RESUMO
Background: Initial choices of antimicrobial therapy for most cases of community-acquired pneumonia (CAP) in children under 5 years of age are typically based on local epidemiology, risk factors assessment, and subsequent clinical parameters and positive cultures, which can lead to the underdiagnosis and underestimation of lung infections caused by uncommon pathogens. Contezolid, an orally administered oxazolidinone antibiotic, gained approval from the National Medical Products Administration (NMPA) of China in June 2021 for managing complicated skin and soft tissue infections (cSSTI) caused by staphylococcus aureus (SA), streptococcus pyogenes, or streptococcus agalactis. Owing to its enhanced safety profile and ongoing clinical progress, the scope of contezolid's clinical application continues to expand, benefiting a growing number of patients with Gram-positive bacterial infections. Case summary: In this report, we present the first use of contezolid in a toddler with severe CAP caused by SA, aiming to avoid potential adverse drug reactions (ADRs) associated with vancomycin and linezolid. Conclusion: Although contezolid has not been officially indicated for CAP, it has been shown to be effective and safe in the management of SA-induced severe CAP in this toddler, suggesting its potential as an alternative option in the dilemma, especially for patients who are susceptible or intolerant to ADRs associated with first-line anti-methicillin-resistant staphylococcus aureus (MRSA) antimicrobial agents.
RESUMO
OBJECTIVES: The main purpose of this meta-analysis was to compare the long-term efficacy of cryoballoon ablation (CBA) with irrigated radiofrequency catheter ablation (RFCA) for the treatment of atrial fibrillation (AF). METHODS: The Medline, Cochrane Library and Embase Database were searched for clinical studies published up to October 2014. Studies that fulfilled our predefined inclusion criteria were included. The primary clinical outcome was the proportion of patients free from AF (follow-up≥3months), and the secondary clinical outcomes included acute pulmonary vein (PV) isolated rate, fluoroscopy time, procedure time and complications. RESULTS: After a literature search in the major databases, three randomized controlled trials (RCTs) and eight retrospective trials with a total of 1216 patients were identified. Pool-analysis demonstrated that, as compared RFCA, CBA was associated with a similar proportion of patients free from AF at a mean 16.5months follow-up (66.9% vs 65.1%; relative risk [RR]: 1.01; 95% CI: 0.94 to 1.07, P=0.87). Acute PV isolation rate (RR: 0.92; 95% CI: 0.82 to 1.03) and fluoroscopy time (weighted mean difference WMD: -8.60; 95% CI: -18.29 to 3.69) were not statistically significant difference. The procedure time was shorter in CBA group ([WMD]: -31.94; 95% CI: -60.43 to -3.45). Transient phrenic nerve palsy was uniquely observed in the CBA group (5.4%, P<0.00001) and resolved in all during the follow-up period, total complication was similar in both groups (RR: 1.30; 95% CI: 0.91 to 1.85). CONCLUSIONS: CBA was as effective as RFCA for the treatment of atrial fibrillation during long-term follow-up with comparable procedural features.
