Devyani Gholap

TOPLINE:

A single dose of respiratory syncytial virus (RSV) vaccine provided protection against RSV illness and associated health care use in nearly 290,000 older US veterans over 2 respiratory illness seasons compared with unvaccinated individuals; however, protection declined over time, particularly among immunocompromised individuals.

METHODOLOGY:

• Researchers emulated a target trial to assess the long-term effectiveness of a single does of RSV vaccine, administered between September 2023 and March 2024, to prevent RSV infection and associated health care use among older US veterans.
• The primary outcome was any positive RSV test from 14 days after vaccination; secondary outcomes included RSV-associated emergency department or urgent care visits, hospitalizations, and ICU admissions.
• The median follow-up duration, measured from 14 days after vaccination, was 15.8 months, with a maximum of 19.0 months.

TAKEAWAY:

• The estimated vaccines effectiveness against RSV infection decreased from 82.5% (95% CI, 77.5%-86.9%) over 0 to 1 month to 59.4% (95% CI, 55.6%-63.5%) over 0 to 18 months of follow-up.
• Protection against RSV-associated emergency department and urgent care visits fell from 84.9% over 0 to 1 month to 60.6% over 0 to 18 months, and the estimated effectiveness against hospitalizations decreased from 88.9% to 57.3% over the same interval.
• The estimated effectiveness against RSV-associated ICU admissions reduced from 92.5% (95% CI, 61.1%-100%) over 0 to 1 month to 71.9% (95% CI, 42.8%-90.0%) over 0 to 18 months.
• Among immunocompromised individuals, protection against RSV infection showed the largest decline from 75.2% at 0 to 1 month to 39.7% over 18 months.

IN PRACTICE:

"Boosters may be needed, but for now, our efforts should be focused on saving lives and decreasing disease by encouraging vaccination of persons 75 years and older and those 60 years and older with underlying health issues," experts wrote in an accompanying editorial.

SOURCE:

The study was led by Kristina L. Bajema, MD, Veterans Affairs Portland Health Care System, Portland, Oregon. It was published online on November 24, 2025, in JAMA Internal Medicine.

LIMITATIONS:

RSV documentation may have been incomplete for veterans who sought care outside the Veterans Health Administration. The cohort was predominantly White men, limiting generalizability. Residual confounding could not be excluded. Estimates of long-term effectiveness should be interpreted cautiously because they reflect patients who remained in care and may differ from the original matched cohort.

DISCLOSURES:

The study was supported by the US Department of Veterans Affairs Cooperative Studies Program, US Department of Health and Human Services, Biomedical Advanced Research and Development Authority, and FDA. Two authors reported receiving grants from the study funder and/or the Patient-Centered Outcomes Research Institute; one of these authors also reported co-ownership of van Breemen & Hynes, LLC, unrelated to the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

A single dose of respiratory syncytial virus (RSV) vaccine provided protection against RSV illness and associated health care use in nearly 290,000 older US veterans over 2 respiratory illness seasons compared with unvaccinated individuals; however, protection declined over time, particularly among immunocompromised individuals.

METHODOLOGY:

• Researchers emulated a target trial to assess the long-term effectiveness of a single does of RSV vaccine, administered between September 2023 and March 2024, to prevent RSV infection and associated health care use among older US veterans.
• The primary outcome was any positive RSV test from 14 days after vaccination; secondary outcomes included RSV-associated emergency department or urgent care visits, hospitalizations, and ICU admissions.
• The median follow-up duration, measured from 14 days after vaccination, was 15.8 months, with a maximum of 19.0 months.

TAKEAWAY:

• The estimated vaccines effectiveness against RSV infection decreased from 82.5% (95% CI, 77.5%-86.9%) over 0 to 1 month to 59.4% (95% CI, 55.6%-63.5%) over 0 to 18 months of follow-up.
• Protection against RSV-associated emergency department and urgent care visits fell from 84.9% over 0 to 1 month to 60.6% over 0 to 18 months, and the estimated effectiveness against hospitalizations decreased from 88.9% to 57.3% over the same interval.
• The estimated effectiveness against RSV-associated ICU admissions reduced from 92.5% (95% CI, 61.1%-100%) over 0 to 1 month to 71.9% (95% CI, 42.8%-90.0%) over 0 to 18 months.
• Among immunocompromised individuals, protection against RSV infection showed the largest decline from 75.2% at 0 to 1 month to 39.7% over 18 months.

