In the presence of a prosthetic joint, it is recommended to prolong IV treatment to 4-6 weeks, even if there are no signs of PJI!
🆕️⚡️⚡️Prevalence and risk factors for haematogenous PJI during Staphylococcus aureus bacteraemia
#IDXposts
Cefepime Vs. Piperacillin tazobactam:
Both cover pseudomonas aeruginosa
Neither covers MRSA
Only Pip tazo covers
Enterococcus & anaerobes
Only Cefepime can be used in CNS infections
Cefepime is more neurotoxic
Pip tazo + Vanco 🔼AKI risk*
Cefepime better AmpC coverage*
Others?
The ‘Big Five’ carbapenemases:
1️⃣VIM
2️⃣IMP
3️⃣NDM
4️⃣KPC
5️⃣OXA-48
🌟Timeline representing the introduction of carbapenems & the appearance of carbapenemases worldwide. 🌟
#IDXposts
🌟Fantastic figure🌟 you can show when someone asks why we need to combine Ceftazidime-avibactam & Aztreonam for treatment of MBL🦠 infections?
⚡️Aztreonam isn't hydrolyzed by MBL enzymes
⚡️Avibactam takes care of ESBL/AmpC co-produced by MBL🦠
Ceftazidime ⁉️
H t
@drtimothyli
"There isn’t an ID doc in this country who hasn’t been at the bedside of a patient who’s desperately ill & for whom we did not have an antibiotic.”
@IDSAInfo
President Dr. Cynthia Sears.
#IDquotes
#IDTwitter
Retweet if you ever had a patient with no
#antibiotic
to treat.
Everyone who's treating MRSA Bacteremia should read this article now!
An excellent review by
@VanceFowler5
et Al
@CIDJournal
Persistent MRSA Bacteremia: Resetting the Clock for Optimal Management
🌟Excellent figures 🌟
@snap_trial
Thoughts 🤔
#IDTwitter
🔥 Just published 🔥
@CMIJournal
The Dutch Working Party on Antibiotic Policy (SWAB) guideline for the approach to suspected antibiotic allergy
Presented today
@ESCMID
#ECCMID2023
by Prof Mark De Boer
🌟Cross reactivity in beta-lactam antibiotics🌟
EnJoY
Important NIH 💥💥
Before prescribing ritonavir-boosted nirmatrelvir (Paxlovid), clinicians should carefully review concomitant medications, including over-the-counter medicines and herbal supplements, to evaluate the potential for drug-drug interactions
🔥🆕️MERCY RCT🆕️🔥
Continuous administration of meropenem, compared with intermittent administration, does NOT improve clinically relevant outcomes in critically ill patients with sepsis.
#IDTwitter
🆕️🔥 Position paper
@CMIJournal
Pseudomonas aeruginosa antimicrobial susceptibility profiles, resistance mechanisms and international clonal lineages: update from ESGARS-
@ESCMID
/ ISARPAE Group
#idxposts
#bookmark
#mustread
✨If you have Staph in urine check blood culture✨
💥Excellent narrative review on the role of Staphylococcus aureus Bacteriuria in S. aureus Bacteremia
Epidemiology and pathogenesis of SABU in patients with SAB💥
#IDTwitter
#ofid
Myth:Bactrim is not active against β-hemolytic Streptococcus,is now totally BUSTED
🆕️🔥
@ChristianCho
In vitro activity against clinical isolates of β-hemolytic Strept via BMD
TMP/SMX:100%🌟
Clinda:85%
Doxy:57%
For S.pyogenes TMP/SMX was 100% S
#idxposts
Fever is a major driver of antibiotics
prescription
Fever isn't always an indication to start antibiotics
Fever isn't always a reason to get cultures from everywhere
When a patient has a fever,slow down,think twice
There are many non infectious causes of fever,can u mention one?
🆕🔥🔥🔥Clinical Practice Guideline
@IDSAInfo
@SHEA_Epi
2021 Focused Update Guidelines on Management of CDI in Adults
Major update💥:for patients with an initial CDI episode, guidelines suggest using fidaxomicin rather than a standard course of vancomycin
🔥BREAKING🔥
US FDA approved Xacduro (sulbactam durlobactam for injection), a new treatment for hospital-acquired bacterial pneumonia &ventilator-associated bacterial pneumonia caused by Acinetobacter baumannii-calcoaceticus complex
#IDTwitter
Things We Do for No Reason: Obtaining urine culture in older adults with delirium without signs or symptoms of urinary tract infection
#idxposts
#TWDFNR
SHORTEN RCT 🔥🔥🔥
@CMIJournal
Seven versus 14-days course of antibiotics for the treatment of bloodstream infections by Enterobacterales
7-day course of antibiotics as the preferential treatment for eBSI, as long as the source is properly controlled
Wow!
🔥The PALACE RCT 🔥
@TrubianoJason
et Al
@JAMAInternalMed
Direct oral penicillin challenge in patients with a low-risk penicillin allergy was noninferior compared with standard-of-care skin testing followed by oral challenge
Thanks
@Inox94
Finally published
🔥SABATO🔥
But preprint
Early oral switch in low-risk Staphylococcus aureus bloodstream infection
Oral switch was non-inferior to intravenous standard therapy in participants with low-risk SAB
@BradSpellberg
@sebpoule
#IDTwitter
🔥The ACORN RCT🔥
N: 2511
Cefepime vs Piperacillin tazobactam in Adults Hospitalized With Acute Infection w/in 12h presentation to ER/ICU
AKI did not differ between FEP & TZP , but neurological dysfunction more common with FEP
H/t
@DrToddLee
#IDWeek2023
💥STOIC Phase 2 open label RCT💥
@LancetRespirMed
Early administration "within 7 days of the onset of mild COVID-19 symptoms" of inhaled budesonide reduced the likelihood of needing urgent medical care and reduced time to recovery after early COVID-19
🔥The BLING III RCT🔥
The most anticipated trial in infectious diseases!
The use of continuous compared w intermittent infusions of β-lactam antibiotics in critically ill patients w sepsis DIDN'T meet statistical significance in reducing mortality at 90d
A 🆕️🔥🔥 state of art review article
@yourICM
by many 🌟s
@andymoz78
@DrAndreKalil
I highly recommend everyone to read !
How to use biomarkers of infection or sepsis at the bedside: guide to clinicians.
Procalcitonin 🔥
#IDTwitter
🌟Just published 🌟
@CIDJournal
@iwgdf
/
@IDSAInfo
2023
IWGDF/IDSA Guidelines on the diagnosis and treatment of diabetes related foot infections PS: Published/posted May 2023 ,now if you like the IDSA/CID style
#IDXposts
✨️Excellent 🆕️review ✨️
Resistance in Pseudomonas aeruginosa: A Narrative Review of Antibiogram* Interpretation and Emerging Treatments
EnJoy
#IDXposts
#MedEd
Antibiogram= Susceptibility report
Ex: oprD loss of function/downregulation Antibiogram👇
🆕️⚡️🔥Study of risk of infective endocarditis in patients with streptococcal bloodstream infection demonstrated that Streptococcus sanguinis,
S. mutans, and S. gallolyticus were significantly associated with higher risk of infective endocarditis
#IEWiki
Each additional day of antibiotic therapy is associated with measurable antibiotic harm, particularly adverse events
🆕💥💥
@CMIJournal
@BRxAD
et Al
Estimating daily antibiotic harms: an umbrella review with individual study meta-analysis
#IDTwitter
NEW💥🔥💥
@TheLancet
@aurdinh
PTC RCT 16 🇫🇷 centers >700 patients
Among hospitalized patients with CAP who met clinical stability criteria, discontinuing β-lactam treatment after 3 days was non-inferior to 8 days of treatment
#IDTwitter
#Shorterisbetter
✨✨Fantastic Review✨✨
@antibioticsmdpi
✴️Very important question✴️
Follow-Up Blood Cultures Useful in the Antimicrobial Management of Gram Negative Bacteremia? A Reappraisal of Their Role Based on Current Knowledge
#IDTwitter
NEW by Dr. Mical Paul🔥🔥in CID
Seven versus fourteen Days of Antibiotic Therapy for uncomplicated Gram-negative Bacteremia: a Non-inferiority Randomized Controlled Trial. Shorter is better.
Could be the Best study of 2018
🔥🔥Breaking News🔥
#RECOVERYtrial
Dexamethasone reduced deaths by one-third in ventilated patients and by one fifth in other patients receiving oxygen only There was no benefit among those patients who did not require respiratory support
#COVID19
🔥Linezolid d/d Interactions and Serotonin syndrome 🔥
🆕️⚡️Population-based cohort study of 1134 patients who were prescribed linezolid,215 patients (19.0%) were taking antidepressants
Serotonin syndrome occurred in less than 0.5% of patients
#IDTwitter
🔥 JUST PUBLISHED 🔥
@SCCM
2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, ARDS, and CAP
Strong recommendation for use of steroids in hospitalized patients with severe CAP
#idxposts
Thanks
@Inox94
🆕️⚡️Ceftazidime/Avibactam and Meropenem/Vaborbactam for the Management of Enterobacterales Infections: A Narrative Review, Clinical Considerations, and Expert Opinion⚡️🆕️
#IDXposts
🔥AstraZeneca : A careful review of all available safety data of more than 17 million people vaccinated in the European Union & UK with COVID-19 Vaccine AstraZeneca has shown NO evidence of an increased risk of pulmonary embolism, deep vein thrombosis🔥
HECK-YES🔥
No more SPICE or SPACE💥
Enterobacterales w mod/high risk for clinically significant AmpC production due to an inducible ampC gene:
✨Hafnia alvei
✨Enterobacter cloacae
✨Citrobacter freundii
✨Klebsiella aerogenes
✨YErSinia enterocolitica
#IDTwitter
#MedEd
#TwitteRx
🔥🔥COVACTA study🔥🔥
Tocilizumab did NOT meet its primary endpoint of improved clinical status in hospitalised adult patients severe
#COVID19
associated pneumonia. In addition, the difference in patient mortality at week four,were not MET
@CarlosdelRio7
🔥🔥SABATO RCT 🔥🔥
@TheLancetInfDis
Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus BSI
Oral switch antimicrobial therapy was non-inferior to IV standard therapy in participants with low-risk S aureus BSI
@BradSpellberg
🆕💥💥
@NEJM
Single dose liposomal amphotericin B combined with flucytosine and fluconazole was noninferior to the WHO-recommended treatment for HIV-associated cryptococcal meningitis and was associated with fewer adverse events
#IDTwitter
#MedEd
#TwitteRx
🆕💥💥
#IJAA
@ischemo
@Critcare_bear
@jasonroberts_pk
Pharmacodynamics of ceftriaxone for the treatment of MSSA:Is it a viable treatment option?
Only a HIGH ceftriaxone dose of 2 g q12h achieves bacterial killing & sustained inhibition of bacterial growth
🆕️⚡️⚡️🔥Multicenter Retrospective, Cohort Study
@CIDJournal
@BradSpellberg
et Al
Real-world Application of Oral Therapy for Infective Endocarditis
The study esults demonstrates similar outcomes of real-world use of oral vs. IV-only therapy for IE
🔥Fantastic review🔥
@InfectDis_Ther
β-Lactam Resistance in ESKAPE Pathogens Mediated Through Modifications in Penicillin-Binding Proteins
🌟Excellent Fig 1👇: Classification of PBPs and their implications for beta-lactam resistance🌟
#IDTwitter
The future of ID practice is going to be changed with many 🌟s
@DrToddLee
@syctong
et Al
A new project, "Expanding the SNAP"
3 RCTs
Ertapenem + cefazolin for MSSA bacteremia
Rifampin for PVE
Daptomycin Vs Vancomycin in MRSA bacteremia(superiority trial)
Fantastic 🆕️⚡️⚡️Review article
@antibioticsmdpi
When & How to Use MIC in Clinical Practice?
