Paul Adamson MD MPH

Antibiotics in Hospice: Applying the Four-Quadrant Approach to Improve Patient-Centered Care Abstract. The use of antibiotics in the hospice setting is complicated by differing patient goals, elevated side effects, and limited information regarding

As (also) a palliative care doc, this message hit home with me:

“Antibiotics may be beneficial in some cases and should not be denied to patients enrolled in hospice care.”

Sometimes treating active infection improves sxs and is aligned with hospice goals.

academic.oup.com/cid/advance-... #IDSky

As an aside, how do you see these so quickly?!? I heard it here before it was in my email box! 😱

Very interesting. It seems we have also been seeing an increase in KS recently, some in PLWH (though no necessarily with advanced disease) and some without. Some of us have wondered if there is something else going on.

Reports of organ donor–derived Kaposi sarcoma–associated herpesvirus among transplant recipients (n = 46) and investigation of additional recipients* — United States, January 2021–September 2025. * Retrospective KSHV testing of the 46 donors whose organs were associated with posttransplant donor organ KSHV infection identified 25 (54%) who received positive results and four (9%) who received negative results; organs from 17 (37%) donors had not been tested.

Number of reports of suspected organ donor–derived Kaposi sarcoma–associated herpesvirus infections in transplant recipients (N = 57) — United States, January 2010–September 2025

Kaposi Sarcoma–Associated Herpesvirus Infection and Complications Among Solid Organ Transplant Recipients — United States, January 2021–September 2025

New in MMWR

-46 cases of susp donor-derived KS in SOT, vs 9 from 2016–2020
-2/3 donors had a hx of nonmedical drug use

www.cdc.gov/mmwr/volumes...

Exciting research here on the development and lab evaluation of #CRISPR #POC tests for #STIs (chlamydia, gonorrhea, syphilis, HSV 1 /2)

Also very interesting they could detect S91F to predict cipro resistance in #gonorrhea

POC tests for STIs can be game-changers in many settings

#STIsky #IDsky

They are the fire extinguishers of medicine.

The subscription style reimbursement models seem to be a good move. The US just re-introduced the PASTEUR Act (2.0) for this too 🙏🏽 #AMR

My top 10 ID papers for 2025. Full citations and descriptions available at clarityinitiative.org/hot-takes

Also see/hear our Communicable podcast episode on this at communicable.transistor.fm/episodes/com...

What were your top 10? Any thoughts about what I missed welcome!

#IDSky #Top10papers

A titan of vaccine development sees his field’s achievements slip away Stanley Plotkin, the 93-year-old "godfather of vaccines," is watching his field’s achievements slip away.

A doozy of a quote in this profile of the "godfather of vaccines" by @helenbranswell.bsky.social, as he watches his field trend in the wrong direction

“All I can say is that I’m beginning to regret having lived so long — because we’re going downhill,”

www.statnews.com/2026/03/02/s...

Effectiveness of Doxycycline in Combination with Other Antibiotics for Gram-Positive Periprosthetic Joint Infections: a Causal Inference Study AbstractObjectives. Doxycycline is occasionally used as step-down therapy in periprosthetic joint infections (PJI), but evidence supporting its efficacy is

New PJI study in @ofidjournal.bsky.social:

Largest restrospective study to date of doxycycline use for PJI treatment with encouraging results

All doxycycline use was in combination though, primarily rifampin. Limited to Staph, Coryne, & Cuti

#IDSky #OrthoID

academic.oup.com/ofid/advance...

Transplant Infectious Diseases Career Development Position 2026-2027 University of California, Los Angeles is hiring. Apply now!

We are still accepting applications for our #TID fellowship/advanced training year at UCLA for 2026-27 ☀️ 🌴 - please reach out w any questions about this opportunity! recruit.apo.ucla.edu/JPF10380 #MedEd #IDSky @txidfellows.bsky.social @ast-idcop.bsky.social @idsainfo.bsky.social @idjclub.bsky.social

Uncomplicated Urinary Tract Infections: From an Invisible Impact to a Visible Change in Complex Care Uncomplicated UTIs may have high recurrence rates in subsets of patients, causing a substantial burden. Increasing antimicrobial resistance in uropathogens

Good overview of an increasingly rapid-evolving field, including newly updated guidelines, non-antibiotic treatments and focus on quality of life. #UTISky

academic.oup.com/cid/advance-...

WHO now recommends near point-of-care tests, tongue swabs, and sputum pooling for TB diagnosis!

Big advance!!

www.who.int/teams/global...

Liver Necrosis in a Patient Receiving Isavuconazole: Making the Case for Therapeutic Drug Monitoring Abstract. An 81-year-old man prescribed isavuconazole for pulmonary fungal infection developed high serum transaminases and biopsy-confirmed hepatic necros

A case of liver necrosis 2/2 isavuconazole in a patient with genetic mutation leading to low CYP3A5 activity.

😳 Detectable levels 3 months after medication stopped
🤔 Authors suggest ALT/AST testing and TDM in older pts who have longer Isavu courses

#IDSky

academic.oup.com/ofid/advance...

🤨Comparative Effectiveness of 3 Benzathine Penicillin G-Based Regimens in PWH With Early Syphilis #CROI2026

credits @ hivvirology

Very interesting!

