Navigation Links
Scientists debate CDC recommendations during meningitis outbreak
Date:2/5/2013

A pair of commentaries to appear in an upcoming issue of the journal Antimicrobial Agents and Chemotherapy highlight a debate within the public health community surrounding Centers for Disease Control and Prevention (CDC) recommendations for treatment of exposed individuals during last year's fungal meningitis outbreak. Manuscripts of the commentaries were published ahead of print today on the journal's webpage.

"I will try to offer sufficient documentation to show there are alternative approaches worthy of consideration," writes David A Stevens of Stanford University Medical School, the author of the first commentary which questions the CDC recommendations.

In late 2012 the United States experienced its largest reported healthcare-associated outbreak when some patients who had received contaminated steroid shots developed fungal meningitis. As of January 14, 2013 there have been 678 cases and 44 deaths reported. Approximately 14,000 people were potentially exposed to the contaminated steroids. During the outbreak the CDC recommended that clinicians closely monitor individuals who had been exposed but specifically recommended against the use of preventative (prophylactic) use of antifungal drugs in asymptomatic patients in the absence of a clinical diagnosis of meningitis infection.

In his commentary, Stevens puts forth a detailed argument concluding that the CDC should have recommended prophylactic treatment with oral antifungal drugs for all exposed individuals. He also voiced other concerns with the CDC recommendations including the focus on only two specific drugs for treatment.

"If I were advising any patient who had been injected intrathecally or into a space adjacent to the intrathecal sac with material from one of the known contaminated lots, I would recommend taking chances with the known, uncommon and usually inconsequential side effects of the oral drugsand try to prevent onset of a serious and lethal disease," writes Stevens.

In the second commentary, a rebuttal of the Stevens' commentary, a group of scientists including one CDC official defend the CDC's recommendation against prophylactic antifungal therapy, describing the CDC's decision analysis model.

"Most of these cases resulted from epidural injections; these patients did not intentionally receive intrathecal injections, as suggested by Stevens," write the scientists. "Clinicians must carefully weigh the benefit of treatment of asymptomatic patients with the significant expense associated with drug acquisition, monitoring drug levels and substantial drug-drug interactions. For this reason, CDC chose to recommend careful clinical evaluation and imaging for high risk patients, independent of symptoms, with the goal of finding early indications of infection."

The manuscripts of the commentaries are available online at http://bit.ly/asmpr0205a and http://bit.ly/asmpr0205b. Formal publication is scheduled for the April 2013 issue of Antimicrobial Agents and Chemotherapy.


'/>"/>

Contact: Jim Sliwa
jsliwa@asmusa.org
202-942-9297
American Society for Microbiology
Source:Eurekalert

Related medicine news :

1. Scientists solving the mystery of human consciousness
2. Scientists uncover multiple faces of deadly breast cancer
3. Scientists identify major source of cells defense against oxidative stress
4. Scientists tailor cell surface targeting system to hit organelle ZIP codes
5. Scientists rewrite rulebook on breast cancer in landmark global study
6. Warwick scientists uncover how checkpoint proteins bind chromosomes
7. NIH scientists link quickly spreading gene to Asian MRSA epidemic
8. Joslin scientists identify important mechanism that affects the aging process
9. Scripps Research scientists show how memory B cells stay in class to fight different infections
10. Scientists Map Melanomas Genome
11. A*STAR scientists discover switch to boost anti-viral response to fight infectious diseases
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... June 19, ... the dangers associated with chronic pain and the benefits of holistic treatments, Serenity ... who are suffering with Sickle Cell Disease. , Sickle Cell Disease (SCD) is a ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, ... Elite. The attorneys chosen by their peers for this recognition are considered among the ... Traurig Shareholders received special honors as members of this year’s Legal Elite Hall of ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway ... call for a minimum wage raise to $12 an hour by 2020 and then adjusting ... restore the lost value of the minimum wage, assure the wage floor does not erode ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... Living, is proud to recognize Dr. Barry M. Weintraub as a prominent plastic ... most beautiful women in the world, and the most handsome men, look naturally ...
(Date:6/24/2016)... ... June 24, 2016 , ... National recruitment firm Slone ... executive with extensive sequencing and genomics experience, as Vice President of North American Capital ... will be responsible for leading the sales team in the commercialization of the HTG ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced the ... report to their offering. ... favourable commercial environment for MedImmune to enter. The US ageing ... serve to drive considerable growth for effective anti-influenza medications. The ... sales considerably, but development is still in its infancy. ...
(Date:6/23/2016)... RIDGE, Ill. and INDIANAPOLIS ... of students receiving a Lilly Diabetes Tomorrow,s Leaders Scholarship ... The 2016 scholarship winners, announced today online at ... to let type 1 diabetes stand in the way ... Diabetes has supported the Foundation,s scholarship program since 2012, ...
(Date:6/23/2016)... N.J. , June 23, 2016  Guerbet announced ... Premier Inc.,s Supplier Horizon Award . ... year, Guerbet was recognized for its support of Premier ... creation through clinical excellence, and commitment to lower costs. ... to receive this recognition of our outstanding customer service ...
Breaking Medicine Technology: