Infectious Disease Conferences Research Articles

Abstracts of the 12th International Equine Infectious Diseases Conference International Conference Centre (CID), Deauville, France 30th September–4th October 2024

Abstracts of the 12th International Equine Infectious Diseases Conference International Conference Centre (CID), Deauville, France 30th September–4th October 2024

Abstracts from the 5th Manipal International Infectious Diseases Conference

Abstracts from the 5th Manipal International Infectious Diseases Conference

VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation): protocol for a multicenter randomized open-label trial of watchful waiting versus antimicrobial therapy for ventilator-associated tracheobronchitis.

Ventilator-associated tracheobronchitis is a common condition among invasively ventilated patients in intensive care units, for which the best treatment strategy is currently unknown. We designed the VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) trial to assess whether a watchful waiting antibiotic treatment strategy is noninferior to routine antibiotic treatment for ventilator-associated tracheobronchitis regarding days free of mechanical ventilation. VATICAN is a randomized, controlled, open-label, multicenter noninferiority trial. Patients with suspected ventilator-associated tracheobronchitis without evidence of ventilator-associated pneumonia or hemodynamic instability due to probable infection will be assigned to either a watchful waiting strategy, without antimicrobial administration for ventilator-associated tracheobronchitis and prescription of antimicrobials only in cases of ventilator-associated pneumonia, sepsis or septic shock, or another infectious diagnosis, or to a routine antimicrobial treatment strategy for seven days. The primary outcome will be mechanical ventilation-free days at 28 days, and a key secondary outcome will be ventilator-associated pneumonia-free survival. Through an intention-to-treat framework with a per-protocol sensitivity analysis, the primary outcome analysis will address noninferiority with a 20% margin, which translates to a 1.5 difference in ventilator-free days. Other analyses will follow a superiority analysis framework. The VATICAN trial will follow all national and international ethical standards. We aim to publish the trial in a high-visibility general journal and present it at critical care and infectious disease conferences for dissemination. These results will likely be immediately applicable to the bedside upon trial completion and will provide information with a low risk of bias for guideline development.

Late-Onset Granulomatous Pneumocystis jirovecii Pneumonia in A Renal Transplant Recipient: A Clinical Grand Round Conference Case in 2022.

Late-onset Pneumocystis jirovecii pneumonia (PCP) can be developed in solid organ transplant (SOT) patients. Granulomatous P. jirovecii pneumonia (GPCP) can occur in immunocompromised patients, but has rarely been reported in SOT recipients. The diagnosis of GPCP is difficult since the sensitivity of sputum and bronchoalveolar lavage is low and atypical patterns are shown. A 60-year-old man, who had undergone renal transplantation 24 years ago presented with nodular and patchy lung lesions. He was asymptomatic and stable. After empirical treatment with a fluoroquinolone, the condition partially resolved but relapsed 4 months later. The pulmonary nodule was resected, and GPCP was confirmed. The pathogenesis of GPCP remains unclear, but in SOT recipients presenting with an atypical lung pattern, GPCP should be considered. This case was discussed at the Grand Clinical Ground of the Korean Society of Infectious Disease conference on November 3, 2022.

Reflecting on the 11th International Equine Infectious Diseases Conference.

Julia Kydd, Martin Nielsen and Andrew Waller highlight some of the key presentations given at last year's 11th International Equine Infectious Diseases Conference, which was held virtually.

Mitigating the Impact of Emerging Animal Infectious Disease Threats: First Emerging Animal Infectious Diseases Conference (EAIDC) Report.

From 29 November to 1 December 2021, an “emerging animal infectious disease conference (EAIDC)” was held at the Pennsylvania State University. This conference brought together distinguished thought leaders in animal health, veterinary diagnostics, epidemiology and disease surveillance, and agricultural economics. The conference’s primary objective was to review the lessons learned from past experiences in dealing with high-consequence animal infectious diseases to inform an action plan to prepare for future epizootics and panzootics. Invited speakers and panel members comprised world-leading experts in animal infectious diseases from federal state agencies, academia, professional societies, and the private sector. The conference concluded that the biosecurity of livestock operations is critical for minimizing the devastating impact of emerging animal infectious diseases. The panel also highlighted the need to develop and benchmark cutting-edge diagnostics for rapidly detecting pathogens in clinical samples and the environment. Developing next-generation pathogen agnostic diagnostics will help detect variants of known pathogens and unknown novel pathogens. The conference also highlighted the importance of the One Health approach in dealing with emerging animal and human infectious diseases. The recommendations of the conference may be used to inform policy discussions focused on developing strategies for monitoring and preventing emerging infectious disease threats to the livestock industry.

