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:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... “America On ... Christian identity. “America On The Brink” is the creation of published author, William ... several great-grandchildren. As a WWII veteran, he spent thirty years in the Navy. ...
(Date:10/12/2017)... , ... October 12, 2017 , ... ... to meet the demand of today’s consumer and regulatory authorities worldwide. From Children’s ... experts and tested to meet the highest standard. , These products are ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... ... drug delivery system that we intend to develop to enable prevention of a ... lead to severe hearing loss, especially in pediatric patients. For cisplatin, hearing loss ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... On Saturday, ... a treadmill relay – Miles by Moonlight to raise money for the American Heart ... or more. , Teams will work together to keep their treadmills moving for ...
(Date:10/12/2017)... FL (PRWEB) , ... October 12, 2017 , ... ... presenting the latest in wound care advancements to physician colleagues, skilled nursing facility ... is titled, "Navigating the Treacherous Waters of Wound Care." , "At many of ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... -- West Pharmaceutical Services, Inc. (NYSE: WST), ... administration, today announced that it will release third-quarter 2017 ... 26, 2017, and will follow with a conference call ... a.m. Eastern Time. To participate on the call, please ... is 94093362. A ...
(Date:10/11/2017)... -- Caris Life Sciences ® , a leading innovator in ... medicine, today announced that St. Jude Medical Center,s Crosson ... as its 17 th member. Through participation with ... Institute will help develop standards of care and best ... cancer treatment more precise and effective. ...
(Date:10/11/2017)... 2017  Hill-Rom Holdings, Inc. ("Hill-Rom") (NYSE: HRC), today ... Las Piedras, Puerto Rico , where ... Following a comprehensive ... minor structural damage, temporary loss of power and minimal ... completed, manufacturing operations have resumed, and the company expects ...
Breaking Medicine Technology: