The edition · Infectious Diseases
Daily zinc cut infections in young children with sickle cell anaemia; universal iron gave no cognitive gain in Malawi
A small Ugandan zinc trial, a large Malawian iron and malaria chemoprevention trial, a pooled analysis of whether other respiratory viruses block SARS-CoV-2, and a daptomycin regulatory action.
The edition in brief
ZIPS-2 randomised 100 Ugandan children aged 1 to 5 with sickle cell anaemia, all on hydroxyurea, to zinc sulfate 20 mg daily or placebo for 6 months. All-cause infections were 305.7 vs 480.7 per 100 person-years (adjusted incidence rate ratio 0.62, 95% CI 0.45 to 0.86); the trial was single-site and small. The IRMA trial randomised 2,168 rural Malawian infants at 6 months to iron syrup or iron-containing micronutrient powder with malaria chemoprevention, chemoprevention alone, or placebo. Neither iron arm improved the Bayley-III cognitive score (mean difference -0.52, 95% CI -2.52 to 1.48 for syrup) or anaemia prevalence, though ferritin rose and malaria risk did not increase; chemoprevention alone reduced malaria. An individual participant data meta-analysis of cohorts tested for viral interference with SARS-CoV-2: in samples taken regardless of symptoms co-detection was less frequent than expected but not significantly so (OR 0.72, 95% CI 0.40 to 1.25), while symptom-driven testing gave a strongly negative association (OR 0.16), which may reflect selection bias. The FDA record lists a supplement action on an NDA for daptomycin in sodium chloride from Baxter, dated 24 September; the record does not state what changed.
Daily zinc was linked to fewer infections in young children with sickle cell anaemia
Consider zinc supplementation as an add-on to standard infection prevention in young children with sickle cell anaemia only after multisite confirmation, and never in place of it.
FDA records a supplement action on daptomycin in sodium chloride
No change in practice follows from this entry; read the current FDA label if you use this product.
Other respiratory viruses may reduce SARS-CoV-2 co-detection, but the effect weakened without symptom-based testing
Do not assume that detecting one respiratory virus rules out another, particularly in severe or prolonged illness.
Daptomycin: check creatine kinase weekly and do not use it for pneumonia
Check creatine kinase weekly on daptomycin and choose another agent for pneumonia.
Universal iron with malaria chemoprevention did not improve cognition in Malawian infants
Continue to treat confirmed iron deficiency, but do not expect universal iron supplementation to improve cognition, and keep malaria chemoprevention where it is recommended.
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