Should Efavirenz Remain a Tier 1 ART Drug?

In a recent publication Raffi et al. suggest that it may be time to drop efavirenz (Sustiva®) from 1st line HIV treatment recommendations [1].  The authors make the claim that efavirenz was inferior to rilpivirin (Edurant®) and dolutegravir (Tivicay®) in a total of 3 recent controlled studies.  They review the CNS side effect profile Continue reading Should Efavirenz Remain a Tier 1 ART Drug?

Fighting P. aeruginosa (Part I)

It has never been easy to cure Pseudomonas aeruginosa infections.  Few antibiotics nowadays have reliable activity against this problem pathogen that seems to have more built-in resistance features than most other Gram-negatives.  In the past, cephalosporins, aztreonam, penems, ciprofloxacin, and aminoglycosides were useful drugs with reliably cidal activity, especially when Continue reading Fighting P. aeruginosa (Part I)

Strep Infections in High Places

George Washington, age 67,  had a bad peritonsillar or epiglottal abscess; indeed, he died from it as his personal physicians resorted to extensive blood letting and did not dare lance the abscess.  He would have recovered with penicillin, I guess, but in his days the best treatment option for quinsy was surgical drainage. Continue reading Strep Infections in High Places