In India and China, indigenous drug manufacturers market arbitrarily combined parenteral β-lactam and β-lactamase inhibitors (BL-BLIs). In these fixed-dose combinations, sulbactam or tazobactam is indiscriminately combined with parenteral cephalosporins, with BLI doses kept in ratios similar to those for the approved BL-BLIs. Such combinations have been introduced into clinical practice without mandatory drug development studies involving pharmacokinetic/pharmacodynamic, safety, and efficacy assessments being undertaken. Such unorthodox combinations compromise clinical outcomes and also potentially contribute to resistance development.
Pneumococcal conjugate vaccines (PCVs) (pneumococcal 13-valent conjugate vaccine [PCV-13] and pneumococcal 10-valent conjugate vaccine [PCV-10]) are available for prevention of pneumococcal infections in children. To determine the vaccine effectiveness (VE) of PCV-13 and PCV-10 in preventing invasive pneumococcal disease (IPD) and acute otitis media (AOM) in children <5 years. Systematic searches of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Cochrane. Eligible studies examined the direct effectiveness and/or efficacy of PCV-10 and PCV-13 in reducing the incidence of disease in healthy children <5 years. Two reviewers independently conducted data extraction and methodologic quality assessment. Significant effectiveness against vaccine-type IPD in children ≤5 years was reported for ≥1 dose of PCV-13 in the 3 + 1 (86%–96%) and 2 + 1 schedule (67.2%–86%) and for PCV-10 for the 3 + 1 (72.8%–100%) and 2 + 1 schedules (92%–97%). In children <12 months of age, PCV-13 VE against serotype 19A post–primary series was significant for the 3 + 1 but not the 2 + 1 schedule. PCV-10 crossprotection against 19A was significant in children ≤5 years with ≥1 dose (82.2% and 71%). Neither PCVs were found effective against serotype 3. PCV-13 was effective against AOM (86%; 95% confidence interval [CI]: 61 to 94). PCV-10 was effective against clinically defined (26.9%; 95% CI: 5.9 to 43.3) and bacteriologically confirmed AOM (43.3%; 95% CI: 1.7 to 67.3). Because of the large heterogeneity in studies, a meta-analysis for pooled estimates was not done. Both PCVs afford protection against pneumococcal infections, with PCV-10 protecting against 19A IPD, but this VE has not been verified in the youngest age groups.
Several antiemetics have been used in children with acute gastroenteritis. However, there is still controversy over their use. To determine the effectiveness and safety of antiemetics for controlling vomiting in children with acute gastroenteritis. Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Latin America and the Caribbean Literature on Health Sciences, and gray literature, until December 2018. We selected randomized clinical trials comparing metoclopramide, ondansetron, domperidone, dexamethasone, dimenhydrinate, and granisetron. Two reviewers independently screened abstracts and full texts, extracted the data, and assessed the risk of bias. We performed pairwise and network meta-analysis using the random-effects model. Twenty-four studies were included (3482 children). Ondansetron revealed the largest effect in comparison to placebo for cessation of vomiting (odds ratio = 0.28 [95% credible interval = 0.16 to 0.46]; quality of evidence: high) and for hospitalization (odds ratio = 2.93 [95% credible interval = 1.69 to 6.18]; quality of evidence: moderate). Ondansetron was the only intervention that reduced the need for intravenous rehydration and the number of vomiting episodes. When considering side effects, dimenhydrinate was the only intervention that was worse than placebo. Most treatment comparisons had low- or very low–quality evidence, because of risk of biases and imprecise estimates. Ondansetron is the only intervention that revealed an effect on the cessation of vomiting, on preventing hospitalizations, and in reducing the need for intravenous rehydration. Ondansetron was also considered a safe intervention.
Our economy is in deep trouble, from whichever perspective you look at it. The economic battering taken by economically strong countries is frightening, leaving us in South Africa to fear the worst.
Argentina is a case study in what happens when an economy already on its knees implements an aggressive lockdown, says Mac Margolis.
Government went to war against Covid-19 with very low supplies in citizen trust and financial reserves, says Solly Moeng.
A team of social media analysts at an SA business school is tracking misinformation, disinformation, distortion and lies online.
To history buffs, the Covid-19 pandemic must seem eerily familiar, says Noah Smith.
Strategic partnerships could be used to create win-win outcomes, says Sifiso Skenjana.
Read an extract from business author and coach Douglas Kruger's latest book, Virus-proof your small business.
Where businesses are fighting to survive, agility is the name of the game, says Mignon Reynecke.
Handyman Vincenzo Perugia walked out of the Louvre with a rolled-up painting under his smock. What ensured should be a lesson to us all, says Hannes Viljoen.
For the first time in 130 years, there will be no rallies and marches to celebrate what began as a campaign for an eight-hour working day.
The furore surrounding the arrival of over 200 Cuban medical doctors in South Africa to fight the coronavirus has highlighted a failure on the part of the SA government to explain the nature and drivers of our country’s relationship with Cuba, says Mills Soko.
The future choices made by airlines matter a great deal for the oil market, say Liam Denning and Brooke Sutherland.
As editor Wilhelm Crous puts it, "We haven't seen this movie before."
There’s always been massive inequality in South Africa, but those who have the money and power still aren’t getting it, says Carmen Williams.
Authorities unable or unwilling to face up to a reality that might reveal their own shortcomings and ineptitude, usually resort to pinpointing a scapegoat. This year, Covid-19 fits that bill, says Terry Bell.
For companies to survive and even thrive beyond the coronavirus pandemic, they’re going to have think more like the millennial generation, says Dr Anushka Bogdanov.
Now, more than ever, we need to be listening for market signals and ensuring that our businesses are primed to both take advantage of opportunities and to mitigate risks, says Allon Raiz.
Stokvels are an important strategy for financial survival, so it's crucial to find a way to make them work during the pandemic, says Dr Norman Chivasa.
Banks can be as powerful and valued as the big technology firms. Yes, those trillion-dollar titans.
Allon Raiz is CEO of business incubator Raizcorp. In this series of articles, he offers entrepreneurs advice on surviving a crisis.
GLUMNESS settles on a large part of the nation whenever the subject of comedy comes up now. The lockdown has led to a more frenetic search for entertainment, and the current state of humour hasn’t wanted for critics. This week, Royle Family star Ricky Tomlinson, 80, said it was dire, and listed several comedians, adding: “They should be done under the Trade Description Act.”