Health Care Professionals' Perspectives on Life-Course Immunization: A Qualitative Survey from a European Conference.

Today, fewer children die each year from vaccine-preventable diseases than older adults. Health systems need new immunization strategies to tackle the burden of vaccine-preventable disease in an aging society. A life-course immunization (LCI) approach—which entails vaccination throughout an individual’s lifespan—enables adults to age with reduced risk to disease, thereby enabling healthy, active and productive aging. We conducted an audience response system (ARS)-based survey to investigate HCP perspectives on LCI in an opportunistic sample of 222 health care professionals (HCPs) from around the world who attended a European infectious diseases conference. Survey results show that LCI is a priority for HCPs (77.4%–88.6%), with most of them stating the need to frame it as a part of a healthy lifestyle (91.0%–100.0%). Insufficient LCI recommendations by vaccine providers (12.9%–33.3%) and governments (15.2%–41.9%) and insufficient targeted budget allocation (6.1%–21.7%) were indicated as the main barriers to implement LCI, ahead of vaccine hesitancy (9.7%–15.2%). HCPs were willing to make LCI a gateway to healthy aging but need support to work together with other stakeholders involved in the vaccination journey. This could be a step towards equitable health care for all of society.

Amikacin Liposome Inhalation Suspension for Mycobacterium avium Complex Lung Disease

OBJECTIVE: To review the pharmacology, pharmacokinetics, pharmacodynamics, clinical efficacy, safety, administration, and role of amikacin liposome inhalation suspension (ALIS) in treatment of Mycobacterium avium complex (MAC) lung disease.<br/> DATA SOURCES: A PubMed search using the terms "amikacin inhaled," "nebulized," and "liposome suspension" was performed. Selected infectious diseaseconference posters were also examined for relevant information. In addition, pertinent guidelines were reviewed.<br/> STUDY SELECTION/DATA EXTRACTION: Guidelines for the management of nontuberculous mycobacterial infections from the American Thoracic Society/ Infectious Diseases Society of America and the British Thoracic Society were used to summarize guidelinebased therapy (GBT). A phase II and a phase III clinical trial were reviewed to evaluate the role of ALIS in the treatment of MAC lung disease.<br/> DATA SYNTHESIS: ALIS is a new formulation of inhaled amikacin (AMK) indicated for the treatment of MAC lung disease refractory to GBT in adults who are not candidates for intravenous AMK. An ongoing clinical trial has demonstrated that once-daily ALIS plus GBT results in higher rates of culture conversion compared with GBT alone by month 6 among patients with a mean age of 65 years. The most common adverse reactions associated with ALIS were dysphonia, cough, bronchospasm, hemoptysis, and ototoxicity. Nephrotoxicity was uncommon.<br/> CONCLUSION: ALIS has been shown to increase culture conversion rates when added to GBT in adults with difficult-to-treat MAC lung disease. ALIS is associated with high rates of pulmonary and auditory adverse reactions and a low risk of renal adverse reactions. ALIS may be an attractive treatment option for older adults who are at high risk for nephrotoxicity.

Influenza vaccines in immunosuppressed adults with cancer.

