@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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Alasdair Munro retweeted
🛡️ Why are transplant recipients especially vulnerable to infections as they age?
At #IDWeek2026, Anoma Nellore, MD, explored how immunosenescence + “inflammaging” compound the effects of transplantation.
Key takeaways 🧵👇
Alasdair Munro retweeted
Agree, of we’re not all moving to Bluesky or Roon, we might as well ask me on here and intermittently clean our feeds to keep it all the politics/racism
#IDtwitter forever!
An unpopular opinion:
The Bluesky experiment for the ID community has officially failed, IMHO.
Remember when so many ID folks migrated? Did we build a stronger community—or just split it across platforms?
#IDWeek2026 #IDXposts @BradSpellberg @PaulSaxMD @PulmCrit @IDstewardship
Alasdair Munro retweeted
We have a commentary out on some really interesting findings by colleagues in UCL and Finland on some of the maths behind some of the high profile shingles -> dementia analyses. In brief +
Paper: pubmed.ncbi.nlm.nih.gov/4245…
Commentary: kwnsfk27.r.eu-west-1.awstrac…
Alasdair Munro retweeted
The coolest part to me though was the protocol had patients switch to PO (cephalexin, cefadroxil, or linezolid) at 48-72hr after blood culture clearance. Nice to see early PO protocolized like this, especially with cephalexin and cefadroxil. I'm sure @BradSpellberg will be a fan
Alasdair Munro retweeted
Had another discussion with an MD concerned re fosfomycin for pyelo because "it doesn't get into the kidney". The damage guidelines have done medicine is incalculable. Perpetetuators of myth & legend. Forcing patients to get IV when they don't need it. It is time for a reckoning.
Alasdair Munro retweeted
The 1st of 2 new articles in CID critical of clinical guideline process is out. See
academic.oup.com/cid/article…
It is long past time clinical guidelines incorporate the humility of uncertainty & stop creating standards of care absent of reproducible prospective studies.
@ABsteward
Alasdair Munro retweeted
Underpinning this is a concept that became very apparent during #COVID19
Is the presentation missed, delayed or or late?
blogs.bmj.com/bmj/2020/08/15…
When undertaking reviews of these cases understanding these subtle differences critical to ensure true learning for the future
Alasdair Munro retweeted
A tour-de-force in healthcare communication from @apsmunro
The contradiction of a healthcare campaign promoting illness recognition only to see it potentially make the problem worse....
alasdairmunro.substack.com/p…
Alasdair Munro retweeted
Nice explanation from @apsmunro
Sepsis is rare, but devastating. It is a needle in a haystack for emergency care. Campaigns for ‘early awareness’ makes the haystack bigger, meaning that the needles are even more difficult to find.
There is a massive amount of attention on sepsis and "increasing awareness" among the public
There seems to be little recognition that increasing the amount of early presentations will also, paradoxically, increase the number of "missed" diagnoses
munro-link.alasdairmunro.wor…
Alasdair Munro retweeted
Does the shingles vaccine reduce the risk of developing dementia? The science isn't as solid as some claim, but private vaccinations are soaring. Was great to speak to @apsmunro to understand where we are at on the evidence:
thetimes.com/article/f9801b5…
Alasdair Munro retweeted
The NHS specifically advises AGAINST sponging or ANY physical cooling measures for fever
It does NOT bring core temperature down, and only serves to make the patient LESS COMFORTABLE by increasing their bodies efforts to keep their temperature elevated
nhs.uk/symptoms/fever-in-chi…
Alasdair Munro retweeted
We need this on t-shirts all over the land.
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
Alasdair Munro retweeted
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…
Alasdair Munro retweeted
Can I boost my child’s immunity with diet or supplements? The short answer is No
alasdairmunro.substack.com/p… via @apsmunro
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/…
