View abstract Necrotizing soft tissue infections (NSTIs) are life-threatening conditions that require prompt surgical and antimicrobial intervention. An upward global trend in invasive group A streptococcal infections, concerning for a synchronous rise in NSTIs, warrants a standardized approach to antibiotic management of NSTIs to optimize care. Emerging data support a shorter antibiotic course following definitive surgical debridement, even in cases with concurrent streptococcal bacteremia. Individualized antibiotic management guided by surgical source control, as opposed to fixed durations, may help minimize unnecessary antibiotic exposure and the resultant adverse events and antimicrobial resistance. The use of clindamycin as an adjunctive anti-toxin antibiotic remains a common practice, though rising resistance and comparative studies suggest linezolid may be a safe alternative. This review aims to offer strategies to optimize antibiotic care in NSTIs by reviewing the growing body of evidence on antibiotic duration, de-escalation strategies, and adjunctive anti-toxin therapy.

Podcast Episode · The Host Response: A FirstcallID Podcast · 12/28/2025 · 5m

AbstractDescription. Babesiosis is a tick-borne disease that is endemic in the United States (US). The major species, Babesia microti, is readily transmiss

This target trial emulation study assesses outcomes of broad-spectrum antibiotics de-escalation compared with continuation on encounter day 4 in patients hospitalized for community-onset sepsis.

Clinical prediction scores such as NOVA and DENOVA aim to identify patients with enterococcal bacteremia at low risk of infective endocarditis (IE) in whom imaging might be safely avoided. The aim was to evaluate the performance of NOVA and DENOVA scores and to introduce a modified tool, DENOVi.MethodsThis retrospective study included adult patients with enterococcal bacteremia at two Swiss tertiary centers (2015–2024). IE was adjudicated by multidisciplinary Endocarditis Teams according to 2023 Duke-ISCVID criteria. Patients were stratified as high risk for IE using the adapted NOVA score (cut-off: ≥4), the DENOVA score (≥3), and a newly developed DENOVi score (≥2), which excluded the subjective murmur criterion and broadened “valve disease” to include intracardiac electronic devices (new Vi component).ResultsAmong 827 bacteremia episodes, 172 (21%) were diagnosed with IE. The adapted NOVA, DENOVA, and DENOVi scores classified 76%, 26%, and 42% of patients as high risk, respectively. Corresponding NLRs were 0.04 (95% CI, 0.01–0.15), 0.10 (0.06–0.16), and 0.04 (0.02–0.10). The adapted NOVA substantially increased the proportion of echocardiograms needed to be performed from 58% based on clinical evaluation alone to 76%, whereas the DENOVA and DENOVi scores would have reduced this proportion to 26% and 42% of episodes, respectively.ConclusionsBoth adapted NOVA and DENOVi scores reliably ruled out IE, but DENOVi provided the most balanced approach between diagnostic safety and resource utilization. DENOVi therefore represents a pragmatic and objective tool for IE risk stratification in enterococcal bacteremia. Prospective validation is warranted.

Early IV to oral transition improves antibiotic treatment safety across many serious infections. In a rural health system, implementation of the COPAT Tria

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Background: In this systematic review of molecular epidemiology studies, we describe the prevalence of Mycobacterium tuberculosis complex strain discordance amo

AbstractBackground. Adults aged ≥65 years are at high risk of harm from antibiotic misuse due to misdiagnosis of asymptomatic bacteriuria (ASB) as urinary