IN PRACTICE:

"Boosters may be needed, but for now, our efforts should be focused on saving lives and decreasing disease by encouraging vaccination of persons 75 years and older and those 60 years and older with underlying health issues," experts wrote in an accompanying editorial.

SOURCE:

The study was led by Kristina L. Bajema, MD, Veterans Affairs Portland Health Care System, Portland, Oregon. It was published online on November 24, 2025, in JAMA Internal Medicine.

LIMITATIONS:

RSV documentation may have been incomplete for veterans who sought care outside the Veterans Health Administration. The cohort was predominantly White men, limiting generalizability. Residual confounding could not be excluded. Estimates of long-term effectiveness should be interpreted cautiously because they reflect patients who remained in care and may differ from the original matched cohort.

DISCLOSURES:

The study was supported by the US Department of Veterans Affairs Cooperative Studies Program, US Department of Health and Human Services, Biomedical Advanced Research and Development Authority, and FDA. Two authors reported receiving grants from the study funder and/or the Patient-Centered Outcomes Research Institute; one of these authors also reported co-ownership of van Breemen & Hynes, LLC, unrelated to the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

A single dose of respiratory syncytial virus (RSV) vaccine provided protection against RSV illness and associated health care use in nearly 290,000 older US veterans over 2 respiratory illness seasons compared with unvaccinated individuals; however, protection declined over time, particularly among immunocompromised individuals.

METHODOLOGY:

• Researchers emulated a target trial to assess the long-term effectiveness of a single does of RSV vaccine, administered between September 2023 and March 2024, to prevent RSV infection and associated health care use among older US veterans.
• The primary outcome was any positive RSV test from 14 days after vaccination; secondary outcomes included RSV-associated emergency department or urgent care visits, hospitalizations, and ICU admissions.
• The median follow-up duration, measured from 14 days after vaccination, was 15.8 months, with a maximum of 19.0 months.

TAKEAWAY:

• The estimated vaccines effectiveness against RSV infection decreased from 82.5% (95% CI, 77.5%-86.9%) over 0 to 1 month to 59.4% (95% CI, 55.6%-63.5%) over 0 to 18 months of follow-up.
• Protection against RSV-associated emergency department and urgent care visits fell from 84.9% over 0 to 1 month to 60.6% over 0 to 18 months, and the estimated effectiveness against hospitalizations decreased from 88.9% to 57.3% over the same interval.
• The estimated effectiveness against RSV-associated ICU admissions reduced from 92.5% (95% CI, 61.1%-100%) over 0 to 1 month to 71.9% (95% CI, 42.8%-90.0%) over 0 to 18 months.
• Among immunocompromised individuals, protection against RSV infection showed the largest decline from 75.2% at 0 to 1 month to 39.7% over 18 months.

IN PRACTICE:

"Boosters may be needed, but for now, our efforts should be focused on saving lives and decreasing disease by encouraging vaccination of persons 75 years and older and those 60 years and older with underlying health issues," experts wrote in an accompanying editorial.

SOURCE:

The study was led by Kristina L. Bajema, MD, Veterans Affairs Portland Health Care System, Portland, Oregon. It was published online on November 24, 2025, in JAMA Internal Medicine.

LIMITATIONS:

RSV documentation may have been incomplete for veterans who sought care outside the Veterans Health Administration. The cohort was predominantly White men, limiting generalizability. Residual confounding could not be excluded. Estimates of long-term effectiveness should be interpreted cautiously because they reflect patients who remained in care and may differ from the original matched cohort.

DISCLOSURES:

The study was supported by the US Department of Veterans Affairs Cooperative Studies Program, US Department of Health and Human Services, Biomedical Advanced Research and Development Authority, and FDA. Two authors reported receiving grants from the study funder and/or the Patient-Centered Outcomes Research Institute; one of these authors also reported co-ownership of van Breemen & Hynes, LLC, unrelated to the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

Army recruits who lost excess weight to enter military training experienced fewer musculoskeletal injuries (MSKIs), particularly in the lower extremities, during basic combat training than those who did not lose weight to join the service.

