In a clinical trial conducted by the CDC's Tuberculosis Trials Consortium in collaboration with the NIH-funded AIDS Clinical Trials Group, a new 4-month regimen for treatment of drug-susceptible pulmonary tuberculosis was found to be noninferior to 6 months of standard treatment.

On June 25, 2021, the FDA added a warning to the Fact Sheets for the mRNA-based COVID-19 vaccines manufactured by Pfizer/BioNTech (Comirnaty) and Moderna (Spikevax) about an increased risk of myocarditis and pericarditis following administration of the vaccines.

Gastroesophageal reflux disease (GERD) is the most frequent GI condition encountered in the outpatient setting; it affects about 20% of the US population. Heartburn and regurgitation are the classic symptoms of GERD.

The FDA has approved two new drugs for treatment of adults with acute bacterial skin and skin structure infections caused by susceptible gram-positive bacteria. Dalbavancin (Dalvance – Durata) is a long-acting intravenous (IV) lipoglycopeptide antibiotic similar to telavancin (Vibativ). Tedizolid phosphate (Sivextro – Cubist) is an IV and oral oxazolidinone antibacterial drug similar to linezolid (Zyvox). A third IV antibiotic, oritavancin (Orbactiv), recently approved by the FDA for the same indication, will be reviewed in a future issue.

Bedaquiline (bed ak' wi leen; Sirturo – Janssen), a diarylquinoline antimycobacterial, has been given accelerated approval by the FDA as an orphan drug for use in addition to other drugs for treatment of adults with multidrug-resistant pulmonary tuberculosis (MDR-TB). It is the first drug approved specifically to treat MDR-TB.

Tuberculosis (TB) is still a common cause of death worldwide, and the prevalence of drug-resistant TB poses challenges to its treatment and control. Guidelines with detailed management recommendations are available from the American Thoracic Society, Centers for Disease Control and Prevention (CDC) and Infectious Diseases Society of America (IDSA).

Even though the incidence continues to decline in the United States, tuberculosis (TB) is still a common cause of death worldwide, and the prevalence of drug-resistant TB poses severe challenges to its treatment and control. Guidelines with detailed management recommendations are available from the Centers for Disease Control and Prevention (CDC), American Thoracic Society and Infectious Diseases Society of America (IDSA).

Quantiferon - TB Gold (Cellestis) is a T-cell interferon-gamma release assay approved by the FDA as an alternative to the tuberculin skin test for diagnosis of infection with Mycobacterium tuberculosis (TB). An earlier assay (Quantiferon-TB), which is no longer commercially available, was approved by the FDA in 2001. Other interferon-gamma release assays (IGRAs) are available abroad.

Information about empirical treatment of bacterial infections, emerging trends in antimicrobial resistance, new drugs and new data about older drugs continue to become available. Usual pathogens and empiric treatment for some common types of infections are summarized in the text and a table listing the drugs of choice and alternatives for each pathogen begins on page 40. The recommendations made here are based on the results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants.

Even though the incidence continues to decline, tuberculosis (TB) is still a problem in the United States. Treatment of TB can be divided into treatment of latent infection and treatment of active disease. Atable listing the first-line drugs used for treatment of TB with their doses and adverse effects can be found on page 16. Other guidelines with more detailed management recommendations are available.

Tuberculosis (TB) is still a problem in the United States, even though the incidence continues to decline in most of the country (MMWR Morbid Mortal Wkly Rep 2004; 53:209). Treatment of TB can be divided into treatment of latent infection diagnosed by a positive PPD and treatment of active clinical TB. Guidelines with detailed management recommendations are available from the US Centers for Disease Control and Prevention (CDC) (MMWR Morbid Mortal Wkly Rep 2003; 52RR-11:1).

New drugs for bacterial infections and new information about older drugs continue to become available. Empirical treatment of some common bacterial infections is discussed in this article. A table listing the drugs of choice and alternatives for each pathogen begins on page 18. These recommendations are based on results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants. Local resistance patterns should be taken into account. Trade names are listed on page 24.

The choice of drugs for treatment of pneumonia depends on the most likely pathogens causing the infection and local antimicrobial resistance patterns. Factors such as severity of illness, presence of co-morbid conditions and whether the infection is community or hospital-acquired also need to be considered.

Mycophenolate mofetil (CellCept - Roche) has been approved by the US Food and Drug Administration for oral use in preventing organ rejection in patients receiving allogeneic renal transplants. It is being promoted as an improvement over azathioprine (Imuran) for concurrent use with cyclosporine (Sandimmune; Neoral) and corticosteroids.

Tuberculosis (TB) continues to be a major problem in the United States, particularly in areas where drug resistance is common (Morbid Mortal Weekly Rep, 44:387, May 26, 1995). Since poor compliance is the most important cause of treatment failure and is associated with emergence of drug resistence, some experts now recommend that all patients take drugs for TB under direct observation (SE Weis et al, N Engl J Med, 330:1179, 1994; R Bayer and D Wilkinson, Lancet, 345:1545, June 17, 1995).

The rising incidence of tuberculosis (TB) has been accompanied by a dramatic increase in drug resistance in some areas of the USA (TR Frieden et al, N Engl J Med, 328:521, 1993). Since poor compliance is the most important cause of treatment failure and associated with emergence of drug resistance, some experts now recommend that patients with TB take their drugs under direct obeservation (MD Iseman et al, N Engl J Med, 329:576, 1993).

After many years of decline in the USA, the incidence of tuberculosis (TB) has recently increased, partly because the disease occurs more frequently in patients with human immunodeficiency virus (HIV) infection and in the homeless (PF Barnes et al, N Engl J Med, 324:1644, 1991; Morbid Mortal Weekly Rep, 40:869, Dec 20, 1991).

With the deployment of hundreds of thousands of troops in Saudi Arabia, health problems endemic to the Arabian Peninsula may be coming to the attention of physicians in the USA and other areas.

After many years of decline, the incidence of tuberculosis has recently increased because the disease occurs in patients with AIDS (Morbid Mortal Weekly Rep, 36:817, Jan 1, 1988). For uncomplicated tuberculosis, the recent trend in tuberculosis treatment has been toward a shorter period of therapy and increased use of pyrazinamide.