Microbiological,pharmacological & clinical situations where an interpretation of antibiotic conc in relation to the MIC determination would be useful
🌟Bookmark🌟
Fluids are an important component of treating patients who are critically ill with sepsis
🆕️⚡️Review
Fluid Therapy for Critically Ill Adults With Sepsis
#IDTwitter
Patients with procalcitonin <0.5 ng/mL still showed significant clinical bacteremia
Procalcitonin-based algorithms may not be appropriate for bacteremia management
Are you using PCT algorithm in pts with Bacteremia?!
#IDTwitter
#medtwitter
#TwitteRx
Great!
Ontario becomes the first province to list fluvoxamine as a
#COVID19
treatment to consider in mildly ill patients symptoms <=7d
Clinical Practice Guideline Recommended Drugs & Biologics in Adult Pts with COVID-19 - Ontario COVID-19 Science Advisory
FANTASTIC⚡️⚡️
The evidence base for refraining from screening for or treating ASB in elderly is strong,but both practices remain prevalent
Bacteriuria in older adults triggers confusion in healthcare providers:A mindful pause to treat the worry
#IDTwitter
🆕⚡⚡ematic Review & Meta-Analysis
@CIDJournal
@DrToddLee
🌟s
@BogochIsaac
@DrEmilyMcD
Revisiting the Evidence Base for Modern Day Practice of Treatment of Toxoplasmic Encephalitis
TMP-SMX appears to be as effective & safer than pyrimethamine-containing
Can spironolactone tablets replace antibiotics for acne?
🔥SAFA RCT🔥
@bmj_latest
Spironolactone improved acne on all outcomes
Spironolactone provides a safe and effective alternative to oral antibiotics for adult women with persistent acne
#IDTwitter
Fever of unknown origin
and inflammation of unknown origin are diagnostic challenges that often require an extensive workup!
🆕️⚡️⚡️Narrative review
@CMIJournal
Update on imaging in fever and inflammation of unknown origin: focus on infectious disorders
🆕️⚡️🔥 State of art review article
@NatureRevMicro
Antibiotic-induced collateral damage to the microbiota & associated infections
How antibiotic can facilitate subsequent infections due to both loss of colonization resistance& overgrowth of resistant mos
🆕️🔥Retrospective, multicenter, cohort study
Twice daily cephalexin is as effective as four times daily dosing for for the treatment of uncomplicated UTI with a cefazolin-susceptible urine culture
#IDXposts
Another
⭐masterpiece Review Article⭐
in
#CMR
The Echo of Pulmonary Tuberculosis: Mechanisms of Clinical Symptoms and Other Disease-Induced Systemic Complications.
#IDTwitter
🔥 Just published 🔥
@IDSAInfo
2024 Guideline Update on the Risk Assessment, Diagnostic Imaging, and Microbiological Evaluation of Complicated Intra-abdominal Infections in Adults, Children, and Pregnant People
#idxposts
🔥 Just PUBLISHED 🔥
Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults
2022 Recommendations of the International Antiviral Society–USA Panel
#IDTwitter
#hivtwitter
NEW 🔥🔥
#CID
@BradSpellberg
A simple diagnostic ASP ⛔ routine ordering of urine cultures using education, audit&feedback➕ hospital-wide screensaver👇
⬇️ inpatient U. Cx orders(~-50%) & rates of hospital CAUTIs w/o change in hospital mortality
#IDtwitter
NEW 🔥🔥
#CID
@eliowa
et Al
Comparative Effectiveness of Switching to Daptomycin Versus Remaining on Vancomycin Among Patients With (MRSA) BSI
Switching to dapto within 3 days of initial receipt of vanco is associated with ⬇️ 30-day mortality
#IDTwitter
It's hard to believe that Spain a country with the highest number of abstracts over many years and with the greatest impact on the infectious diseases practice yet their ID physicians are still struggling to get recognized as specialty
#IDTwitter
#ECCMID2022