METHODOLOGY:

• The nation’s obesity epidemic means that fewer individuals meet the US Army’s weight and body-fat standards for entering basic combat training. Only 29% of 17- to 24-year-olds in the country would have qualified to join the military in 2018, with overweight and obesity among the leading disqualifying factors.
• Researchers analyzed data from 3168 Army trainees (mean age, 20.96 years; 62.34% men; mean maximum-ever BMI, 26.71) to examine the association between weight loss before enlistment and rates of MSKI during basic combat training.
• Trainees completed a baseline questionnaire that asked whether the person lost weight to enter the Army and included follow-up questions about the amount of weight lost, duration of weight loss, methods used, and prior physical activity.
• MSKIs were classified as any injury to the musculoskeletal system and further categorized by body region (lower extremities, upper extremities, spine/back, and other areas, including the torso and head/neck).
• Researchers identified MSKIs from medical records collected throughout basic combat training and for up to 6 weeks afterward to capture injuries that occurred during training but were documented only after its completion.

TAKEAWAY:

• Overall, 829 trainees (26.16%) reported losing weight to enter the Army, and they tended to have higher mean maximum-ever BMI, body-fat percentage, and lean mass compared with those who did not lose weight to join the service. The mean weight loss was 9.06 kg at a rate of 1.27 kg/wk among the 723 trainees with complete data.
• The most commonly reported weight-loss methods were exercising more (83.7%), changing diet (61.0%), skipping meals (39.3%), and sweating using a sauna or rubber suit (25.6%).
• Trainees who lost weight to join the service had a lower risk of any MSKI (hazard ratio [HR], 0.86) and lower extremity MSKIs (HR, 0.84) during training than those who did not lose weight to enter the Army. No difference was found between the two groups in the risk of upper extremity, spine/back, or other MSKIs.
• Among trainees who lost weight to join the Army, the amount of time it took to lose weight was not associated with the risk for any MSKI or region-specific MSKIs.

IN PRACTICE:

“The findings highlight that losing excess weight before entering military training may reduce MSKI risk for incoming recruits, enforcing the benefits of healthy weight loss programs,” the authors wrote.

SOURCE:

The study, led by Vy T. Nguyen, MS, DSc, Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, was published online in Obesity .

LIMITATIONS: 

The study did not assess whether the association between weight loss and the rate of MSKIs persisted over long-term military service. How the two most frequently reported weight loss methods — increased exercise and dietary changes — may have influenced the observed association remains unclear. Medical records may not have captured all MSKIs if trainees did not seek medical care due to concerns about graduating on time or being placed on limited duty.

DISCLOSURES:

The study was supported by the US Army Medical Research and Development Command’s Military Operational Medicine Program. Two authors received support from the funder.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com. 

TOPLINE:

Army recruits who lost excess weight to enter military training experienced fewer musculoskeletal injuries (MSKIs), particularly in the lower extremities, during basic combat training than those who did not lose weight to join the service.

METHODOLOGY:

• The nation’s obesity epidemic means that fewer individuals meet the US Army’s weight and body-fat standards for entering basic combat training. Only 29% of 17- to 24-year-olds in the country would have qualified to join the military in 2018, with overweight and obesity among the leading disqualifying factors.
• Researchers analyzed data from 3168 Army trainees (mean age, 20.96 years; 62.34% men; mean maximum-ever BMI, 26.71) to examine the association between weight loss before enlistment and rates of MSKI during basic combat training.
• Trainees completed a baseline questionnaire that asked whether the person lost weight to enter the Army and included follow-up questions about the amount of weight lost, duration of weight loss, methods used, and prior physical activity.
• MSKIs were classified as any injury to the musculoskeletal system and further categorized by body region (lower extremities, upper extremities, spine/back, and other areas, including the torso and head/neck).
• Researchers identified MSKIs from medical records collected throughout basic combat training and for up to 6 weeks afterward to capture injuries that occurred during training but were documented only after its completion.

