IDSA News - August 2008
Vol. 18 No. 8
(Print All Articles)

Flu Vaccine Begins Shipping

Steve Baragona

Flu vaccine for the upcoming season has begun shipping from five manufacturers. All three strains of virus have been changed this season, following mismatches in last season’s vaccine.

Flu vaccine for the upcoming season has begun shipping from five manufacturers. All three strains of virus have been changed this season, following mismatches in last season’s vaccine.

Four inactivated vaccines—Fluzone from Sanofi Pasteur, Fluvirin from Novartis, Fluarix from GlaxoSmithKline Biologicals, and FluLaval from ID Biomedical Corporation of Quebec—as well as MedImmune’s live, attenuated FluMist vaccine have received clearance from the Food and Drug Administration (FDA), and the companies report shipping the first lots of vaccine.

CSL Limited's Afluria is also expected to enter the market this year. Vaccine supply is expected to be excellent and may set a record.

Last season, the vaccine’s A (H3N2) strain and influenza B strain were a poor match for the circulating viruses. All three strains have been changed in this season’s vaccine. The new formulation includes an A/Brisbane/59/2007 (H1N1)-like virus, an A/Brisbane/10/2007 (H3N2)-like virus, and a B/Florida/4/2006-like virus. The latter two strains are currently included in the Southern Hemisphere’s flu vaccines.

Despite last season’s poor match, the vaccine was still partially effective, according to an interim study from the Centers for Disease Control and Prevention (CDC) and researchers at the Marshfield Clinic Research Foundation in Wisconsin.

For this season, the CDC’s Advisory Committee on Immunization Practices (ACIP) recommends yearly vaccination for all children aged 6 months to 18 years, with an emphasis on children aged 6 months to 5 years because of their elevated risk of complications from influenza. As of this season, ACIP has cleared live, attenuated vaccine for healthy children as young as 2 years. The previous recommendation was for people 5 to 49 years old.

IDSA Journal Club, August 2008

  • Plenty of Downsides, Little Upside to Adding Rifampin for Staph Endocarditis
  • Empirical Fluconazole Not Beneficial in Critically Ill Adults at Risk for Candida
  • Two Nucleic Acid Amplification Tests Detect Pharyngeal and Rectal Gonorrhea, Chlamydia
  • Darunavir as First-line Therapy?
  • Risk-Factor Screening Does Not Predict HPV Infection

In this feature, a panel of IDSA members identifies and critiques important new infectious diseases studies in the current literature that have a significant impact on the practice of infectious diseases medicine.

For more from Clinical Infectious Diseases and The Journal of Infectious Diseases, see the "In the IDSA Journals" section of IDSA News.


Plenty of Downsides, Little Upside to Adding Rifampin for Staph Endocarditis
Sara E. Cosgrove, MD, MS

The use of rifampin as adjunctive therapy in the treatment of native valve endocarditis due to Staphylococcus aureus is associated with drug-drug interactions, transaminase elevations, and emergence of rifampin resistance during therapy while not offering clear benefit, according to a study in the July edition of Antimicrobial Agents and Chemotherapy

The authors compared 42 case patients with S. aureus native valve endocarditis who were treated with adjunctive rifampin to 42 control patients who did not receive rifampin.  Three quarters of patients in both groups had methicillin-resistant S. aureus.  The median duration of rifampin therapy was 20 days. Emergence of resistance to rifampin occurred in nine (21 percent) of cases; all were bacteremic when rifampin was initiated.  Elevation of transaminases to five or more times baseline was more common in cases than controls (21 percent vs. 2 percent, p = 0.014); all patients who experienced this side effect had infection with hepatitis C virus.  Fifty-two percent of patients had drug interactions while on rifampin; the implicated agents were methadone, warfarin, protease inhibitors, azole antifungal agents, and phenytoin. 

Cases were more likely to have left-sided endocarditis, had a longer median duration of bacteremia, were more likely to require valve surgery, and had higher mortality, suggesting that they may have had more complicated disease than controls.  Consequently, it is difficult to derive conclusions regarding the efficacy of the addition of rifampin to standard therapy from this study.  Nonetheless, this study demonstrates the important and likely underestimated potential adverse effects of adjunctive rifampin, reminding clinicians of the importance of monitoring hepatic function and assessing for drug interaction when using the agent.  In addition, it suggests that if rifampin is used, it may be optimal to wait until blood cultures have cleared before adding the agent to avoid emergence of resistance. (Riedel et al., Antimicrob Agents Chemother. 2008;52:2463-7.)

