Antibiotic Steward 🅱️C🆔🅿️🌟
Stay up-to-date in Infectious Diseases, Clinical Pharmacist, Antibiotics, #IDTwitter t✨p influencer #interstellar #dune
🌹❤️Misk #idsky #medsky #AMSsky #idxposts
Bassam Ghanem,PharmD MS BCPS BCIDP
- Reposted by Antibiotic Steward 🅱️C🆔🅿️🌟[Not loaded yet]
- Practice changer RCT? No difference in perforation risk if surgery <24h. Slightly lower SSI (1.6% vs 3.2%), but not statistically significant. Supports a more selective, stewardship-friendly approach—especially with timely surgery access #IDsky #EMIMCC
- 🔥🆕PERFECT RCT Preoperatively started antibiotic treatment did not decrease the risk of appendiceal perforation when appendectomy was performed within 24h in adult patients with presumed uncomplicated acute appendicitis. #IDsky A new standard of care? jamanetwork.com/journals/jam...
- A brilliant title that flips the classic quote to reflect how the practice of medicine evolves. This article pushes back against IV dogma in bone & joint infections, spotlighting the solid evidence for oral therapy. A much-needed shift—one I fully stand behind #idsky
- 🆕💫Standing on the Shoulders of Imperfect Humans: from IV dogma to oral antibiotic therapy for bone and joints infections #idsky www.sciencedirect.com/science/arti...
- 🆕💫Standing on the Shoulders of Imperfect Humans: from IV dogma to oral antibiotic therapy for bone and joints infections #idsky www.sciencedirect.com/science/arti...
- Despite its established role in PJI,the use of rifampin remains subject to debate, primarily due to inconsistencies in literature regarding clinical efficacy,timing of initiation,choice of combination agent & variability in outcomes across infection types #idsky www.sciencedirect.com/science/arti...
- 🔥🆕PERFECT RCT Preoperatively started antibiotic treatment did not decrease the risk of appendiceal perforation when appendectomy was performed within 24h in adult patients with presumed uncomplicated acute appendicitis. #IDsky A new standard of care? jamanetwork.com/journals/jam...
- Reposted by Antibiotic Steward 🅱️C🆔🅿️🌟This reflects a deficit in how we are trained to read the scientific literature. We always focus on how to interpret a single study. Every journal club everywhere = 1 article. We rarely discuss how to integrate multiple divergent articles (which can actually be a lot harder).
- Reposted by Antibiotic Steward 🅱️C🆔🅿️🌟REMAP CAP was too underpowered to show anything or add substantially to the existing evidence base. the reason it’s getting so much press is recency bias. we have a natural tendency to get jazzed up about the newest, hottest trial while ignoring the previous dozens of trials… #1/2 #EMIMCC
- 🆕🔥Updated systematic review & meta-analysis (+REMAP CAP) 30 RCTs,N=7519 Corticosteroids probably 🔽 short-term mortality 🔽the need for invasive mechanical ventilation & likely 🔽duration of ICU stay in adult pts hospitalised with non viral CAP #idsky #EMIMCC link.springer.com/article/10.1...
- 🆕💫The MEFIER Score - A Risk Score to Stratify Infective Endocarditis in Patients with Enterococcus faecalis bacteremia based on an 11-year territory-wide cohort AUROC of 0.79 (95%CI 0.72-0.88), and a NPV of 0.98 (95%CI 0.97-0.99) #idsky #IEWiki academic.oup.com/ofid/advance...
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- 🆕💫 Systematic Review and Meta-Analysis 30 observational studies( SNAP & CloCeBa not included) N: 3869 Cefazolin versus Antistaphylococcal Penicillins for the Treatment of MSSA Bacteremia #idsky www.clinicalmicrobiologyandinfection.com/article/S119...
- "The available clinical evidence does not support replacing the recommendation of trimethoprim-sulfa as first line therapy. However, considering the PK/PD findings, it is equally possible to conclude that in these studies suboptimal agents were compared to suboptimal agents" #idsky
- 🆕💫 New narrative review challenges the longstanding reliance on TMP-SMX for the treatment of Stenotrophomonas infections—citing PK/PD concerns and rising resistance. Also questions mono vs combo use. Clinical data still limited. Worth a close read #idsky www.sciencedirect.com/science/arti...
- All treatment recommendations are confounded by the fact that the isolation of S. maltophilia from clinical specimens other than blood cultures often represents colonisation rather than active infection where the benefits of antimicrobial treatment are doubtful #idsky
- 🆕💫 New narrative review challenges the longstanding reliance on TMP-SMX for the treatment of Stenotrophomonas infections—citing PK/PD concerns and rising resistance. Also questions mono vs combo use. Clinical data still limited. Worth a close read #idsky www.sciencedirect.com/science/arti...
- 🆕💫 New narrative review challenges the longstanding reliance on TMP-SMX for the treatment of Stenotrophomonas infections—citing PK/PD concerns and rising resistance. Also questions mono vs combo use. Clinical data still limited. Worth a close read #idsky www.sciencedirect.com/science/arti...
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- 🆕💫 Viewpoint JAMA Nitrites for Urinary Tract Infection—Time to Say Goodbye? #idsky #EMIMCC #UTIsky jamanetwork.com/journals/jam...
- 🆕🔥Updated systematic review & meta-analysis (+REMAP CAP) 30 RCTs,N=7519 Corticosteroids probably 🔽 short-term mortality 🔽the need for invasive mechanical ventilation & likely 🔽duration of ICU stay in adult pts hospitalised with non viral CAP #idsky #EMIMCC link.springer.com/article/10.1...
- For streptococci, blood cultures virtually always cleared by day 2, so clearing quickly is not helpful. In contrast, for MSSA, MRSA, and E faecalis, clearance of blood cultures after 1 day of therapy was also very helpful at negatively adjusting the risk of IE. #IDSky
- 🆕🔥Case-control study @bradspellberg.bsky.social Just 1/4 blood cultures positive (≥2 sets drawn) or early clearance → low IE probability. Persistent bacteremia or 4/4 bottles ↑ pretest probability Simple bedside clues to sharpen your endocarditis game. #IDSky #EMIMCC jamanetwork.com/journals/jam...
- All species had significant negative LRs if only 1 of 4 blood culture bottles was positive on admission. This includes S aureus, challenging the current practice that every patient with S aureus community-acquired bacteremia requires a TTE for further work-up. #IDSky #EMIMCC
- 🆕🔥Case-control study @bradspellberg.bsky.social Just 1/4 blood cultures positive (≥2 sets drawn) or early clearance → low IE probability. Persistent bacteremia or 4/4 bottles ↑ pretest probability Simple bedside clues to sharpen your endocarditis game. #IDSky #EMIMCC jamanetwork.com/journals/jam...
- 🆕🔥Case-control study @bradspellberg.bsky.social Just 1/4 blood cultures positive (≥2 sets drawn) or early clearance → low IE probability. Persistent bacteremia or 4/4 bottles ↑ pretest probability Simple bedside clues to sharpen your endocarditis game. #IDSky #EMIMCC jamanetwork.com/journals/jam...
- I don’t usually post around this time—unless something 🔥 drops. Time zones don’t matter when it’s this good Worth breaking the pattern #IDsky #EMIMCC
- 🆕🔥 State of the art review article @cmicomms.bsky.social Approach to Clostridioides difficile Diarrheal Infection ( CDI) Excellent discussions about the management of CDI #IDsky #mustread www.sciencedirect.com/science/arti...
- 🆕💫New Hope, New Threat: Ceftazidime/avibactam brought promise—resistance followed fast. England’s 4-year data shows why real-time surveillance and stewardship matter more than ever. A must-read #IDsky pmc.ncbi.nlm.nih.gov/articles/PMC...
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- 🆕🔥 State of the art review article @cmicomms.bsky.social Approach to Clostridioides difficile Diarrheal Infection ( CDI) Excellent discussions about the management of CDI #IDsky #mustread www.sciencedirect.com/science/arti...
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- 🆕💫Large Multicentre cohort study Epidemiology, Treatment, and Outcomes of Gram-Negative Bacteremia in Solid Organ Transplant Recipients #IDsky onlinelibrary.wiley.com/doi/full/10....
- Tetracyclines, esp doxycycline and minocycline, are of interest because of their broad-spectrum activities,good oral bioavailability, and potential efficacy in treating BJIs 🆕💫Review Oral tetracyclines for bone and joint infections: what do we know? #idsky jbji.copernicus.org/articles/10/...