TAKEAWAY:

• Overall, 829 trainees (26.16%) reported losing weight to enter the Army, and they tended to have higher mean maximum-ever BMI, body-fat percentage, and lean mass compared with those who did not lose weight to join the service. The mean weight loss was 9.06 kg at a rate of 1.27 kg/wk among the 723 trainees with complete data.
• The most commonly reported weight-loss methods were exercising more (83.7%), changing diet (61.0%), skipping meals (39.3%), and sweating using a sauna or rubber suit (25.6%).
• Trainees who lost weight to join the service had a lower risk of any MSKI (hazard ratio [HR], 0.86) and lower extremity MSKIs (HR, 0.84) during training than those who did not lose weight to enter the Army. No difference was found between the two groups in the risk of upper extremity, spine/back, or other MSKIs.
• Among trainees who lost weight to join the Army, the amount of time it took to lose weight was not associated with the risk for any MSKI or region-specific MSKIs.

IN PRACTICE:

“The findings highlight that losing excess weight before entering military training may reduce MSKI risk for incoming recruits, enforcing the benefits of healthy weight loss programs,” the authors wrote.

SOURCE:

The study, led by Vy T. Nguyen, MS, DSc, Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, was published online in Obesity .

LIMITATIONS: 

The study did not assess whether the association between weight loss and the rate of MSKIs persisted over long-term military service. How the two most frequently reported weight loss methods — increased exercise and dietary changes — may have influenced the observed association remains unclear. Medical records may not have captured all MSKIs if trainees did not seek medical care due to concerns about graduating on time or being placed on limited duty.

DISCLOSURES:

The study was supported by the US Army Medical Research and Development Command’s Military Operational Medicine Program. Two authors received support from the funder.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com. 

TOPLINE:

Army recruits who lost excess weight to enter military training experienced fewer musculoskeletal injuries (MSKIs), particularly in the lower extremities, during basic combat training than those who did not lose weight to join the service.

METHODOLOGY:

• The nation’s obesity epidemic means that fewer individuals meet the US Army’s weight and body-fat standards for entering basic combat training. Only 29% of 17- to 24-year-olds in the country would have qualified to join the military in 2018, with overweight and obesity among the leading disqualifying factors.
• Researchers analyzed data from 3168 Army trainees (mean age, 20.96 years; 62.34% men; mean maximum-ever BMI, 26.71) to examine the association between weight loss before enlistment and rates of MSKI during basic combat training.
• Trainees completed a baseline questionnaire that asked whether the person lost weight to enter the Army and included follow-up questions about the amount of weight lost, duration of weight loss, methods used, and prior physical activity.
• MSKIs were classified as any injury to the musculoskeletal system and further categorized by body region (lower extremities, upper extremities, spine/back, and other areas, including the torso and head/neck).
• Researchers identified MSKIs from medical records collected throughout basic combat training and for up to 6 weeks afterward to capture injuries that occurred during training but were documented only after its completion.

TAKEAWAY:

• Overall, 829 trainees (26.16%) reported losing weight to enter the Army, and they tended to have higher mean maximum-ever BMI, body-fat percentage, and lean mass compared with those who did not lose weight to join the service. The mean weight loss was 9.06 kg at a rate of 1.27 kg/wk among the 723 trainees with complete data.
• The most commonly reported weight-loss methods were exercising more (83.7%), changing diet (61.0%), skipping meals (39.3%), and sweating using a sauna or rubber suit (25.6%).
• Trainees who lost weight to join the service had a lower risk of any MSKI (hazard ratio [HR], 0.86) and lower extremity MSKIs (HR, 0.84) during training than those who did not lose weight to enter the Army. No difference was found between the two groups in the risk of upper extremity, spine/back, or other MSKIs.
• Among trainees who lost weight to join the Army, the amount of time it took to lose weight was not associated with the risk for any MSKI or region-specific MSKIs.

IN PRACTICE:

“The findings highlight that losing excess weight before entering military training may reduce MSKI risk for incoming recruits, enforcing the benefits of healthy weight loss programs,” the authors wrote.

SOURCE:

The study, led by Vy T. Nguyen, MS, DSc, Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, was published online in Obesity .

LIMITATIONS: 

The study did not assess whether the association between weight loss and the rate of MSKIs persisted over long-term military service. How the two most frequently reported weight loss methods — increased exercise and dietary changes — may have influenced the observed association remains unclear. Medical records may not have captured all MSKIs if trainees did not seek medical care due to concerns about graduating on time or being placed on limited duty.