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Empirical Fluconazole Not Beneficial in Critically Ill Adults at Risk for Candida
Khalil G. Ghanem, MD

In the intensive care unit (ICU), it is not uncommon for clinicians to consider adding empiric antifungal coverage in patients who are persistently febrile despite being on broad spectrum antibiotics.

In the July 15 issue of Annals of Internal Medicine, Schuster et al. randomized 270 such patients to receive either 800 mg daily of fluconazole or placebo for two weeks. They followed these patients for an additional month after therapy.  A successful outcome was defined as resolution of fever, absence of invasive fungal infection, no discontinuation because of toxicity, and no need for other systemic antifungal medication.

Only about a third of either group had a successful outcome, mainly because fevers did not resolve (51 percent fluconazole vs. 57 percent placebo). Documented invasive candidiasis occurred in 5 percent of fluconazole recipients and 9 percent of placebo recipients (relative risk [RR], 0.57 [95 percent CI, 0.22 to 1.49]). Fifteen percent of patients colonized with Candida species at baseline who received fluconazole developed invasive fungal infection, compared with 25 percent of patients who received placebo (RR, 0.63 [CI, 0.23 to 1.67]).

An important limitation was the relatively small sample size: The rates of invasive fungal infections were lower than what the authors had anticipated. Thus, the authors could not exclude a relative benefit of fluconazole of up to 32 percent, which is clinically significant.

This study suggests that, in general, the empirical use of fluconazole may not provide additional benefit in febrile ICU patients already receiving broad spectrum antimicrobial therapy. However, this study does not address the potential benefits of fluconazole in other patients who are at high risk of candidal infection, such as those colonized with Candida species, receiving total parenteral nutrition, recovering from recent surgery, etc. (Schuster et al., Ann Intern Med. 2008;149:83-90.)

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Two Nucleic Acid Amplification Tests Detect Pharyngeal and Rectal Gonorrhea, Chlamydia
Khalil G. Ghanem, MD

Persons who engage in unprotected receptive oral and anal sex are at increased risk of Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) infections at these sites, but the nucleic acid amplification tests (NAATs) that have revolutionized testing for GC and CT infections of the lower genital tract are not currently FDA-approved for pharyngeal and rectal samples.

In the July issue of Sexually Transmitted Diseases, Schachter et al. evaluated two NAATs, Becton Dickinson's ProbeTec Strand Displacement Assay and Gen-Probe's APTIMA Combo 2 Assay, to detect oral and pharyngeal CT and GC infections in 1,110 men who have sex with men. (Roche's Amplicor CT/NG PCR-based test was abandoned because of poor specificity in detecting oropharyngeal GC infection.) Both tests were superior to culture: Culture was only about 40 percent sensitive to detect rectal and pharyngeal GC, compared to 70-90 percent for the NAATs. Similarly, CT culture was about 30-40 percent sensitive vs. 60-100 percent for NAATs. Specificity of NAATs was greater than 99 percent.

Strikingly, the prevalence of GC and CT infections in the oropharynx and rectum of asymptomatic men was just as high as for symptomatic men. This finding reinforces the importance of testing all persons if exposure has occurred, even those without symptoms.

Despite having a relatively small sample size, this study is important because it highlights the limitation of culture-based methods to detect non-genital GC and CT infections and suggests that some NAATs may be used instead. Since FDA has not yet cleared any of the NAATs for testing on non-genital specimens, laboratories must perform in-house validation studies to use NAATs on rectal and pharyngeal swabs in order to adhere to Clinical Laboratory Improvement Amendments (CLIA) guidelines. (Schachter et al., Sex Transm Dis. 2008;35:637-642.)

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Darunavir as First-line Therapy?
Sabrina Renee Kendrick, MD

Darunavir is generally prescribed for patients with virus resistant to other protease inhibitors. In a study in the July 31 edition of AIDS, darunavir/ritonavir (DRV/r) proved non-inferior to lopinavir/ritonavir (LPV/r) in treatment-naïve HIV-1 infected patients at 48 weeks, with lower incidence of diarrhea and other gastrointestinal side effects,.

Nearly 700 patients with a median CD4 count of 225 cells/ml and mean baseline HIV-1 RNA load of 4.85 log10 copies/ml were randomized in this open-label trial to receive DRV/r 800/100 mg qd or LPV/r 800/200 mg total daily dose (bid or qd) plus fixed-dose tenofovir and emtricitibine.