This is an update of the Cochrane review published in 2013, Issue 10.Immunosuppressed cancer patients are at increased risk of serious influenza-related complications. Guidelines, therefore, recommend influenza vaccination for these patients. However, data on vaccine effectiveness in this population are lacking, and the value of vaccination in this population remains unclear. To assess the effectiveness of influenza vaccine in immunosuppressed adults with malignancies. The primary review outcome is all-cause mortality, preferably at the end of the influenza season. Influenza-like illness (ILI, a clinical definition), confirmed influenza, pneumonia, any hospitalisations, influenza-related mortality and immunogenicity were defined as secondary outcomes. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and LILACS databases up to May 2017. We searched the following conference proceedings: ICAAC, ECCMID, IDSA (infectious disease conferences), ASH, ASBMT, EBMT (haematological), and ASCO (oncological) between the years 2006 to 2017. In addition, we scanned the references of all identified studies and pertinent reviews. We searched the websites of the manufacturers of influenza vaccine. Finally, we searched for ongoing or unpublished trials in clinical trial registry databases. Randomised controlled trials (RCTs), prospective and retrospective cohort studies and case-control studies were considered, comparing inactivated influenza vaccines versus placebo, no vaccination or a different vaccine, in adults (16 years and over) with cancer. We considered solid malignancies treated with chemotherapy, haematological cancer patients treated or not treated with chemotherapy, cancer patients post-autologous (up to six months after transplantation) or allogeneic (at any time) haematopoietic stem cell transplantation (HSCT). Two review authors independently assessed the risk of bias and extracted data from included studies adhering to Cochrane methodology. Meta-analysis could not be performed because of different outcome and denominator definitions in the included studies. We identified six studies with a total of 2275 participants: five studies comparing vaccination with no vaccination, and one comparing adjuvanted vaccine with non-adjuvanted vaccine. Three studies were RCTs, one was a prospective observational cohort study and two were retrospective cohort studies.For the comparison of vaccination with no vaccination we included two RCTs and three observational studies, including 2202 participants. One study reported results in person-years while the others reported results per person. The five studies were performed between 1993 and 2015 and included adults with haematological diseases (three studies), patients following bone marrow transplantation (BMT) (two studies) and solid malignancies (three studies).One RCT and two observational studies reported all-cause mortality; the RCT showed similar mortality rates in both arms (odds ratio (OR) 1.25 (95% CI 0.43 to 3.62; 1 study, 78 participants, low-certainty evidence)); and the observational studies demonstrated a significant association between vaccine receipt and lower risk of death, adjusted hazard ratio 0.88 (95% CI 0.78 to 1; 1 study, 1577 participants, very low-certainty evidence) in one study and OR 0.42 (95% CI 0.24 to 0.75; 1 study, 806 participants, very low-certainty evidence) in the other. One RCT reported a reduction in ILI with vaccination, while no difference was observed in one observational study. Confirmed influenza rates were lower with vaccination in one RCT and the three observational studies, the difference reaching statistical significance in one. Pneumonia was observed significantly less frequently with vaccination in one observational study, but no difference was detected in another or in the RCT. One RCT showed a reduction in hospitalisations following vaccination, while an observational study found no difference. No life-threatening or persistent adverse effects from vaccination were reported. The strength of evidence was limited by the low number of included studies and by their low methodological quality and the certainty of the evidence for the mortality outcome according to GRADE was low to very low.For the comparison of adjuvanted vaccine with non-adjuvanted vaccine, we identified one RCT, including 73 patients. No differences were found for the primary and all secondary outcomes assessed. Mortality risk ratio was 0.54 (95% CI 0.05 to 5.73; low-certainty evidence) in the adjuvanted vaccine group. The quality of evidence was low due to the small sample size and the large confidence intervals for all outcomes. Observational data suggest lower mortality and infection-related outcomes with influenza vaccination. The strength of evidence is limited by the small number of studies and low grade of evidence. It seems that the evidence, although weak, shows that the benefits overweigh the potential risks when vaccinating adults with cancer against influenza. However, additional placebo or no-treatment controlled RCTs of influenza vaccination among adults with cancer is ethically questionable.There is no conclusive evidence regarding the use of adjuvanted versus non-adjuvanted influenza vaccine in this population.

Twitter big data and infectious disease conferences

Public health and communicable diseases are closely linked, from the planning, delivery, and evaluation of vaccination programmes to responding to cases and outbreaks of familiar and emerging infections. However, many professionals (myself included) are only involved in the health protection role during periods on call, so there is the need to remain up to date through training and education.

Planning an innovation marathon at an infectious disease conference with results from the International Meeting on Emerging Diseases and Surveillance 2016 Hackathon

