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Regdanvimab is the only monoclonal antibody available in Korea that targets severe acute respiratory syndrome coronavirus 2. We retrospectively evaluated the clinical characteristics of 374 adults hospitalized with coronavirus disease 2019 (COVID-19) who were treated with regdanvimab from September through December 2021. In total, 322 (86.1%) patients exhibited risk factors for disease progression. Most patients (91.4%) improved without additional treatment. No patient died or was transferred to intensive care. This study shows that regdanvimab prevented disease progression in high-risk patients with mild to moderate COVID-19 infections during Delta variant predominance. [ABSTRACT FROM AUTHOR]

배경 There is limited information describing the presenting characteristics and dynamic clinical change of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection diagnosed at early phase of illness. Case series of patients with COVID-19 admitted to 11 hospitals in South Korea. 방법 Patients with confirmed SARS-CoV-2 infection by positive PCR testing of respiratory specimens by active surveillance and finally discharged between February 20 and April 30, 2020 were included. Patients were classified into mild and non-mild groups on initial admission according to oxygen demand and Sequential Organ Failure Assessment score, and the mild group was followed up and sub-grouped into non-aggravation and aggravation groups. 결과 A total of 161 patients with SARS-COV2 infection were enrolled. Among mild group of 136 patients, 11.7% of patients experienced clinical aggravation during hospitalization but there was no initial clinical parameter on admission predicting their aggravation. Fever (OR, 4.56), thrombocytopenia (OR, 12.87), fever (OR, 27.22) and LDH >300 U/L (OR, 18.35), and CRP >1 mg/dL (OR, 11.31) significantly indicated the aggravation in the 1st, 2nd, 3rd, and 4th 5-days-periods, respectively. The PCR positivity lasted for median 22 days and 32 days after onset of illness in the non-aggravation and aggravation groups, respectively. 결론 Old age was associated with early severe presentation. Clinical aggravation among asymptomatic or mild patients could not be predicted initially but was heralded by fever and several laboratory markers during the clinical course. [ABSTRACT FROM AUTHOR]

Background: Vertebral osteomyelitis (VO) is a rare but serious condition, and a potentially significant cause of morbidity. Methicillin-susceptible Staphylococcus aureus (MSSA) is the most common microorganism in native VO. Long-term administration of parenteral and oral antibiotics with good bioavailability and bone penetration is required for therapy. Use of oral β-lactams against staphylococcal bone and joint infections in adults is not generally recommended, but some experts recommend oral switching with β-lactams. This study aimed to describe the current status of antibiotic therapy and treatment outcomes of oral switching with β-lactams in patients with MSSA VO, and to assess risk factors for treatment failure. Materials and Methods This retrospective study included adult patients with MSSA VO treated at nine university hospitals in Korea between 2005 and 2014. Treatment failure was defined as infection-related death, microbiological relapse, neurologic deficits, or unplanned surgical procedures. Clinical characteristics and antibiotic therapy in the treatment success and treatment failure groups were compared. Risk factors for treatment failure were identified using the Cox proportional hazards model. Resu A total of 100 patients with MSSA VO were included. All patients were treated, initially or during antibiotic therapy, with one or more parenteral antibiotics. Sixty-nine patients received one or more oral antibiotics. Antibiotic regimens were diverse and durations of parenteral and oral therapy differed, depending on the patient and the hospital. Forty-two patients were treated with parenteral and/or oral β-lactams for a total duration of more than 2 weeks. Compared with patients receiving parenteral p-lactams only, no significant difference in success rates was observed in patients who received oral p-lactams for a relatively long period. Sixteen patients had treatment failure. Old age (adjusted hazard ratio [HR] 5.600,95% confidence interval [Cl] 1.402 - 22.372, P= 0.015) and failure to improve C-reactive protein levels at follow-up (adjusted HR 3.388,95% Cl 1.168 - 9.829, P= 0.025) were independent risk factors for treatment failure. Conclusion In the study hospitals, diverse combinations of antibiotics and differing durations of parenteral and oral therapy were used. Based on the findings of this study, we think that switching to oral (3-lactams may be safe in certain adult patients with MSSA VO. Since limited data are available on the efficacy of oral antibiotics for treatment of staphylococcal VO in adults, further evaluation of the role of oral switch therapy with (3-lactams is needed [ABSTRACT FROM AUTHOR]

Antibiotic stewardship is a key strategy for limiting antibiotic resistance. Over the last decade the South Korean government has implemented a series of healthcare policies directed to this end, consisting of legislative separation of drug prescribing and dispensing, antibiotic utilization reviews, healthcare quality assessment, and public reporting. As a result, the proportion of antibiotic prescriptions for acute upper respiratory tract infections in primary healthcare facilities decreased from 72.9% in 2002 to 42.7% in 2013. However, no significant decrease in antibiotic resistance occurred over the same period in clinically important bacteria such as Streptococcus pneumoniae. These government-driven policies played a pivotal role in improving antibiotic use for outpatients and surgical patients in South Korea. However, to achieve long-lasting successful outcomes, coordinated efforts and communications among the stakeholders, including physicians and medical societies, are needed. [ABSTRACT FROM AUTHOR]