At 48 weeks, 84 percent of DRV/r and 78 percent of LPV/r patients achieved HIV-1 RNA less than 50 copies/ml (p<0.001), demonstrating non-inferiority between the comparators. Significantly higher response rates were observed with DRV/r in patients with HIV-1 RNA load of at least 100,000 copies/ml (p<0.05).

Gastrointestinal-related adverse events, including moderate-to-severe diarrhea, were less common in the DRV/r group (4 percent vs. 10 percent). Three percent of patients discontinued DRV/r because of adverse events, compared to 7 percent for LPV/r. However, the flexibility in LPV/r dosing across the study sites may limit the findings of gastrointestinal-related adverse events. This potential confounder may need sorting in future analyses.

Although the data offers DRV/r as a safe and effective option, clinicians should note that no changes in the treatment guidelines have been made for treatment-naïve HIV-1 infected patients, and these trials are still ongoing. Stay tuned for further details. (Ortiz et al, AIDS 2008, 22:1389-1397.)

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Risk-Factor Screening Does Not Predict HPV Infection
Jason B. Weinberg, MD

Screening adolescents for risk factors does not predict future infection with human papillomavirus (HPV) and is therefore unlikely to be an adequate strategy for the implementation of catch-up HPV vaccination, according to a study in the July 2008 issue of Pediatrics.

Universal HPV immunization is recommended for all 11- to 12-year old girls. Catch-up vaccination for older adolescents and young adults is also advised, but there are multiple barriers to comprehensive catch-up vaccination. Dempsey and colleagues studied the utility of a risk factor-based approach to HPV catch-up vaccination.

Risk factors were assessed in a large cohort of adolescent females. Sexually active subjects were assessed for previously identified risk factors for HPV infection and HPV-associated disease, while risk factors associated with future sexually transmitted diseases or eventual high-risk sexual behaviors were assessed for subjects who were not sexually active. Several years later, subjects were tested for HPV.

Neither initial adolescent sexual activity status nor assessed risk factors predicted future infection with vaccine-specific HPV types or other HPV types assessed in the study.

These findings suggest that the use of risk factors to identify adolescents and young adults for HPV catch-up vaccination will ultimately not provide adequate protection, because essentially all individuals who become sexually active are at risk. As the authors suggest, comprehensive catch-up vaccination will be more likely to substantially reduce the incidence of HPV infection and HPV-associated cervical carcinoma. Emphasis must therefore be placed on overcoming the logistical and financial barriers to providing universal access to the vaccine. (Dempsey et al., Pediatrics. 2008;122:1-7.)

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IDSA News CORRECTION

The July issue of IDSA News incorrectly reported that MMRV is available but zoster vaccine is not (“ACIP Makes New Recommendations on Rabies, HPV, Pneumococcal Vaccines”). The opposite is true: zoster vaccine is available; MMRV is not and may not be until early 2009. The error was corrected online, but may not have been seen by all readers. We regret the error.

In the IDSA Journals

  • Valganciclovir to Prevent Kaposi Sarcoma?
  • Genetics of Smallpox Vaccine Adverse Events
  • Iron Deficiency Protects Pregnant Women against Malaria
  • Control of an Institutional Outbreak of Influenza
  • Catheter Lock Solutions for Hemodialysis
  • MRSA Infection Risk in Long-term Carriers 

Valganciclovir to Prevent Kaposi Sarcoma?

Valganciclovir, a pro-drug for the anti-cytomegalovirus (CMV) agent ganciclovir, reduced replication of human herpesvirus-8 (HHV-8) in oropharyngeal swab samples in a randomized, double-blind, placebo-controlled crossover trial of 26 men.  Virus was detected on about half as many days in the saliva of subjects receiving valganciclovir, and the quantity of virus detected was significantly reduced. The study suggests valganciclovir should be studied for clinical efficacy in preventing Kaposi sarcoma, primary effusion lymphoma, and multicentric Castleman disease caused by HHV-8. (Casper et al., J Infect Dis. 2008;198:23-30. Commentary by Crumpacker, J Infect Dis. 2008;198:6-7.)

Genetics of Smallpox Vaccine Adverse Events

Using data from two separate smallpox vaccine trials, researchers found two genes strongly associated with systemic adverse events in both trials. One gene, MTHFR, is involved in DNA synthesis and repair and has been implicated in adverse reactions to several other pharmacological agents. The other, IRF-1, codes for an interferon regulatory factor, one of a family of proteins that viruses commonly target to suppress host immune responses. (Reif et al., J Infect Dis. 2008;198:16-22. Commentary by Relman, J Infect Dis. 2008;198:4-5.)

Iron Deficiency Protects Pregnant Women against Malaria

Iron-deficient pregnant women were less likely to have placental malaria than women with normal iron levels in a study of 445 women in Tanzania. Logistic regression analysis found iron-deficient women were 80 percent less likely (P<0.0001) to have placental malaria than women with normal iron status. The effects were most pronounced among women in their first pregnancy, and suggest the need for more study into the risks and benefits of iron supplementation for anemia. (Kabyemela et al., J Infect Dis. 2008;198:163-166. Commentary by Daily and Wiley, J Infect Dis. 2008;198:157-158.)

Control of an Institutional Outbreak of Influenza

This study compared facilities that began chemoprophylaxis for influenza A five or fewer days after the start of an outbreak with facilities that began chemoprophylaxis more than five days after the start of an outbreak. Early intervention resulted in shorter outbreaks, lower incidence rates, and lower case-fatality rates. (Rubin et al., Clin Infect Dis. 2008;47:47-52.)

Catheter Lock Solutions for Hemodialysis  

Central venous catheter-related blood stream infection is an important cause of morbidity and mortality among hemodialysis patients. This review of 16 randomized trials compared antibiotic lock solutions with heparin and found that antibiotic locks reduced bloodstream infections. (Yahav et al., Clin Infect Dis. 2008;47:83-93.)

MRSA Infection Risk in Long-term Carriers

The authors had previously found that 33 percent of new carriers of methicillin-resistant Staphylococcus aureus (MRSA) in a tertiary care center developed invasive infections in the year after acquisition. Here, they have extended the study to evaluate the risk of subsequent MRSA infection among patients known to have harbored MRSA for at least one year. A total of 23 percent of the carriers developed MRSA infection within one year. Pneumonia, soft-tissue infection, and central venous catheter infection were the most common infections. (Datta and Huang et al., Clin Infect Dis. 2008;47:176-181.)

More from the literature: the IDSA Journal Club

Don’t miss this feature to help you stay up to date on the infectious diseases literature. Each month, the IDSA Journal Club features brief summaries of key infectious diseases studies in the previous month’s major journals chosen by the new IDSA Literature Review Panel.

In addition, the “In This Issue” section of each issue of Clinical Infectious Diseases highlights several important studies from that journal. (Click for August 1 or August 15.)

For a review of other recent research in the infectious diseases literature, see “In the Literature,” by Stanley Deresinski, MD, in each issue of Clinical Infectious Diseases.

August 1:

  • TIBOLA and DEBONEL in Tuscanya
  • Chronic Hepatitis E Virus (HEV) Infection
  • Probiotics and Severe Acute Pancreatitis
  • Invasive Candidiasis in Patients with Cancer

August 15:

  • Idiopathic CD4+ Lymphocytopenia (ICL)
  • Failure of Therapy for Chronic Hepatitis C Virus (HCV) Infection: An Increased Response to Endogenous IFN Interferes with a Therapeutic Response to Exogenous IFN
  • Abacavir: Better Living through Pharmacogenomics
  • Identification of a Novel Arenavirus Transmitted by Organ

EIN: Alternative Dosages for Clinamycin

Is IV clindamycin effective at dosages lower than the recommended 900 mg every 8 hours?


The Emerging Infections Network (EIN) is a forum for infectious diseases consultants and public health officials to report information on clinical phenomena and epidemiological issues with public health significance. Any diagnostic or therapeutic recommendations and all opinions presented are those of the individual contributor. They do not necessarily represent the views of EIN, IDSA (EIN's sponsor), or the Centers for Disease Control and Prevention, which funds the EIN. The reader assumes all risks in using this information.

 

Is IV clindamycin effective at dosages lower than the recommended 900 mg every 8 hours? An EIN member in California suggested to the Network that this dosage “has crept into common usage, with little or no data” to support it.

Several members responded that they routinely used other dosages. “For many years we have been using clindamycin 900 mg IV q 12 hours on a routine basis,” said a member in Montana. “Where we go to 900 mg q 8 hours is in a situation like necrotizing fasciitis or a synergistic gangrene, for the anti-protein effect, along with another antibiotic like penicillin. I have felt the half life and effect of clindamycin would allow the longer interval. No increase in toxicity, no increase in Clostridium difficile, and no increase in clinical failures were seen when we made this switch in about 1993.”

A member from Texas said, “I remember that we used to give 600 mg every 6 to 8 hours until Upjohn started promoting the 900 mg q 8 hours as saving pharmacy costs compared to the q 6 hour regimen. That was back in the days when we were doing aminoglycosides q 8 hours as well, and mixing the clindamycin plus gentamicin/ tobramycin in the same bag was also supposed to cut down on administration costs. We certainly use lower doses orally with good success.”

A member involved in early studies of clindamycin for treatment of Pneumocystis carinii pneumonia in the early 1990s said the dosages were empirically derived. “An oral dose of 450 to 600 mg every 6 to 8 hours was chosen for mild to moderate infections because we thought it would be the maximum dose tolerated in HIV/AIDS patients. We chose 600 mg q 6 hours and 900 mg q 8 hours for smaller studies of severe disease based upon tolerance studies for other infections. As I recall, as much as 1200 mg q 8 hours was used in cerebral toxoplasmosis studies; again, an empiric choice based upon less-than-full CNS penetration.”

This discussion raises a larger question “about how decisions are made regarding the proper use of antibiotics,” said a member in Massachusetts. The member noted that recommended dosages are set by drug company-sponsored clinical trials, which examine drug usage under ideal circumstances. “There is a need for the continued review of the use of antibiotics in new settings, against changing pathogens,” the member said, but there is no financial incentive for drug manufacturers to do such studies. “Good studies are hard and expensive. The reality is that the lack of good studies is harder and more expensive. But who will fund the studies, and can they be done free of commercial bias?”

[Note: IDSA has been recommending the National Institute of Allergy and Infectious Diseases (NIAID) conduct these studies, and NIAID has begun funding some of them. See the June IDSA News for more information.]

Quinine Recommended for Malaria, but Hard to Find

The Centers for Disease Control and Prevention (CDC) has received several reports of patients with malaria who appear to have been treated only with doxycycline. CDC is cautioning physicians that doxycycline, tetracycline, or clindamycin should not be prescribed alone to treat malaria, but should be combined with quinine.

However, several EIN members reported difficulty obtaining quinine. The only quinine drug available in the United States is Qualaquin (quinine sulfate), manufactured by AR Scientific.

Cost can be an issue—one member reported that the prescription would cost about $200, which was more than the patient could afford. Two members reported obtaining it from Canada, where it is much cheaper.


The Emerging Infections Network (EIN) is a provider-based sentinel network designed to help the public-health community detect trends in emerging infectious diseases.

A joint project of IDSA and the Pediatric Infectious Diseases Society (PIDS) and supported by funding from the Centers for Disease Control and Prevention.

EIN tracks emerging infectious diseases and keeps the public-health community up to date with issues that are currently affecting or may soon affect members’ clinical practices.The Network provides a great opportunity for members to share knowledge quickly across large geographical distances. Both IDSA and PIDS members are eligible to join. The EIN listserve allows members to discuss new disease trends and difficult cases. Click here for more information or to join EIN.

Drug Approvals, Recalls, Adverse Events Update

Rebecca Dotson

  • Ziagen (abacavir sulfate) hypersensitivity reactions

The Food and Drug Administration (FDA) recently approved changes to the package insert for Ziagen (abacavir sulfate) highlighting information about the association of the HLA-B*5701 allele and hypersensitivity reactions caused by abacavir-containing therapy. 

For urgent clinical updates from the Centers for Disease Control and Prevention (CDC) and FDA, IDSA offers two e-mail services to help members stay informed.  IDSA members can sign up for this service online. (You must be logged in to have access to this link.)

Medicare Adds Only One New HAC to the List for Nonpayment in 2009

Diana Olson

IDSA and SHEA were successful this summer in making the case that Medicare should take a cautious approach in implementing a new policy to limit payment for hospital-acquired conditions.

IDSA and the Society for Healthcare Epidemiology of America (SHEA) were successful this summer in making the case that Medicare should take a cautious approach in implementing a new policy to limit payment to hospitals for secondary diagnoses that are not present on admission—commonly referred to as hospital-acquired conditions (HACs).

As of Oct. 1, 2008, hospitals will not receive additional payment for several conditions if they were not present on admission. The conditions most relevant to infectious disease are catheter-associated urinary tract infections, vascular catheter-associated infections, and mediastinitis after coronary artery bypass graft surgery.