A hackathon is best described as an ‘innovation marathon’. Derived from the words ‘hacking’ and ‘marathon’, it brings together multidisciplinary teams to collaborate intensely over a short period of time to define a problem, devise a solution, and design a working prototype. International scientific meetings are conducive to successful hackathons, providing an audience of expert professionals who describe challenges and ensure the proposed solutions address end-user needs. Collaborations with local organizations and academic centers are crucial to attracting complementary specialties such as IT advisors, engineers, and entrepreneurs to develop sustainable projects. The core process of first identifying and deconstructing a problem followed by solution iteration is applicable to challenges at workplaces around the world. Ultimately, this model can be used to drive innovation and catalyze change in the global health community. The planning, execution, and outcomes of a hackathon event organized in conjunction with the International Meeting on Emerging Diseases and Surveillance (IMED 2016) are described in this article. Physicians, public health practitioners, veterinarians, IT professionals, engineers, and entrepreneurs came together for 2days to develop solutions at the intersection of emerging infectious diseases and climate change. Projects that resulted from the IMED 2016 Hackathon included environmental impact assessment software for humanitarian organization relief efforts; enhanced communication tools to prevent disease outbreaks; a participatory mobile application to speed the elimination of rabies in Indonesia; integrated disease surveillance platforms; and an improved search function for infectious disease outbreak reports in the ProMED-mail network.

What Makes a Tweet Fly? Analysis of Twitter Messaging at Four Infection Control Conferences.

OBJECTIVE To examine tweeting activity, networks, and common topics mentioned on Twitter at 4 international infection control and infectious disease conferences. DESIGN A cross-sectional study. METHODS An independent company was commissioned to undertake a Twitter 'trawl' each month between July 1, 2016, and November 31, 2016. The trawl identified any tweets that contained the official hashtags of the conferences for (1) the UK Infection Prevention Society, (2) IDWeek 2016, (3) the Federation of Infectious Society/Hospital Infection Society, and (4) the Australasian College for Infection Prevention and Control. Topics from each tweet were identified, and an examination of the frequency and timing of tweets was performed. A social network analysis was performed to illustrate connections between users. A multivariate binary logistic regression model was developed to explore the predictors of 'retweets.' RESULTS In total, 23,718 tweets were identified as using 1 of the 2 hashtags of interest. The results demonstrated that the most tweets were posted during the conferences. Network analysis demonstrated a diversity of twitter networks. A link to a web address was a significant predictor of whether a tweet would be retweeted (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.9-2.1). Other significant factors predicting a retweet included tweeting on topics such as Clostridium difficile (OR, 2.0; 95% CI, 1.7-2.4) and the media (OR, 1.8; 95% CI, 1.6-2.0). Tweets that contained a picture were significantly less likely to be retweeted (OR, 0.06; 95% CI, 0.05-0.08). CONCLUSION Twitter is a useful tool for information sharing and networking at infection control conferences. Infect Control Hosp Epidemiol 2017;38:1271-1276.

Burden of Surgical Site Infections Associated with Select Spine Operations and Involvement of Staphylococcus aureus.

Background: Spine operations may be indicated for treatment of diseases including vertebral injuries, degenerative spinal conditions, disk disease, spinal misalignments, or malformations. Surgical site infection (SSI) is a clinically important complication of spine surgery. Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA), is a leading cause of post-spinal SSIs.Methods: PubMed and applicable infectious disease conference proceedings were searched to identify relevant published studies. Overall, 343 full-text publications were screened for epidemiologic, mortality, health care resource utilization, and cost data on SSIs associated with specified spine operations.Results: Surgical site infection rates were identified in 161 studies from North America, Europe, and Asia. Pooled average SSI and S. aureus SSI rates for spine surgery were 1.9% (median, 3.3%; range, 0.1%–22.6%) and 1.0% (median, 2.0%; range, 0.02%–10.0%). Pooled average contribution of S. aureus infections to spinal SSIs was 49.3% (median, 50.0%; range, 16.7%–100%). Pooled average proportion of S. aureus SSIs attributable to MRSA was 37.9% (median, 42.5%; range, 0%–100%). Instrumented spinal fusion had the highest pooled average SSI rate (3.8%), followed by spinal decompression (1.8%) and spinal fusion (1.6%). The SSI-related mortality rate among spine surgical patients ranged from 1.1%–2.3% (three studies). All studies comparing SSI and control cohorts reported longer hospital stays for patients with SSIs. Pooled average SSI-associated re-admission rate occurring within 30 d from discharge ranged from 20% to 100% (four studies). Pooled average SSI-related re-operation rate was 67.1% (median, 100%; range, 33.5%–100%). According to two studies reporting direct costs, spine surgical patients incur approximately double the health care costs when they develop an SSI.Conclusions: Available published studies demonstrate a clinically important burden of SSIs related to spine operations and the substantial contribution of S. aureus (including MRSA). Preventive strategies aimed specifically at S. aureus SSIs could reduce health care costs and improve patient outcomes for spine operations.

