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Mar '22 Infectious Disease Update

Mar 8th 2022

Sanford Guide ID Update features current developments in infectious diseases, curated by the Sanford Guide Editorial Board. Links marked with an asterisk (*) provide details to Web Edition subscribers, while all other links are universal. To sign up for ID updates to your inbox, register here.

March 2022

SARS-CoV-2 / COVID-19

Sanford Guide SARS-CoV-2 / COVID-19 material is freely available to all for the course of the pandemic.

  • February 11: EUA issued by US FDA for bebtelovimab, a new monoclonal antibody that retains activity against omicron. The EUA is for the treatment of mild to moderate COVID-19 in adults and pediatric patients (≥12 years of age, weight ≥40 kg) with a positive COVID-19 test, and who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options approved or authorized by the FDA are not accessible or clinically appropriate.
  • COVID-19 vaccination in cancer patients: preliminary recommendations from NCCN here.
  • Currently authorized vaccines. See COVID-19 Prevention for table summarizing use and data.
  • ESCMID COVID-19 living guidelines: drug treatment and clinical management (Clin Microbiol Infect 2021 Nov 22 [online ahead of print]). Available at PMC.
  • Guidelines on COVID-19 diagnosis, serology, treatment and management, and infection prevention: IDSA and NIH.
  • Living WHO guideline on drugs for COVID-19 (BMJ 2021;375:n2936).
  • Living WHO guideline on drugs to prevent COVID-19 (BMJ 2021;372:n526). Available here.
  • Living WHO guideline on prophylaxis against COVID-19 (BMJ 2021;373:n949). Available at PMC.
  • Management of hospitalized adults with COVID-19: a European Respiratory Society living guideline (Eur Respir J 2021;57(4):2100048). Available at PMC.

Interim CDC Guidance for a Novel TB Regimen

  • CDC recommends the 4-month RPT-MOX regimen as an option for treating patients aged ≥12 years and body weight ≥40 kg with pulmonary TB caused by organisms that are not known or suspected to be drug-resistant and who have no contraindications to this regimen. The 4-month daily treatment regimen consists of an intensive phase composed of 8 weeks of daily treatment with rifapentine, moxifloxacin, INH, and PZA, followed by a continuation phase of 9 weeks of daily treatment with rifapentine, moxifloxacin, and INH. The drugs are administered once daily with food, 7 days per week, for a total of 119 treatment doses. Similar to the standard 6-month regimen, at least 5 of 7 weekly doses should be administered under DOT. Ref: MMWR Morb Mortal Wkly Rep 2022;71:285. PDF of guidance here.

Updated ACIP Recommendations

New or Updated Practice Guidelines

  • Updated Japanese clinical practice guidelines for the management of children with mother-to-child transmitted HCV infection, from the Japan Society for Pediatric Gastroenterology, Nutrition, and Hepatology (Pediatr Int 2022 Jan;64(1):e14962). Available to read here.
  • Updated clinical practice guidelines for the use of tympanostomy tubes in children, from the American Academy of Otolaryngology–Head and Neck Surgery Foundation (Otolaryngol Head Neck Surg 2022;166(1 suppl):S1-S55). These guidelines update the 2013 release. Available as PDF here.

Drug Shortages (US)

  • Antimicrobial drugs or vaccines in reduced supply or unavailable (as of March 7, 2022) due to increased demand, manufacturing delays, product discontinuation by a specific manufacturer, or unspecified reasons:
    • New on the list since February 8, 2022:
      • None
    • Shortage recently resolved:
      • Ceftolozane-tazobactam injection
    • Antibacterial and antimycobacterial drugs in continued reduced supply:
      • Aminoglycosides:
        • Amikacin injection
        • Gentamicin injection
        • Gentamicin sulfate 3% ophthalmic ointment
        • Neomycin tablets
        • Tobramycin injection
      • Carbapenems:
        • Meropenem injection
      • Cephalosporins:
        • Cefazolin injection
        • Cefepime injection
        • Cefixime capsules
        • Cefotaxime injection (FDA is allowing temporary importation of product from SteriMax in Canada, in conjunction with Provepharm Life Solutions and its distributor Direct Success. Click here for details).
        • Ceftazidime injection
      • Clindamycin injection
      • Doxycycline oral suspension
      • Fluoroquinolones:
        • Ciprofloxacin 0.3% ophthalmic solution
        • Gemifloxacin tablets
      • Glycopeptides, glycolipopeptides, lipopeptides:
        • Vancomycin injection
      • Macrolides/azalides:
        • Azithromycin ophthalmic solution 1% (unavailable)
      • Methanamine hippurate tablets
      • Metronidazole injection
      • Nitrofurantoin oral suspension
      • Penicillins:
        • Ampicillin-sulbactam injection
        • Dicloxacillin capsules
        • Piperacillin-tazobactam injection
      • Topical (miscellaneous) antibacterials:
        • Bacitracin ophthalmic ointment
        • Neomycin and Polymyxin B sulfates GU irrigant
        • Neomycin and Polymyxin B sulfates and Dexamethasone ophthalmic ointment
        • Sulfacetamide 10%/Prednisolone 0.2% ophthalmic ointment (unavailable)
        • Sulfanilamide 15% vaginal cream (unavailable)
    • Antifungal drugs in continued reduced supply:
      • Amphotericin B injection
      • Clotrimazole 10 mg oral troches
      • Posaconazole injection
    • Antimycobacterial drugs in continued reduced supply:
      • Ethambutol tablets
      • Rifampin injection
      • Rifapentine tablets
    • Antiviral drugs in continued reduced supply:
      • Acyclovir injection
      • Tocilizumab injection
    • Vaccines in continued reduced supply:
      • Hepatitis B vaccine recombinant
  • Antimicrobial drugs recently discontinued:
    • Mupirocin calcium 2% cream (Bactroban [GSK], June 2020)
    • Bacitracin injection (February 2020)
    • Interferon alfa-2b (Intron A, October 2019)
    • Mupirocin calcium 2% nasal ointment (Bactroban Nasal [GSK], August 2019)
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