Do you know the doxy duration?

Randomized? Couldn't tell from abstract.

French study confirms efficacy of on-demand PrEP Eight years after it started, the final results of a large French study that offered a choice of daily or event-driven oral PrEP (using tenofovir disoproxil/emtricitabine) were presented at the Confer...

Final results from a huge French PrEP study finds both daily and on-demand (aka 2-1-1) oral PrEP are safe and effective for HIV prevention.
#CROI2026

The #GoGoVax 🇦🇺 trial of the #menB vaccine against #gonorrhea among men observed no effectiveness.

Results obviously disappointing, as we need more tools to prevent gonococcal infections, esp as #AMR rises. Some hope for #MAGI study 🙏🏽

#IDSky #STIsky #MedSky #CROI2026

www.healio.com/news/infecti...

Strong real-world evidence that a single dose of benzathine penicillin G or a 28-day course of oral doxycycline is not inferior to three doses of benzathine penicillin G for the treatment of late late... Noah Kojima, Jeffrey D Klausner; Strong real-world evidence that a single dose of benzathine penicillin G or a 28-day course of oral doxycycline is not inf

Editorial is definitely worth a read - it goes into some of the historical aspects of #syphilis and treatments.

Interesting (but not terribly surprising) to learn that 3-dose regimens were based on very low quality evidence and haven't changed in 50 years! 🤯

academic.oup.com/cid/advance-...

There are shortages of #BPG. Cases of #congenitalsyphilis are surging. A clinical trial of different treatment regimens for late or unk duration #syphilis is desperately needed.

Not only in the US, but in other global settings where access and resources are limited.

#STIsky

Is three really what we need? Relative effectiveness of benzathine penicillin G and doxycycline treatment regimens for late or unknown duration syphilis in 6 United States jurisdictions, 2016–2021 In this retrospective cohort analysis using surveillance data, appropriate serological response by 24 months was comparable among persons with late or unkn

Important paper about how we treat #syphilis - are 3 doses of benzathine #penicillin G needed for late or unk duration infections? Using surveillance data, no differences in 1 v 3 doses of BPG (or vs 28d of #doxy) were observed.

We need a trial👇🏽!

#IDsky #STIsky

academic.oup.com/cid/advance-...

#CROI2025 #idsky Twice-Daily Dolutegravir With a 4-Month Rifapentine-Based Regimen for HIV-Associated Tuberculosis presented by Sean Wasserman:
-DTG clearance markedly increased by RPT 1200mg co-administration
-DTG bid dosing with RPT-based TB tx:
therapeutic, safe, achieved Viral suppression

Unfortunate results of the #STOMP trial for #mpox.

We really need therapeutic options for mpox, as infections are ongoing in many communities.

And bravo to the study team - trial data on investigational treatment options are so important.

Pretransplant serologic testing for fungal infections in a large commercial health insurance database, United States Abstract. Reactivation of latent fungal infections poses a substantial risk for solid organ transplantation (SOT) and hematopoietic cell transplantation (H

Great data on pre-transplant serologic testing for fungal infections in the US by my friends at the CDC and @jessicalittlemd.bsky.social #IDSky #MedSky academic.oup.com/mmy/advance-...

More than a message: Death by a 1,000 “Chats” Abstract. Secure electronic messaging within the electronic health record (EHR), such as Epic Chat, has transformed communication in hospitals by enabling

This is SUCH a good point. Life now all about being peppered by 100s of parallel mini-conversations by various message platforms.

In clinical space, what does this do? Can we do more things at once? Are we more distracted, and creating risk?

Food for thought for all of us, not just #IDSky #MedSky

Such a good article!

This has become such a big issue recently. Definitely need to plan around, since unlikely going away

Also interesting chats seem more efficient than in-person/phone comm, but I suspect actually take longer to type, read, respond, back-forth etc (+ add constant distraction)

More than a message: Death by a 1,000 “Chats” Abstract. Secure electronic messaging within the electronic health record (EHR), such as Epic Chat, has transformed communication in hospitals by enabling

Check out our article and guidance on Epic chat messages in CID. Anyone doing frontline clinical work understands the substantial downsides of constant, on-demand, text communication in the EHR. So great to write this with ID fellows. doi.org/10.1093/cid/...

Brilliant plenary on STI trends at #CROI2026. DoxyPEP implementation in Seattle shows indirect reductions of syphilis rates in cisgender women who are not the target group for the intervention. Shared sexual networks with men who are the target intervention group?

This is concerning on so many levels

Hospitals Fighting Measles Confront a Challenge: Few Doctors Have Seen It Before - KFF Health News As the number of cases grows to about 1,000 in the Carolinas, health care workers who’ve never seen the vaccine-preventable disease can get caught by surprise.

This is the consequence of a successful measles vaccination program and achieving the measles elimination status. Until recently, physicians mostly saw measles cases in international travelers and visitors.
#measles #vaccination #pedsky #IDSky
kffhealthnews.org/news/article...

As always @holdenthorp.bsky.social hits the nail on the head. Deprioritizing discovery science stifles innovation & means less US created intellectual property. How-and will-US biosciences recover? @idsainfo.bsky.social @csis.org