Recently, the Centers for Medicare and Medicaid Services (CMS) proposed adding several additional conditions to the list for 2009, including certain surgical site infections, Legionnaires’ disease, ventilator-associated pneumonia, Staphylococcus aureus septicemia, Clostridium difficile-associated disease, and methicillin-resistant Staphylococcus aureus. Thanks in part to efforts by IDSA and SHEA, CMS added only one new condition for next year: expanding the category for surgical site infections to include certain orthopedic procedures and beriatric surgery for obesity.

In a letter to CMS, the two medical societies had expressed concern that even the best hospitals may not be able to eliminate these conditions entirely over time, even with complete adherence to evidence-based guidelines. Furthermore, there could be unintended consequences, such as causing hospitals to misdirect resources that could be better spent on infection prevention.

Although IDSA and SHEA leaders are pleased with this latest development, CMS could reconsider the other conditions in future years. (See IDSA News, June 2008.)

Plan Your ICAAC/IDSA Conference with the Online Program Planner

Jeanna Ray

Before you head out to Washington, DC for the 48th ICAAC/IDSA 46th Annual Meeting, check out the sessions and plan your schedule with the Online Program Planner.

Before you head out to Washington,DC for the 48th ICAAC/IDSA 46th Annual Meeting, Oct. 25-28, check out the sessions and plan your schedule with the Online Program Planner. The planner enables you to search for individual presentations or sessions and create a personal itinerary.

Ways to Search

  • search by keywords using the search box
  • use the advanced search engine to find more specific results of a particular session type, session title, presentation number, abstract title, keyword, author’s last name, institution, or session date/time; or,
  • browse to explore the ICAAC/IDSA presentations by category, session type, and date

Personalized Itineraries

Whichever way you view a list of sessions or presentations, you can add items to a personalized itinerary. Use My Itinerary to create your own schedule of meeting and personal events.

Itinerary Downloads

You may also download your itinerary using the AvantGo system. You can add personal notes, export a copy to Excel, or even transfer a copy of the itinerary to your personal digital assistant (PDA) or Web-enabled phone.

You can print out your final itinerary at the end to take with you. Bookmark the page to check back for additional session listings.

The Online Program Planner and more information about the 2008 ICAAC/IDSA meeting are available online at www.icaacidsa2008.org.

IDSA Advocacy Update: Animal Drug Legislation Passes

Rebecca Dotson

Congress this month passed legislation requiring drug manufacturers to report to the Food and Drug Administration (FDA) the quantities of antibiotics sold for use in food animals.

Congress this month passed legislation requiring drug manufacturers to report to the Food and Drug Administration (FDA) the quantities of antibiotics sold for use in food animals. IDSA was a primary supporter of the provision, found in the Animal Drug User Fee Amendments of 2008.  The provision provides an important step toward better understanding the amounts of antibiotics used in food animals, with the end goal of limiting any negative impacts of such use on human health.

Other advocacy efforts include:

  • The Society asked the FDA to clarify whether the Orphan Drug (OD) Act or a parallel regulatory framework would be an appropriate mechanism to spur research and development of antibacterial therapies and related diagnostics and vaccines for drug-resistant infections.  Previous conflicting comments from FDA officials have caused confusion for policymakers trying to address the problems outlined in IDSA’s 2004 “Bad Bugs, No Drugs” report.
  • IDSA issued a press release opposing the Environmental Protection Agency’s decision to permit the State of Michigan to spray the state’s apple orchards with gentamicin. The Society said this decision risks undermining the value of this important antibiotic to treat blood infections in newborns and other serious human infections.

Applications Being Accepted for Lyme Disease Review Panel

Applications are now being accepted for physicians and scientists to participate in a review panel that will evaluate the literature and other information on Lyme disease in order to make a recommendation to IDSA on the need for a revision or update of the Society's 2006 Lyme disease guidelines.

Applications are now being accepted for physicians and scientists to participate in a review panel that will evaluate the literature and other information on Lyme disease in order to make a recommendation to IDSA on the need for a revision or update of the Society's 2006 Lyme disease guidelines.

In May 2008, IDSA signed an agreement with the Attorney General of Connecticut ending his antitrust investigation of the Society's Lyme disease guidelines. Under the agreement, the guidelines remain in effect; but IDSA is agreeing to an extra step: a one-time special review to determine whether the 2006 guidelines should be revised or updated.

