Abstract Purpose of Review Deep neck infections (DNI) are serious infections that can have fatal complications and may have unpredictable outcomes despite parenteral antibiotic therapy. We aimed to investigate the prognostic factors determinig the success of empirical parenteral antibiotic therapy when it is employed together with surgical drainage in patients diagnosed with DNI. Recent Findings A retrospective study was conducted on 112 patients who underwent surgical drainage due to DNI between September 15, 2019, and September 15, 2024 at the Otorhinolaryngology Department of our hospital. 77 patients with complete blood counts and culture results were included in the study. Complications, including necrotizing fasciitis (on admission) and tracheotomy (within the first 48 h), occurred in 9.1% of cases. 38% of patients who were treated with empirical Primary Group Antibiotic combinations (penicillins, cephalosporins, quinolones, clindamycin, metronidazol) required a switch to Secondary Group Antibiotic combinations (vancomycin, teicoplanin, linezolid, carbapenems, piperacillin-tazobactam). There were significant differences in terms of abscess extent, neutrophil count and duration of hospitalization between patients requiring treatment change and those for whom empirical treatment was sufficient. Complications were significantly higher in patients with multi-region abscesses, higher systemic immune-inflammatory (SII) index and neutrophil counts. ( p < 0.05). Summary In patients with multi-region abscessess and an SII index cut-off value of 1616.5 according to ROC analysis, initiation of broad-spectrum Secondary Group Antibiotic combinations together with surgical drainage of abscesses can effectively reduce complication rates and shorten the duration of hospital stay.

Purpose of ReviewTo define international clinical pharmacist contributions to managing sepsis in critically unwell patients and explore variation.Recent FindingsClinical pharmacists improve clinical outcomes and cost efficiencies. They provide pharmaceutical advice on selection, administration, plus monitoring of antimicrobials and supportive therapies. Logistical activities reduce drug administration times. Guideline production, patient/clinician education, prescribing error identification, plus therapeutic optimisation activities are also reported.SummaryA survey incorporating semi-structured interviews identified further antimicrobial stewardship, prescribing and digital contributions to optimise sepsis management. However, disparities associated with multidisciplinary team integration and intensive care unit service provision were found. Variability was attributed to multifaceted physical, social, financial, training and education themes. Findings empower collaborations between pharmacists and stakeholders to identify and overcome contribution barriers. Strategies to mitigate barriers and enhance sepsis contributions were envisaged by reported aspirations. These emphasised the importance of professional advocacy, interprofessional education and impactful implementation research.

Purpose of ReviewAntimicrobial resistance continues to increase throughout the world, with the impact on critically ill children in low- and middle-income paediatric intensive care units largely unknown.Recent FindingsThere has been a global shift indicating a predominance of Gram-negative bacilli among multidrug-resistant isolates. A 4-year review (2019 to 2022) found a progressive and substantial increase in the incidence of carbapenem-resistant Klebsiella pneumoniae (29% to 51%) alongside high levels of carbapenem-resistant Acinetobacter baumannii (93%) within the paediatric intensive care unit at the Chris Hani Baragwanath Academic Hospital in South Africa. The pharmacological treatment of these infections relies heavily on the continued use of carbapenems, often in combination with colistin.SummaryThe burden of antimicrobial resistance is disproportionately borne, particularly within sub-Saharan Africa and South Asia. The resource-constrained South African public healthcare system, already significantly burdened by both HIV and TB, continues to face several challenges in combating the growth in antimicrobial resistance. Limited access, largely driven by prohibitive costs, to sophisticated laboratory techniques and newer pharmacological agents, leaves the implementation of effective infection prevention and control and antimicrobial stewardship programmes as the most pragmatic options to address the problem.

Purpose of ReviewTo identify opportunities and recent advances in the use of multicentric digital data sources and networks to investigate the epidemiology and management of patients with infections admitted to intensive care units (ICUs).Recent FindingsElectronic surveillance systems for a range of serious infections have been reported from large cohorts with evident improvements in efficiency, objectivity, and comprehensiveness of coverage as compared to traditional methods. Electronic data, most notably from electronic health records, has been used to define the epidemiology and outcomes of severe infections in several settings and conditions and has facilitated population-based evaluation. Automated alerts and notifications hold promise to identify patients at risk for sepsis and bloodstream infection although demonstration of efficacy in interventional trials is needed.SummaryExploitation of electronic data in ICUs has led to a better understanding of the epidemiology of severe infections and holds promise for future interventional clinical trials.

Purpose of ReviewTo highlight recent literature on airport COVID-19 testing studies among travelers at international borders and to identify factors that may contribute to bias.Recent FindingsLiterature search shows vastly different study designs and goals for airport COVID-19 screening programs, with positivity rates ranging from 0.1 to 100%. Goals included detecting the maximum cases with enforced isolation, determining an accurate positivity rate among travelers, investigating alternative diagnostics, and evaluating pre-travel programs. Participation rates are in the low (27–40%) to high ranges (72–100%).SummaryThe implementation strategy differs depending on the primary goal. If the goal is to ban new cases or perform active surveillance of new variants, then it is reasonable to consider mandatory airport testing, or voluntary testing with genome sequencing and isolation. If the goal is to determine an accurate positivity rate among travelers or effectiveness of pre-travel programs, then it is reasonable to consider an anonymous, voluntary testing program (without associated isolation) to minimize self-selection bias or distortion of travelers.