Is It Time for Vaccination to "Go Viral"?

To promote and sustain excellent vaccination coverage, while preserving the key core values of ethics, truth, transparency and trust, the vaccine community should adopt modern digital communication strategies. This article summarizes our views-as experts in multidisciplinary field of vaccinology (consisting of an anthropologist, a public health policy advisor, a vaccine industry expert, a health care journalist and a practicing physician)-which were presented at a satellite symposium held at the 33rd European Society of Paediatric Infectious Disease conference in Leipzig, Germany, in May 2015. This article aims to suggest and recommend strategies to promote vaccination awareness, and highlight proactive measures for building, maintaining and enhancing trust in vaccination through innovative communication and evidence-based interaction with the end user. We believe that converting the results of vaccine research into a successful vaccination program, and replacing misinformation with evidence-based communication, will require a multidisciplinary approach that embraces modern digital and tailored applications to reach out to all populations.

The 12th Edition of the Scientific Days of the National Institute for Infectious Diseases “Prof. Dr. Matei Bals” and the 12th National Infectious Diseases Conference

The 12th Edition of the Scientific Days of the National Institute for Infectious Diseases “Prof. Dr. Matei Bals” and the 12th National Infectious Diseases Conference

Drug interactions and protease inhibitors used in the treatment of hepatitis C: How to manage?

The first-generation protease inhibitors (PI) boceprevir and telaprevir combined with pegylated interferon have revolutionized the treatment of type-1 hepatitis C by increasing the rates of sustained virologic response. However, they induce drug interactions, and their clinical relevance is difficult to predict. This review compiles available data on drug-drug interactions (DDI) based on their pharmacokinetic and pharmacodynamic properties with the aim of assisting clinicians in managing DDI METHODS: PubMed, drug interaction databases and hepatology and infectious disease conference abstracts were systematically searched using the key search terms "interaction", "hepatitis C", "telaprevir" and "boceprevir". All known interactions were compiled and reclassified according to their pharmacokinetic and pharmacodynamic mechanisms. The state of knowledge of interaction mechanisms are reported and a therapeutic approach is proposed. Boceprevir and telaprevir are both substrates and potent inhibitors of cytochrome P450 3A4 and the drug transporter P-glycoprotein. They induce overdosage but can sometimes decrease the effect of other drugs by inducing other cytochromes. Overdosage or low dosage mainly affects drugs with a narrow therapeutic range, such as immunosuppressants or antiretrovirals. The distribution and elimination of PI are unaffected by interactions. In terms of pharmacodynamic interactions, PI can trigger drug-induced QT interval prolongation, which means that clinicians should manage such risk factors as potassium/magnesium levels or avoid other QT-prolonging drugs. Management of hepatitis C therapy is complex. The key to interpreting DDI data is a solid understanding of the pharmacokinetic and pharmacodynamic profiles of the drugs involved. Their ability to inhibit cytochrome P450 3A4 and prolong the QT interval can have significant clinical consequences. This review provides a practical guide to the safe and effective management of therapy with boceprevir and telaprevir.