- Reposted by Antibiotic Steward 🅱️C🆔🅿️🌟Wow! If anyone ever doubts the power of crowd sourcing, look at the vaccine RCT table that has been built already, in under 24 h! Unbelievable work by @jakescottmd.bsky.social Dr. Abdhay Dand, @alejodiaz81.bsky.social and Dr. Ali Meza Vazquez! bradspellberg.com Vaccine RCTs | mysite
- A 25 yo man from Guatemala with 5y sore throat, odynophagia & oral papules. Biopsy: non-necrotizing granulomas, multinucleated cells + budding yeasts. All cultures neg x8w. Hx: childhood exposure to coffee crop soil. What’s your differential?! #idsky #idxposts academic.oup.com/cid/article-...
- REMAP-CAP (steroids arm) reignited debate—again. Past RCTs gave mixed signals, and this trial adds fuel and lessons. Yes, it has pitfalls, but even “negative” studies push the field forward. Innovation in trial design is a double-edged sword. Grateful for the dialogue on X & BlueSky #idsky #EMIMCC
- 🔥REMAP-CAP RCT🔥 Among patients admitted to the ICU with severe non-pandemic CAP & either cardiovascular or respiratory failure there was a low probability that a 7d fixed-duration course of hydrocortisone improved 90d mortality @pulmcrit.bsky.social #EMIMCC #IDSky link.springer.com/article/10.1...
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- Not gonna lie, I’m still wrapping my head around RAR (Response-Adaptive Randomization). Anyone have a simple breakdown? #idsky
- 🔥REMAP-CAP RCT🔥 Among patients admitted to the ICU with severe non-pandemic CAP & either cardiovascular or respiratory failure there was a low probability that a 7d fixed-duration course of hydrocortisone improved 90d mortality @pulmcrit.bsky.social #EMIMCC #IDSky link.springer.com/article/10.1...
- Plenty of critiques floating around X platform about the design of this adaptive RCT—what are your thoughts? #idsky #EMIMCC
- 🔥REMAP-CAP RCT🔥 Among patients admitted to the ICU with severe non-pandemic CAP & either cardiovascular or respiratory failure there was a low probability that a 7d fixed-duration course of hydrocortisone improved 90d mortality @pulmcrit.bsky.social #EMIMCC #IDSky link.springer.com/article/10.1...
- 2 recent RCTs: ESCAPe MP ❌️ CAPE COD HC ✅️ ➕️ Meta-analyses ✅️ Now REMAP CAP ❌️ A 🔥 topic in critical care & ID #idsky #EMIMCC
- 🔥REMAP-CAP RCT🔥 Among patients admitted to the ICU with severe non-pandemic CAP & either cardiovascular or respiratory failure there was a low probability that a 7d fixed-duration course of hydrocortisone improved 90d mortality @pulmcrit.bsky.social #EMIMCC #IDSky link.springer.com/article/10.1...
- 🔥REMAP-CAP RCT🔥 Among patients admitted to the ICU with severe non-pandemic CAP & either cardiovascular or respiratory failure there was a low probability that a 7d fixed-duration course of hydrocortisone improved 90d mortality @pulmcrit.bsky.social #EMIMCC #IDSky link.springer.com/article/10.1...
- Measles cases in Europe hit a 25-year high—127,000+ in 2024 alone. Low MCV1 coverage post-pandemic is fueling the surge. But it’s not just the rash: measles can trigger immune amnesia, wiping the body's memory of past infections. A setback we can’t afford #IDsky jamanetwork.com/journals/jam...
- Treatment guidelines recommend rapidly treating all patients with suspected sepsis with broad-spectrum antibiotics. This may contribute to antibiotic overuse. #IDSky
- Sepsis alert in the ED 🚨 Overuse of antibiotics and aggressive regimens are sparking complications. See the alarming stats below! How can we boost antibiotic stewardship? Share your thoughts! [Link to the new study in CID] #IDSky academic.oup.com/cid/advance-...
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- Sepsis alert in the ED 🚨 Overuse of antibiotics and aggressive regimens are sparking complications. See the alarming stats below! How can we boost antibiotic stewardship? Share your thoughts! [Link to the new study in CID] #IDSky academic.oup.com/cid/advance-...
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- Honest reflection: ESCMID 2025 felt quieter online this year—fewer posts, threads, and live updates. Why the shift? – Scattered hashtags – X/Bluesky split – Time zone mismatch – Less live posting – Conference fatigue? Did others notice it too? #ESCMIDGlobal #IDSky
