LDD retweeted
POET II RCT:: In stabilized patients with left-sided endocarditis caused by Streptococcus spp, Entero-coccus faecalis, or Staphylococcus aureus, tailored treatment - guided by the clinical response (POET criteria*) - shortened treatment by app. 2 weeks i.e. by 1/3 compared to standard duration therapy, #IDXposts #IEWiki
🆕🔥🔥POET II RCT NEJM
Among patients with infective endocarditis on the left side of the heart, the use of a response-tailored antibiotic strategy* resulted in a longer time alive without antibiotic therapy than standard-duration therapy and met the criterion for noninferiority with respect to safety but was associated with a higher incidence of relapse of bacteremia or IE #IDXposts
nejm.org/doi/full/10.1056/NE…
LDD retweeted
🚫Very important 🚫
Recommendation 4.6
Cefazolin does not share any side chains with the currently available penicillins and can be used in cases of suspected or proven immediate type allergy to a penicillin*, irrespective of severity or time elapsed since the index reaction (Strong recommendation, moderate quality of evidence – GRADE)
*: With the exception of patients with severe anaphylaxis (e.g. anaphylactic shock), in which case the panel recommends seeking expert evaluation first)
🔥Just published 🔥
ESCMID Clinical Guidelines on the Evaluation and Management of a Reported Antibiotic Allergy #IDXposts
clinicalmicrobiologyandinfec…
ALT Beta lactams flow shart
LDD retweeted
A tablet to prevent COVID infections in close contacts:
Ensitrelvir reduced the risk of transmission among household contacts with covid in this Phase 3 study from Japan.
This could be extraordinarily helpful in Long Term Care among vulnerable people.
tinyurl.com/3dfnman5
LDD retweeted
🆕🔥Systematic Review and Noninferiority Meta-Analysis 🌟s @DrToddLee @DrEmilyMcD
Seven vs Fourteen Days of Antibiotics for Gram-Negative Bloodstream Infection
@BradSpellberg #IDXposts
jamanetwork.com/journals/jam…
LDD retweeted
So:
Measles can be a big deal, most recover but bad outcomes happen and it still kills people - mostly kids- every year.
People may be blasé about this because the vaccine, which is safe, HAS worked well.
For most, two doses and you are good (prior exposures matter)
10/10
LDD retweeted
Hospital antibiotic stewardship programs with designated funding & resources use less fluoroquinolones, anti-pseudomonal agents, and clindamycin
🆕 in @ASHE_Journal
📰doi.org/10.1017/ash.2024.461
#antimicrobialstewardship
LDD retweeted
Post-hoc bias: a marginal improvement in symptoms tends to encourage patients/HCPs to continue treatment even when the change is coincidental. This can lead to continuing dubious and costly treatments, including unnecessary antibiotics:
jamanetwork.com/journals/jam… @JAMANetworkOpen
LDD retweeted
Drug-related hospital re-admission is common in older adults and many events are preventable. #Antibiotics are one of the top 3 drug classes implicated
link.springer.com/article/10… – at Toronto, Ontario
LDD retweeted
94% of patients with a penicillin allergy who were testing were negative.
Penicillin allergy testing should be a part of preoperative management.
Should Penicillin Allergy Testing Be Included as Part of Preoperative Testing? - PubMed pubmed.ncbi.nlm.nih.gov/3742…
LDD retweeted
Important for providers particularly in GTHA to understand most of this area falls into a lyme endemic zone (along with pockets in SW ON, around Kingston, and Up north). Very different than years past with small endemic zones.
publichealthontario.ca/-/med…
LDD retweeted
During Canada's shortage of children’s fever and pain medications, parents were guided to use weight-based divided doses of adult formulations.
Our new @NEJM study reports this was associated with increased paediatric dosing errors for Tylenol and Advil: nejm.org/doi/full/10.1056/NE…
LDD retweeted
An underrated reason to go from IV to Po antibiotics is nursing time required to prepare and administer them:
💊 PO 80 seconds
💉 IV 22 minutes
According to @jabicjenkins this time in motion data will help to convince non-stewards to support this important initiative
#ECCMID23
LDD retweeted
Poster 625 at #SHEASpring2023: Do you have FOMO (fear of missing organisms)? If your patient with a diabetic foot infection has not had a culture with Pseudomonas in the past year, this has a negative predictive value of 94%. Hold on the pip-tazo!
LDD retweeted
Fantastic review I was waiting for
🆕️🔥🔥 @CMIJournal
@CLandersdorfer @GweeAmanda
Prof.Nation
Clinical pharmacological considerations in an early IV to oral antibiotic switch:are barriers real or simply perceived?
Rationale of switch in context of PKPD
clinicalmicrobiologyandinfec…
LDD retweeted
The July issue of @PharmacoJournal is online at: buff.ly/2OJ01s6 @ACCP @Stephan55924484 @GI_PharmD @AbrarThabit @canuckIDpharm @DrRaziKeb @ASPLDD @wsueacphs @IDpharmresearch @LusizzZZ
LDD retweeted
Vaccination supports #antimicrobialstewardship
COVID-19 vaccination associated with reduced antibiotic prescribing in long-term care IRR 0.7 (95%CI 0.4-1) and community residents IRR 0.3 (95%CI 0.3-0.4)
@uOttawa @UofT_dlsph @ICESOntario @MPHMcMaster @PublicHealthON
A smart idea, importance of vaccination & antibiotic stewardship
🆕️⚡️⚡️Population Wide Cohort Study 🇨🇦 @CIDJournal Dr.MacFadden
COVID-19 Vaccination is Associated with Reduced Outpatient Antibiotic Prescribing In Older Adults with Confirmed SARS-CoV-2
academic.oup.com/cid/advance…
LDD retweeted
My husband Tom survived a #superbug infection yrs ago but like many, has several comorbidities. After >3yrs of avoiding #COVID, it hit him hard despite being vaxxed & getting #Paxlovid. He was hospitalized this wknd but is finally on the mend. #COVIDisNotMild #COVIDAwarenessWeek
LDD retweeted
Vancomycin is the oldest and most frequently used drug in our arsenal against MRSA
Despite being used for almost 65 years, vancomycin resistance (MIC ≥ 16 μg/mL) is extraordinarily uncommon, with just 52 incidents of VRSA reported worldwide in the past two decades #IDTwitter
Understanding the interaction
between host and pathogen is crucial to the challenge of improving patient outcomes!
🌟Another fantastic review🌟
by @VanceFowler5 et Al @antibioticsmdpi
Persistent MRSA Bacteremia: Host, Pathogen, and Treatment #IDTwitter
mdpi.com/2079-6382/12/3/455
LDD retweeted
Mandatory antibiotic indication field is a starting point to support #antimicrobialstewardship in the outpatient setting
From @ae_gross @sbleas66 @Papanikrolimus: Implementation and evaluation of the accuracy of mandatory outpatient indication fields - a useful start for benchmarking #outpatient antibiotic #stewardship programs #idtwitter
bit.ly/3EEtqxG
LDD retweeted
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
academic.oup.com/cid/article…
ALT Persistent MRSA bacteremia
