Infectious Disease / Microbiology Updates

🟢 Risk-stratified penicillin-allergy alerts are associated with greater cephalosporin use

Before-and-after study of 26,903 patients with penicillin-allergy labels: cephalosporin use increased 17.8% in hospital and 35.4% in operating rooms after risk-stratified alerts. No anaphylaxis was identified by the study surveillance method. Nonrandomized single-system study; delayed allergic reactions and long-term clinical outcomes were not assessed.

JAMA Network Open | 13 November 2026 | Quality-improvement study

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🔵 Biomarker-guided antibiotics fail to establish noninferiority in very preterm infants

In a randomized trial of 283 infants born at 25–31 weeks, survival without major morbidity was 53% with biomarker-guided treatment versus 55% with universal antibiotics. Noninferiority was not demonstrated. No early-onset sepsis occurred, leaving safety in infected infants uncertain; infants with major infection risk factors were excluded. Original results and limitations reviewed.

JAMA Network Open | 12 November 2026 | Randomized trial

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🟢 Cefazolin causes fewer treatment discontinuations and less kidney injury in MSSA bacteraemia

A Bayesian meta-analysis of CloCeBa and SNAP found fewer adverse-event discontinuations (OR 0.25) and less acute kidney injury (OR 0.54) with cefazolin versus cloxacillin/flucloxacillin. Among 1,579 evaluable patients, the mortality estimate remained uncertain (OR 0.84; 95% credible interval 0.59–1.28): survival superiority was not established. Only two open-label trials; original methods and results reviewed.

JAMA Network Open | 12 November 2026 | Meta-analysis

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