The time commitment will be approximately two to four hours per week or 10 to 15 hours per month for eight to 12 months. Applicants must be physicians or PhD-level scientists. An ombudsman jointly selected by IDSA and the attorney general will evaluate applicants for potential conflicts of interest.

The following must be completed, submitted, and received by October 1, 2008:

  • Application
  • CV
  • Notarized conflict-of-interest disclosure form

The online application, statement of interest disclosure form, and additional information about the selection criteria and time commitment are on IDSA's website. IDSA members are encouraged to apply. 

Vote for the IDSA Board of Directors

Election ballots due September 15

Election Ballots Due September 15

IDSA members will elect new officers and Board members this summer. Your ballot includes biographical statements and personal sketches from each of the candidates. The slate is as follows:

Vice President:

  • James Hughes, MD, FIDSA
    Professor of Medicine and Public Health, Rollins School of Public Health; Director, Program in Global Infectious Diseases, and Senior Advisor to the
    Center for Global Safe Water, Emory University, Atlanta, GA

  • David Relman, MD, FIDSA
    Associate Professor of Medicine and of Microbiology and Immunology, Stanford University; and Chief, Infectious Diseases, VA Palo Alto Health Care System, Stanford, CA

Director (Three slots open):

  • Arturo Casadevall, MD, PhD, FIDSA
    Professor and Chair, Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY

  • Thomas File, Jr, MD, MS, FIDSA
    Chief, Infectious Disease Service and Director, HIV Research, Summa Health System; Professor of Internal Medicine, Master Teacher, and Head, Infectious Disease Section, Northeastern Ohio Universities College of Medicine, Akron, OH

  • Carol Kauffman, MD, FIDSA
    Professor, Department of Internal Medicine, University of Michigan; and Chief, Infectious Diseases, Ann Arbor Veterans’Affairs Medical Center, Ann Arbor, MI

  • Marguerite Neill, MD
    Associate Professor, Infectious Diseases, Brown Alpert Medical School, Providence, RI; and Clinician, Division of Infectious Diseases, Memorial Hospital of Rhode Island, Pawtucket, RI

  • Andrew Pavia, MD, FIDSA
    Professor and Chief, Division of Pediatric Infectious Diseases, University of Utah Medical Center; and Director, Hospital Epidemiology, Primary Children’s Medical Center, Salt Lake City, UT 

  • William Powderly, MD, FIDSA
    Professor, Medicine and Therapeutics; and Head, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland

The deadline for casting your ballot is 5 p.m. EDT, September 15.

Voting is easy and important for setting the priorities and future direction of your Society. Electronic ballots were e-mailed to all members who are eligible to vote and have an e-mail on file. Check your e-mail inbox for a message from IDSA’s president, Donald Poretz, MD, FIDSA, with a subject line, “2008 IDSA Elections.” Paper ballots were mailed to all members who are eligible to vote but do not have an e-mail on file.

Members on the Move

Rebecca Dotson

Jonathan I. Ravdin, MD, FIDSA, has been appointed dean and executive vice president of the Medical College of Wisconsin.  Previously, Dr. Ravdin was the Nesbitt Professor and chairman of medicine at the University of Minnesota Medical School where, under his leadership, the department of medicine became a national leader in the training of subspecialty physicians and a top research department.

Celia J. Maxwell, MD, has been named in the May 2008 issue of Black Enterprise magazine as one of America’s Leading Doctors – a list of physicians “who are changing the world of medicine”. Dr. Maxwell is assistant vice president for health sciences and director of the Women’s Health Institute at Howard University Hospital.  She specializes in internal medicine and infectious diseases.

Welcome, New IDSA Members!

Members

Furuya, E. Yoko, MD
Georgescu, Claudiu, MD
Gonzalez, Blanca, MD
Grimwade
, Kate, MD, PhD
Hickey
, Patrick, MD
Kuhar, David, MD
Martin
, John, PhD
Naz
, Shabana, MD
O'Sullivan, Cathal, MD
Weil, Elizabeth, PhD 

Associate

Espinosa, Claudia, MD
Kaczmarek
, Anya, PA-C
Modan
, Sajid, RPh
Namtu
, Katie, PharmD
Neff
, William, PharmD
Shokouhi
, Shervin, MD
Sprague, Denise, PharmD
Tibbetts
, Robert, PhD

