ASSOCIATION BETWEEN REMOVAL OF A WARNING AGAINST CEPHALOSPORIN USE IN PATIENTS WITH PENICILLIN ALLERGY AND ANTIBIOTIC PRESCRIBING
Electronic health records often include default alerts that can influence physician selection of antibiotics, which in turn may be associated with a suboptimal choice of agents and increased antibiotic resistance. In this retrospective cohort study of 4 398 792 patients, removal of a warning in the electronic health record to avoid cephalosporin use in patients with penicillin allergies was associated with increased dispensing and administration of cephalosporin. No significant differences in anaphylaxis, new allergies, or treatment failures were found. This simple and rapidly implementable system-level intervention may be useful for improvement in antibiotic stewardship. Full Access: JAMA
TRIPLE VS DUAL INHALER THERAPY AND ASTHMA OUTCOMES IN MODERATE TO SEVERE ASTHMA. A SYSTEMATIC REVIEW AND META-ANALYSIS
In this systematic review and meta-analysis published on May 19th, 2021, included 20 randomized clinical trials and 11 894 patients (children aged 6 to 18 and adults with moderate to severe asthma), triple therapy (ICS, LABA, and LAMA), compared with dual therapy (ICS plus LABA), was significantly associated with fewer severe asthma exacerbations and modest improvements in asthma control, but no significant difference in quality of life, most adverse events, or mortality.
Full Access: JAMA
INCIDENCE OF CUTANEOUS REACTIONS AFTER MESSENGER RNA COVID-19 VACCINES
In this prospectively study, researchers calculated the number and frequency of self-reported cutaneous reactions using symptom survey respondents by dose as the denominator. Of 49 197 employees who received the first dose of a COVID-19 vaccine, cutaneous reactions were reported by 776 respondents after dose. Rash and itching (other than at the injection site) was the most common cutaneous reaction. Cutaneous reactions were more common in women than men. Of those with self-reported cutaneous reaction to the first dose, 741 (95%) received their second dose. Among the 609 who completed a symptom survey after the second dose, 508 (83%) reported no recurrent cutaneous reactions.
Full Access: JAMA
UPDATES TO THE PEDIATRICS ASTHMA MANAGEMENT GUIDELINES.
The 2020 Focused Updates to the Asthma Management Guidelines are the first revisions since the previous guidelines were released in 2007. The panel relied on systematic reviews conducted by the Agency for Healthcare Research and Quality to address six priority topics: use of fractional exhaled nitric oxide (FeNO), mitigation of indoor allergens, intermittent medication dosing in recurrent wheezing, long-acting muscarinic-antagonists (LAMA) as step-up therapy,
immunotherapy and bronchial thermoplasty. Some of the recommendations include: for children 4 years and older with moderate to severe persistent asthma, the panel now recommends single maintenance and reliever therapy (SMART) using ICS-formoterol for both daily and rescue use instead of either daily dose ICS with reliever SABA or daily ICS-long-acting beta2-agonist (LABA) with reliever SABA. The recommended LABA for is formoterol because of its rapid onset of action and more frequently allowable dosing.
Full Access: AAP
MODERNA BEGINS FIRST STUDY OF MRNA VACCINE FOR FLU
Moderna announced the start of a phase 1/2 study that will evaluate an investigational messenger RNA vaccine for influenza. First participants have been dosed with mRNA-1010, a quadrivalent seasonal influenza vaccine candidate that targets two influenza A (H1N1 and H3N2) and two influenza B (Yamagata and Victoria) viruses. The trial will enroll approximately 180 adults aged 18 years or older. Additionally, Moderna announced earlier this year that it was expanding its mRNA program to also develop vaccines against HIV and Nipah virus.
Full Access: Healio