Influenza vaccines in immunosuppressed adults with cancer

Immunosuppressed cancer patients are at increased risk of serious influenza-related complications. Guidelines, therefore, recommend influenza vaccination for these patients. However, data on vaccine effectiveness in this population is lacking, and the value of vaccination in this population remains unclear. To assess the effectiveness of influenza vaccine in immunosuppressed adults with malignancies. The primary review outcome is all-cause mortality, preferably at the end of the influenza season. Influenza-like illness (ILI, a clinical definition), confirmed influenza, pneumonia, any hospitalization and influenza-related mortality were defined as secondary outcomes. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and LILACS databases up to August 2013. We searched the following conference proceedings: ICAAC, ECCMID, IDSA (infectious disease conferences), ASH, ASBMT, EBMT (hematological), and ASCO (oncological) between the years 2006 to 2010. In addition, we scanned the references of all identified studies and pertinent reviews. We searched the websites of the manufacturers of influenza vaccine. Finally, we searched for ongoing or unpublished trials in clinical trial registry databases using the website. Randomized controlled trials (RCTs), prospective and retrospective cohort studies and case-control studies were considered, comparing inactivated influenza vaccines versus placebo, no vaccination or a different vaccine, in adults (16 years and over) with cancer. We considered solid malignancies treated with chemotherapy, haematological cancer patients treated or not treated with chemotherapy, cancer patients post-autologous (up to six months after transplantation) or allogeneic (at any time) hematopoietic stem cell transplantation. Two review authors independently assessed the risk of bias and extracted data from included studies adhering to Cochrane methodology. Meta-analysis could not be performed because of different outcome and denominator definitions in the included studies. We identified four studies: one RCT and three observational studies, including 2124 participants. One study reported results in person-years while the other three reported per person. The studies were performed between 1993 and 2012 and included adults with haematological diseases (two studies), patients following bone marrow transplantation (one study) and solid malignancies (three studies). Only two observational studies reported all-cause mortality; one showing an adjusted hazard ratio (HR) of 0.88 (95% CI 0.77 to 0.99) for death with vaccination and the other reporting an odds ratio (OR) of 0.43 (95% CI 0.26 to 0.71). The RCT reported a statistically significant reduction in ILI with vaccination, while no difference was observed in one observational study. Confirmed influenza rates were lower with vaccination in the three observational studies, the difference reaching statistical significance in one. Pneumonia was observed significantly less frequently with vaccination in one observational study, but no difference was detected in another or in the RCT. The RCT showed a reduction in hospitalizations following vaccination, while an observational study found no difference. No life-threatening or persistent adverse effects from vaccination were reported. The strength of evidence is limited by the low number of included studies and by their low methodological quality (high risk of bias). Observational data suggests a lower mortality with influenza vaccination. Infection-related outcomes were lower or similar with influenza vaccination. The strength of evidence is limited by the small number of studies and by the fact that only one was a RCT. Influenza vaccination is safe and the evidence, although weak, is in favour of vaccinating adults with cancer receiving chemotherapy.

Systematic review of the incidence and prevalence of genital warts.

BackgroundAnogenital warts (AGWs) are a common, highly infectious disease caused by the human papillomavirus (HPV), whose high recurrence rates contribute to direct medical costs, productivity loss and increased psychosocial impact. Because of the lack of a systematic review of the epidemiology of AGWs in the literature, this study reviewed the published medical literature on the incidence and prevalence of AGWs.MethodsA comprehensive literature search was performed on the worldwide incidence and prevalence of AGWs between 2001 and 2012 using the PubMed and EMBASE databases. An additional screening of abstracts from relevant sexual health and infectious disease conferences from 2009 to 2011 was also conducted. Only original studies with general adult populations (i.e., at least including ages 20 through 40 years) were included.ResultsThe overall (females and males combined) reported annual incidence of any AGWs (including new and recurrent) ranged from 160 to 289 per 100,000, with a median of 194.5 per 100,000. New AGW incidence rates among males ranged from 103 to 168 per 100,000, with a median of 137 per 100,000 and among females from 76 to 191 per 100,000, with a median of 120.5 per 100,000 per annum. The reported incidence of recurrent AGWs was as high as 110 per 100,000 among females and 163 per 100,000 among males. Incidence peaked before 24 years of age in females and between 25 and 29 years of age among males. The overall prevalence of AGWs based on retrospective administrative databases or medical chart reviews or prospectively collected physician reports ranged from 0.13% to 0.56%, whereas it ranged from 0.2% to 5.1% based on genital examinations.ConclusionsThe literature suggests that AGWs are widespread and the prevalence depends on study methodology as suggested by higher rates reported from routine genital examinations versus those from treatment records. However, there remains a need for more population-based studies from certain regions including Africa, Latin America and Southern Asia to further elucidate the global epidemiology of this disease.

