By Debbie Bunch
April 29, 2024
Antibiotics Fall Short for Lower Respiratory Tract Infections
Do antibiotics help patients recover from lower respiratory tract infections? According to Georgetown University Medical Center researchers publishing in the Journal of General Internal Medicine, the answer is no.
Their study was conducted among a large group of people seeking treatment for a lower respiratory tract infection in U.S. primary care or urgent care centers. While the antibiotics prescribed for these patients were appropriate for bacterial infections and often used for them, results showed people who got them — overall 29% of people at their initial visit — did not recover from their cough any faster or see a reduction in its severity any sooner than people who did not get an antibiotic.
The investigators also used advanced lab tests to determine if the infections were bacterial infections, viral infections, bacterial and viral infections, or no infection. Among people with confirmed bacterial infections, the time to illness resolution was again no better for those who received antibiotics than those who did not. People with and without bacterial infections got better in about 17 days.
The authors emphasize their study was observational and believe a large, randomized controlled trial is warranted to further examine the value, if any, that antibiotics have in the treatment of lower respiratory tract infections.
“Lower respiratory tract infections tend to have the potential to be more dangerous, since about 3% to 5% of these patients have pneumonia,” said study author Dan Merenstein, MD. “But not everyone has easy access at an initial visit to an x-ray, which may be the reason clinicians still give antibiotics without any other evidence of a bacterial infection.”
He also believes patients have come to expect these drugs, even when they don’t help them get better “Basic symptom-relieving medications plus time brings a resolution to most people’s infections,” said Dr. Merenstein. Read More
New Drug May Prevent Influenza-Induced Lung Damage
U.S. researchers believe they have discovered a new drug that can prevent influenza-induced lung damage. So far, the drug has only been tested in a mouse model, but if findings hold true in human trials it could be a game changer for people hospitalized with a severe case of the flu.
The new drug, dubbed UH15-38, works by creating a novel balance between shutting down runaway inflammation and allowing the immune system to stop the virus. Specifically, the drug inhibits one part of a major inflammation protein in immune cells called receptor-interacting protein kinase 3 (RIPK3) that controls two cell death pathways in response to infection: apoptosis, which is not highly inflammatory, and necroptosis, which is highly inflammatory. UH15-38 was designed to prevent RIPK3 from starting necroptosis while maintaining its pro-apoptotic properties.
Through a series of experiments, the investigators found the drug protected mice from developing lung damage when given amounts of influenza virus similar to those seen in humans. The drug worked even when given at a low dose but when it was given at a higher dose, the researchers determined that it could fully protect against an infection with a higher level of virus that is often considered fatal.
Importantly, the drug provided this protection even when given five days after infection, something the authors say has been difficult to achieve with influenza therapeutics.
“Often the worst part of influenza illness happens after the virus is controlled when runaway inflammation destroys lung cells,” said study author Paul Thomas, PhD, from St. Jude Children’s Research Hospital. “UH15-38 can dampen that influenza-caused inflammation while leaving viral clearance and the other functions of the immune and tissue responses intact. That makes it a promising candidate to move forward toward the clinic.”
Researchers from the University of Houston, Tufts University School of Medicine, and Fox Chase Cancer Center were involved in the research as well. The study was published by Nature. Read More
Do They, or Don’t They?
The debate on whether e-cigarettes help people quit smoking traditional cigarettes seems to see-saw back and forth, but a new study out of the Roswell Park Comprehensive Cancer Center suggests they do.
The investigators examined trends in real-world, population-level quit rates between 2013 and 2021 using data on adults age 21 and up from the Population Assessment of Tobacco and Health Study. While quit rates between 2013 and 2016 were about the same between those who did and did not use e-cigarettes — 15.5% and 15.6%, respectively — between 2018 and 2021 there was a big gap between the two groups.
Overall, 20% of smokers who did not use e-cigarettes during the later time period reported quitting vs. 30.9% of those who reported using e-cigarettes. The authors believe changes in the e-cigarette market and more laws restricting tobacco over time may be behind this change.
“While our study doesn’t give the answers as to why vaping is associated with cigarette quitting in the population today when it wasn’t associated with quitting years ago, design changes leading to e-cigarettes that deliver nicotine more effectively should be investigated,” said study author Karin Kasza, an assistant professor of oncology at the center. “This work underscores the importance of using the most recent data to inform public health decisions.”
The study was published by Nicotine & Tobacco Research.Read More