DISCLOSURES:

The study was supported by the US Army Medical Research and Development Command’s Military Operational Medicine Program. Two authors received support from the funder.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com. 

TOPLINE:

In a multinational phase 3 trial, imipenem-cilastatin-relebactam demonstrated noninferiority to piperacillin-tazobactam in treating critically ill patients with hospital-acquired bacterial pneumonia (HABP) or ventilator-associated bacterial pneumonia (VABP), with a comparable safety profile.

METHODOLOGY:

• This multinational phase 3 trial, conducted between September 2018 and July 2022, compared imipenem-cilastatin-relebactam with piperacillin-tazobactam for HABP and VABP to support its use across multiple countries.
• Overall, 270 patients with HABP or VABP (mean age, 57.6 years; 73.3% men) were randomly assigned to receive either intravenous imipenem-cilastatin-relebactam (500 mg/250 mg) or piperacillin-tazobactam (4000 mg/500 mg) every 6 hours over 30 minutes for 7-14 days.
• Both treatment groups included critically ill patients, with 54.5% and 55.1% of patients in the imipenem-cilastatin-relebactam and piperacillin-tazobactam groups, respectively, having an Acute Physiology and Chronic Health Evaluation II score ≥ 15.
• The primary outcome was the 28-day all-cause mortality; secondary outcomes included the rates of clinical and microbiological responses, as well as the incidence of adverse events.

TAKEAWAY:

• Imipenem-cilastatin-relebactam was noninferior to piperacillin-tazobactam in terms of 28-day all-cause mortality (adjusted difference, 5.2%; 95% CI, −1.5-12.4; P = .024 for noninferiority).
• At the end of treatment, the rates of a favorable clinical response were comparable between the imipenem-cilastatin-relebactam (71.6%) and piperacillin-tazobactam (68.4%) groups.
• After treatment, microbiological response rates were 48.8% in the imipenem-cilastatin-relebactam group, whereas the rates were 47.9% in the piperacillin-tazobactam group.
• The incidence of drug-related adverse events was similar across the treatment groups, with diarrhea, increased levels of alanine aminotransferase and aspartate aminotransferase, and abnormal hepatic function being the most common events.

IN PRACTICE:

“These results support the use of IMI/REL [imipenem-cilastatin-relebactam] in MDR [multidrug-resistant] infections globally, including to expand the range of available treatments for critically ill patients with HABP/VABP in China, and provide additional data to inform the World Health Organization’s MDR pathogen strategy,” the authors wrote.

SOURCE:

This study was led by Junjie Li, Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. It was published online on December 12, 2024, in the International Journal of Infectious Diseases.

LIMITATIONS:

This study excluded patients with immunosuppression and those on intermittent hemodialysis, limiting the generalizability of the results to these populations.

DISCLOSURES:

This study was funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co. Inc., Rahway, New Jersey. Some authors served as employees of Merck Sharp & Dohme LLC, New Jersey, and MSD, China.

 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

In a multinational phase 3 trial, imipenem-cilastatin-relebactam demonstrated noninferiority to piperacillin-tazobactam in treating critically ill patients with hospital-acquired bacterial pneumonia (HABP) or ventilator-associated bacterial pneumonia (VABP), with a comparable safety profile.

METHODOLOGY:

• This multinational phase 3 trial, conducted between September 2018 and July 2022, compared imipenem-cilastatin-relebactam with piperacillin-tazobactam for HABP and VABP to support its use across multiple countries.
• Overall, 270 patients with HABP or VABP (mean age, 57.6 years; 73.3% men) were randomly assigned to receive either intravenous imipenem-cilastatin-relebactam (500 mg/250 mg) or piperacillin-tazobactam (4000 mg/500 mg) every 6 hours over 30 minutes for 7-14 days.
• Both treatment groups included critically ill patients, with 54.5% and 55.1% of patients in the imipenem-cilastatin-relebactam and piperacillin-tazobactam groups, respectively, having an Acute Physiology and Chronic Health Evaluation II score ≥ 15.
• The primary outcome was the 28-day all-cause mortality; secondary outcomes included the rates of clinical and microbiological responses, as well as the incidence of adverse events.

