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@NIHRresearch Academic Clinical Lecturer | Paediatric Immunology and Infectious Diseases | Clinical trials | Vaccines | Antibiotics | @apsmunro.bsky.social
United Kingdom
Joined April 2013
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I’ve noticed many comments criticising RCTs of masks or filters come from engineers
These criticisms are often, understandably, caused by misunderstandings about what RCTs are for (engineers do not usually use RCTs)
Here is my attempt to explain
munro-link.alasdairmunro.wor…
Two new trials of adjunctive steroids for Kawasaki disease are negative for the primary outcome of reducing coronary artery aneurysms
But I might use them anyway
Why? Join me to explore the conclusive but intriguing results of these new studies!
munro-link.alasdairmunro.wor…
Alasdair Munro retweeted
The sum total of evidence that IV abx must be used for IE is:
1) uncontrolled case series of oral sulfa drugs (not trim-sulfa, sulfa alone), tetracycline, or erythromycin from the 1940s-50s
2) an opinion from Max Finland in a review article in NEJM in 1954, citing those series
Piperacillin/tazobactam (Tazocin, Zosyn etc) is ultimately a drug for Pseudomonas aeruginosa
Are you worried about Pseudomonas? Pip/taz is a great choice
Not worried about Pseudomonas? You don’t need pip/taz, there is almost certainly a better option
Two new RCTs of adjunctive steroids for Kawasaki disease
Both negative for improving coronary artery aneurysms (primary outcome)
BUT both show quicker resolution of fever and inflammatory markers, and less "salvage therapy" (2nd IVIg, biologics)
Does this make steroids useful?
A truly insane feature within the NHS is nurses needing specific training to be allowed to give IM vaccines that is completely separate from giving any other IM medication
If a child needs vaccinating on a ward, frequently a paediatric SHO will need to give it
Non-sensical
A call to abandon performative physical examinations. Join me?
Physical Examination for Asymptomatic Adults | New England Journal of Medicine nejm.org/doi/full/10.1056/NE…
Alasdair Munro retweeted
Kids are back to school, which means the onslaught of recurrent coughs and colds is about to begin!
But is there any way of “boosting”kids immunity with diet/supplements or exercise to stop them getting sick?
We reviewed the evidence to find out 🧐
munro-link.alasdairmunro.wor…
Kids are back to school, which means the onslaught of recurrent coughs and colds is about to begin!
But is there any way of “boosting”kids immunity with diet/supplements or exercise to stop them getting sick?
We reviewed the evidence to find out 🧐
munro-link.alasdairmunro.wor…
Alasdair Munro retweeted
Interesting post about TriNetX. This is the source for the recent shingles/heart failure piece. It is a very odd database..
Multiple independent analyses by researchers ensures the integrity of results.
While journals require that the authors "have access to the data" authors often use data analyzed by others and not themselves.
"Editors and reviewers need to decide whether authors should be permitted to outsource important analytic decisions."
retractionwatch.com/2026/08/…
The looks on people’s faces every time I prescribe doxycycline for a child 🤭
ITS 2026 PEOPLE GET WITH THE TIMES
I am on a crusade to stop hospital specialists using IV antibiotics where oral antibiotics can be used instead
They are cheaper, safer and more convenient for the patient and the nursing staff
If you want to use the worse alternative you must provide a convincing reason why
If you are going to ask a patient to do something FOUR TIMES A DAY you had better be ~100% sure it is going to make a significant difference to their health
Alasdair Munro retweeted
The story has an academic-careeer-doom reproduction rate greater than 1, which means it only ends after herd immunity is reached and two thirds of academia has resigned.
wait this is true -- the Ghent University rector who (according to Cofnas) suspended him read a speech with fabricated quotes (!!!!)
This story will never end
vrt.be/vrtnws/en/2026/01/08/…
Completing my APLS pre-learning and getting so triggered by constant referrals to “sepsis 6”
Need to keep my mouth shut on the course day…
Alasdair Munro retweeted
RFK Jr said the Samoa measles outbreak may have been caused by the vaccine itself.
He said babies can’t get exposed to Hepatitis B.
He said the Covid shot was the deadliest vaccine ever.
What other conclusion can you reach? He’s a liar.
How do I know RFK Jr lies? Because I’ve been documenting those lies for years.
Read and analyze as much of RFK Jr’s work as I have, and you will conclude the same thing.
theatlantic.com/health/archi…
I had no idea such devices even existed how in earth was this ever allowed to be sold
⚠️ The @MHRAgovuk has issued a warning on all rectal catheters: do not use in infants, including for the treatment of colic, gas-related discomfort or constipation.
Read more here, and please share to your networks: gov.uk/drug-device-alerts/al…
My analysis of the recent Executive Order on the childhood vaccination program from the White House
An ultimately misguided and self defeating document that would only achieve the opposite of its own stated goals
munro-link.alasdairmunro.wor…