Members-in-Training

Abbas, Saima, MD
Abbott, Stephen, MD
Adejumo
, Adetunji, MD
Ahmed, Saud, MD
Ahmed, Yassar, MD
Al Akhrass, Fadi, MD
Alqahtani, Hadi, MD
Bazan, Jose, DO
Bercu
, Tracy, MD
Best
, Leyla, MD
Blanton, Lucas, MD
Blodget
, Emily, MD
Burmann
, Alison, MD
Burton, Catherine, MD
Busowski
, Mary, MD
Cairo, Javier, MD, MPH
Carmody
, Ellie, MD, MPH
Chakrabarti
, Sumontra, MD
Chittick, Paul, MD
Chuang
, Elizabeth, MD
Cober
, Eric, MD
Cooley
, Laura, MD
DeMita
, Rachel, MD
DePetrillo
, John, MD
Derber
, Catherine, MD
Doka
, Najah, MD
Drummond, Wendi, DO, MPH
Eberly
, Matthew, MD
Evans
, Amanda, MD
Fairley
, Jessica, MD
Forrester
, Jennifer, MD
Freed
, Larry, MD
Galang, Gabriel, MD
Gastanaduy
, Paul, MD, MPH
Glasser
, Jessie, MD
Goddard, Amanda, MD
Granada, Michelle, MD
Greer
, Laura, MD
Grennan
, Jonathan, MD
Griffin, Alexander, MD
Gupta
, Sunita, MD
Gutierrez-Jaramillo, Mavel, MD
Han, Jennifer, MD
Haseeb
, Faiuna, MD
Healy, Sara, MD, MPH
Horikoshi
, Yuho, MD
Hsu, Jennifer, MD
Ibanez
, Cedric, MD
Imperial, Miguel, MD
James, Scott, MD
Jaspan
, Heather, MD, PhD
Jauregui
, Clara, MD
Jordon-Villegas
, Alejaondro, MD
Joshi
, Samit, DO
Kalyoussef
, Sabah, DO
Khan
, Zartash, MD
Khyne, Aye, MD
Klotchko
, Alena, MD
Krishnan, Sujatha, MD
Kroll, Jing, MD
Kufelnicka, Anna, MD
Lat
, Asma, PharmD
Lazarte
, Susana, MD
Lazenby
, Gweneth, MD
Lewis, Paul, PharmD
Lloyd
, Spencer, MD
Lundgren
, Ingrid, MD
Lustberg
, Mark, MD, PhD
Mekonnen
, Legesse, MD
Melgarejo,Nicolas, MD
Mercado, Diana, MD
Mikati
, Tarek, MD
Moore, Christopher, MD
Mora
, Andrea, PharmD
Moss
, Nicholas, MD
Nair, Malloy, MD
Nog, Rajat, MD
Oana, Iulia, MD
Osborn, Matthew, MD
Osinusi
, Anu, MD
Palnitkar
, Rachana, MD
Partovi, Iris, MD
Patel
, Nishita, MD
Patel, Tarak, MD
Patil, Naveen, MD
Pau, Wilson, MD
Perez-Acosta
, Sergio, MD
Rana
, Aadia, MD
Ranade, Prachi, MD
Redelman-Sidi
, Gil, MD
Roberts
, Kimberly, MD
Rodriguez
, Minerva, MD
Rothenberger, Meghan, MD
Saharia
, Kapil, MD
Sanchez, Martha, MD
Sanda
, Alina, MD
Schein, Rebecca, MD
Schumacher
, Sandra, MD, MPH
Scoma
, Michael, MD
Sensenig
, Rebekah, DO
Sharma
, Kavita, MD
Shields, Ryan, PharmD
Singh
, Lav, MD
Smith
, Scott, MD, PhD
Smith
, Laurale, MD
Snyder, Graham, MD
Stagliano
, David, MD
Stepanyuk
, Olena, MD
Subhani, Nida, MD
Tamma, Pranita, MD
Taniguchi, Toshibumi, MD
Taylor, James, MD
Thomas
, Nicole, MD
Top
, Karina, MD
Treakle, Amy, MD
Tsalik
, Ephraim, MD, PhD
Tse
, Alena, MD
Udani, Paras, DO
Villegas
, Alejandro, MD
Vodela
, Ravindhar, MD
Warner, Gregory, MD
Watson
, Clay, MD
Wong
, Alexander, MD
Zeuli
, John, PharmD 

In Memoriam

Feigin, Ralph D., MD