TAKEAWAY:

• Imipenem-cilastatin-relebactam was noninferior to piperacillin-tazobactam in terms of 28-day all-cause mortality (adjusted difference, 5.2%; 95% CI, −1.5-12.4; P = .024 for noninferiority).
• At the end of treatment, the rates of a favorable clinical response were comparable between the imipenem-cilastatin-relebactam (71.6%) and piperacillin-tazobactam (68.4%) groups.
• After treatment, microbiological response rates were 48.8% in the imipenem-cilastatin-relebactam group, whereas the rates were 47.9% in the piperacillin-tazobactam group.
• The incidence of drug-related adverse events was similar across the treatment groups, with diarrhea, increased levels of alanine aminotransferase and aspartate aminotransferase, and abnormal hepatic function being the most common events.

IN PRACTICE:

“These results support the use of IMI/REL [imipenem-cilastatin-relebactam] in MDR [multidrug-resistant] infections globally, including to expand the range of available treatments for critically ill patients with HABP/VABP in China, and provide additional data to inform the World Health Organization’s MDR pathogen strategy,” the authors wrote.

SOURCE:

This study was led by Junjie Li, Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. It was published online on December 12, 2024, in the International Journal of Infectious Diseases.

LIMITATIONS:

This study excluded patients with immunosuppression and those on intermittent hemodialysis, limiting the generalizability of the results to these populations.

DISCLOSURES:

This study was funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co. Inc., Rahway, New Jersey. Some authors served as employees of Merck Sharp & Dohme LLC, New Jersey, and MSD, China.

 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

In a multinational phase 3 trial, imipenem-cilastatin-relebactam demonstrated noninferiority to piperacillin-tazobactam in treating critically ill patients with hospital-acquired bacterial pneumonia (HABP) or ventilator-associated bacterial pneumonia (VABP), with a comparable safety profile.

METHODOLOGY:

• This multinational phase 3 trial, conducted between September 2018 and July 2022, compared imipenem-cilastatin-relebactam with piperacillin-tazobactam for HABP and VABP to support its use across multiple countries.
• Overall, 270 patients with HABP or VABP (mean age, 57.6 years; 73.3% men) were randomly assigned to receive either intravenous imipenem-cilastatin-relebactam (500 mg/250 mg) or piperacillin-tazobactam (4000 mg/500 mg) every 6 hours over 30 minutes for 7-14 days.
• Both treatment groups included critically ill patients, with 54.5% and 55.1% of patients in the imipenem-cilastatin-relebactam and piperacillin-tazobactam groups, respectively, having an Acute Physiology and Chronic Health Evaluation II score ≥ 15.
• The primary outcome was the 28-day all-cause mortality; secondary outcomes included the rates of clinical and microbiological responses, as well as the incidence of adverse events.

TAKEAWAY:

• Imipenem-cilastatin-relebactam was noninferior to piperacillin-tazobactam in terms of 28-day all-cause mortality (adjusted difference, 5.2%; 95% CI, −1.5-12.4; P = .024 for noninferiority).
• At the end of treatment, the rates of a favorable clinical response were comparable between the imipenem-cilastatin-relebactam (71.6%) and piperacillin-tazobactam (68.4%) groups.
• After treatment, microbiological response rates were 48.8% in the imipenem-cilastatin-relebactam group, whereas the rates were 47.9% in the piperacillin-tazobactam group.
• The incidence of drug-related adverse events was similar across the treatment groups, with diarrhea, increased levels of alanine aminotransferase and aspartate aminotransferase, and abnormal hepatic function being the most common events.

IN PRACTICE:

“These results support the use of IMI/REL [imipenem-cilastatin-relebactam] in MDR [multidrug-resistant] infections globally, including to expand the range of available treatments for critically ill patients with HABP/VABP in China, and provide additional data to inform the World Health Organization’s MDR pathogen strategy,” the authors wrote.

SOURCE:

This study was led by Junjie Li, Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. It was published online on December 12, 2024, in the International Journal of Infectious Diseases.

LIMITATIONS:

This study excluded patients with immunosuppression and those on intermittent hemodialysis, limiting the generalizability of the results to these populations.

DISCLOSURES:

This study was funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co. Inc., Rahway, New Jersey. Some authors served as employees of Merck Sharp & Dohme LLC, New Jersey, and MSD, China.

 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.