Better oral care cut ward pneumonia by more than half in a cluster trial

The edition in brief

In HAPPEN, a stepped-wedge cluster-randomised trial across nine wards in three Australian hospitals, an enhanced oral care programme with products, education and audit cut non-ventilator hospital-acquired pneumonia from 1.0 to 0.41 infections per 100 admission-days at risk (cumulative HR 0.40, 95% CI 0.19–0.82); protocol completion rose from 16% to 62%. In ISLEND-1, 607 adults with suppressed HIV switched to once-weekly oral islatravir–lenacapavir or stayed on daily bictegravir–emtricitabine–tenofovir alafenamide; at 48 weeks no one on the weekly regimen had viral load of 50 copies or more, against 0.3% on daily therapy, meeting non-inferiority. A Lancet Infectious Diseases systematic review of Nipah virus pooled 119 papers: case fatality ranged from 9% in Singapore to 82% in Bangladesh, median incubation was about 9 days, and nearly all reproduction number estimates were below one. A Personal View on antifungal susceptibility testing argues that an MIC is not self-interpreting and should be read alongside drug exposure, site, source control and host immunity.