Stopping endocarditis antibiotics on clinical response saved two weeks of treatment, but relapse tripled

The edition in brief

POET II randomised 508 stable adults with left-sided infective endocarditis due to S. aureus, E. faecalis or streptococci, all already treated for 2 to 4 weeks, to stop antibiotics on response criteria or complete 4 to 6 weeks. Tailored therapy gave 13 more antibiotic-free days in 6 months and was non-inferior for death, unplanned surgery or embolism (8.2% vs 10.7%), but relapse of bacteraemia or endocarditis was higher (5.1% vs 1.6%). In a Korean trial of clarithromycin-resistant H. pylori, adding bismuth to PPI, amoxicillin and metronidazole raised intention-to-treat eradication from 68.2% to 84.8%, matching classic bismuth quadruple therapy (81.8%) with less nausea. A modelling study of 2,724 suspected mpox cases in DR Congo estimated 35% of PCR positives below Ct 40 were consistent with environmental viral DNA rather than infection; a Ct cut-off below 34 cut that to 5%. In a phase 3 trial of 6,940 African newborns, the recombinant BCG vaccine VPM1002 did not show non-inferiority to BCG against IGRA conversion (HR 1.23, 0.99 to 1.53), though too few events accrued for a firm answer. The FDA lists a supplemental approval for TYZAVAN, Hikma's vancomycin hydrochloride product; the record does not say what the supplement changed.