MRSA screening for MRSA IAIs in critically ill adult patients.
• Among critically ill adult patients with IAIs, a negative nasal MRSA screen within 30 days may help to empirically exclude MRSA as a causative pathogen.

Source: Pharmaceutical Journal

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