A week of systemic antibiotics matched four weeks after orthopaedic infection surgery with local antibiotics; weekly oral HIV treatment held viral suppression

The edition in brief

In SOLARIO, 500 adults who had surgery for orthopaedic infection with a local-antibiotic carrier implanted were randomised to a short (up to 7 days) or long (4 weeks or more) course of systemic antibiotics. Definite treatment failure by 12 months was 11.1% with the short course and 14.1% with the long course (risk difference -3.0 percentage points, 95% CI -9.0 to 3.0), within the 10-point noninferiority margin; treatment-related symptoms by week 6 were less frequent with the short course (17.2% vs 45.2%). The trial was open-label but outcomes were assessed by a blinded committee. In ISLEND-1, 607 adults with suppressed HIV-1 on bictegravir-emtricitabine-tenofovir alafenamide were switched to once-weekly oral islatravir-lenacapavir or continued daily therapy; at 48 weeks no one on the weekly regimen and one person on daily therapy had HIV-1 RNA of 50 copies/mL or higher, meeting noninferiority. The FDA recorded a supplement for a generic tigecycline application; the record does not say what changed. In the HAPPEN stepped-wedge trial in three Australian hospitals (8,870 patients), an enhanced oral-care bundle was associated with less non-ventilator hospital-acquired pneumonia (0.7% vs 1.0%; cumulative hazard ratio 0.40, 0.19 to 0.82). The pearl covers penicillin allergy labels.