Combinational therapies for HIV: a focus on EVG/COBI/FTC/TDF

Introduction: The co-formulation of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF) is a new, investigational, once-daily (q.d.) drug, currently undergoing Phase II and III clinical trials. Next to the nucleotide/nucleoside reverse transcriptase inhibitors FTC and TDF, it contains EVG, the second member of the HIV-1 integrase strand transfer inhibitor class, together with its pharmacokinetic booster COBI.Areas covered: In this article, the authors review EVG/COBI/FTC/TDF, in addition to discussing the single-tablet regimens (STRs) containing EFV/FTC/TDF or RPV/FTC/TDF, and the investigational combination pill containing dolutegravir, lamivudine and abacavir (DTG/3TC/ABC, 572-Trii pill). A Medline review was conducted of Phase II and III trials, as well as a review of abstracts from major HIV and infectious disease conferences from 2010 to 2012, involving EVG/COBI/FTC/TDF.Expert opinion: Next to the combination of EFV/FTC/TDF or RPV/FTC/TDF, the co-formulation of EVG/COBI/FTC/TDF offers a new, q.d., single-tablet alternative in treatment-naïve HIV patients. EVG/COBI/FTC/TDF combines a high efficacy with a good tolerability profile. The effect on the renal function and virologic failure with the development of resistance to two or more compounds present in EVG/COBI/FTC/TDF, requires further monitoring. STRs certainly bring the standard for HIV treatment and drug development to a higher level.

2012 Prescott Lecture: The nonpharmacologic basis of therapeutics: To get to the next level in interprofessional patient care, pharmacists need to recognize the social and interpersonal aspects of medical decision making

I'd like to start off by saying I'm very honored to receive the Albert B. Prescott award for this year. To be recognized among the other distinguished recipients is very humbling. I've given a lot of presentations, but never an award acceptance speech like this. So I tried to apply the principles I've learned in giving other presentations. First, know your audience. What do they know? What are they expecting coming into the talk? What level of knowledge do they already possess? It's much harder to pin down this group than, say, third-year student pharmacists at the University of California, San Francisco (UCSF) or even clinicians attending an infectious diseases conference. But I can imagine that you're going to want to hear about leadership, or education, or both, since this award is given by the Pharmacy Leadership & Education Institute. Second, be prepared. So I read all of the Prescott acceptance speeches for the last few years. There were many visionary speeches about the future of pharmacy or what it takes to be a leader. Well, I've never been too good about predictions. In college, we had to turn in an assignment over e-mail and I thought, “This will never last.” Now e-mail runs my life. And I've never really considered myself to be a leader in the traditional sense. So I'll adapt a third piece of advice often given to writers—“write what you know”—and talk a little bit about the challenges I see in my daily work as a clinician in infectious diseases and a teacher of student pharmacists, and from there perhaps draw out some broader implications for the future of pharmacy education and practice. Wait, didn't I say I wouldn't talk about the future of pharmacy? Well, I guess it's just too tempting to give your opinion on such things when given such a platform! About the Prescott Award Albert B. Prescott was a maverick in the late 1800s because of his advocacy of an academic basis for pharmaceutical education. Founder and dean of the College of Pharmacy at the University of Michigan, Prescott nurtured his idea for nearly 40 years before the rest of the profession caught up with his vision. In 1900, Prescott was the first president of the American Association of Colleges of Pharmacy. This chemist, educator, and leader of pharmacists was also instrumental in founding Phi Delta Chi Pharmacy Fraternity at the University of Michigan in 1883, and he was the advisor to the Alpha Chapter and the first Honorary Brother of the fraternity. The Albert. B Prescott Leadership Award was established by Phi Delta Chi in 1987 to honor young pharmacists who lead their field. Now administered by the Pharmacy Leadership & Education Institute, this annual award is bestowed on a pharmacist who is no more than 10 years into his or her career and who has demonstrated exemplary leadership qualities as a student and young pharmacist. The recipient delivers a scholarly lecture on issues such as pharmacy as a profession, leadership, or future trends in pharmacy practice or education. About the Prescott Award Albert B. Prescott was a maverick in the late 1800s because of his advocacy of an academic basis for pharmaceutical education. Founder and dean of the College of Pharmacy at the University of Michigan, Prescott nurtured his idea for nearly 40 years before the rest of the profession caught up with his vision. In 1900, Prescott was the first president of the American Association of Colleges of Pharmacy. This chemist, educator, and leader of pharmacists was also instrumental in founding Phi Delta Chi Pharmacy Fraternity at the University of Michigan in 1883, and he was the advisor to the Alpha Chapter and the first Honorary Brother of the fraternity. The Albert. B Prescott Leadership Award was established by Phi Delta Chi in 1987 to honor young pharmacists who lead their field. Now administered by the Pharmacy Leadership & Education Institute, this annual award is bestowed on a pharmacist who is no more than 10 years into his or her career and who has demonstrated exemplary leadership qualities as a student and young pharmacist. The recipient delivers a scholarly lecture on issues such as pharmacy as a profession, leadership, or future trends in pharmacy practice or education.