Adequate Penetration of Daptomycin Into Bone Tissue

After a single high dose of (8 or 10 mg/kg BW) of daptomycin IV, bone levels were measured in plasma and trabecular bone obtained during hip or knee surgery of 16 patients.[1] At the time of surgery, mean concentrations in plasma and synovial fluid were 39 and 22 µg/mL, respectively.  Continue reading Adequate Penetration of Daptomycin Into Bone Tissue

QT Prolongation with Azithromycin and Levofloxacin

Several antibiotic classes are associated with QTc prolongation: macrolides, quinolones, the antimalarials that share the quinine structure, and many azole antifungals.  FDA warned about the proarrhythmic effects of azithromycin in 2013 [i] but it is a recent publication by Rao which brings the message home again with some very disquieting Continue reading QT Prolongation with Azithromycin and Levofloxacin

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?