Successful treatment of Enterococcus faecalis bacteremia with dalbavancin as an outpatient in an intravenous drug user.

This report describes the treatment of a 35-year-old male who presented to the emergency department with an empyema, and who had a long hospital course complicated by a catheter-related bloodstream infection and a history of intravenous drug use. Blood culture results confirmed Enterococcus faecalis. He was not a candidate for outpatient intravenous therapy and needed 14days of treatment, but was able to be discharged with a 3-day supply of oral levofloxacin to complete treatment for his empyema and 1 dose of dalbavancin at an outpatient infusion center to treat his bacteremia. Due to the unique properties of dalbavancin, off-label use in specific populations may help facilitate transitions of care. This report outlines the successful use of dalbavancin and removal of the central catheter in the treatment of E. faecalis bacteremia.

Running faster causes disaster: trade-offs between speed, manoeuvrability and motor control when running around corners in northern quolls (Dasyurus hallucatus).

Movement speed is fundamental to all animal behaviour, yet no general framework exists for understanding why animals move at the speeds they do. Even during fitness-defining behaviours like running away from predators, an animal should select a speed that balances the benefits of high speed against the increased probability of mistakes. In this study, we explored this idea by quantifying trade-offs between speed, manoeuvrability and motor control in wild northern quolls (Dasyurus hallucatus) - a medium-sized carnivorous marsupial native to northern Australia. First, we quantified how running speed affected the probability of crashes when rounding corners of 45, 90 and 135 deg. We found that the faster an individual approached a turn, the higher the probability that they would crash, and these risks were greater when negotiating tighter turns. To avoid crashes, quolls modulated their running speed when they moved through turns of varying angles. Average speed for quolls when sprinting along a straight path was around 4.5 m s(-1) but this decreased linearly to speeds of around 1.5 m s(-1) when running through 135 deg turns. Finally, we explored how an individual's morphology affects their manoeuvrability. We found that individuals with larger relative foot sizes were more manoeuvrable than individuals with smaller relative foot sizes. Thus, movement speed, even during extreme situations like escaping predation, should be based on a compromise between high speed, manoeuvrability and motor control. We advocate that optimal - rather than maximal - performance capabilities underlie fitness-defining behaviours such as escaping predators and capturing prey.

Evaluation of the efficacy and safety of outpatient parenteral antimicrobial therapy for infections with methicillin-sensitive Staphylococcus aureus.

OBJECTIVES: As increasing numbers of patients are being treated with outpatient parenteral antimicrobial therapy (OPAT), it becomes ever more important to ascertain the risks and benefits of such treatment for patients. METHODS: We conducted a retrospective analysis of 1,515 patients with methicillin-sensitive Staphylococcus aureus infections who were treated with outpatient parenteral antimicrobial monotherapy. All patients were included in the adverse drug reaction analysis; 1,252 were evaluable for purposes of evaluating treatment efficacy. RESULTS: The six antibiotics most frequently used in this study (ceftriaxone, cefazolin, vancomycin, oxacillin, nafcillin, and clindamycin) appeared to be equivalent in achieving the desired efficacy outcome. CONCLUSIONS: Vancomycin was associated with a significantly greater number of side effects than was ceftriaxone, cefazolin, or oxacillin, and nafcillin was associated with a significantly greater number of adverse events than ceftriaxone.