Matt Pike

Unbelievable detective work….

Wanted to get a feel for how many sites are using loading regimens of clofazimine for NTM given PK. If so, what dosing strategy? Any barriers from FDA or manufacturer as far as IND including this dosing strategy? #IDSky

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

@steventong.bsky.social presents the results of the PSSA domain of the SNAP 🫰 trial - the worlds largest trial of staph aureus bacteremia - at #ESCMID2025

fluclox resulted in higher mortality and more AKI compared to penicillin for PSSA

The most important post in #ESCMIDGlobal #ESCMIDGlobal2025 #escmid2025
#IDSky

Say it aint STENO! New #Breakpoints episode out today with the brilliant Amy Mathers and @juliejusto.bsky.social on behalf of @sidpharm.bsky.social

We hope you love it!! 🎧 🎶 🧫

podcasts.apple.com/us/podcast/b...

A trojan horse, labeled "use case based on need & suitability" with warriors hidden inside labeled "profit-driven use case". Healthcare execs are greeted at the gates. the castle is labeled "healthcare"

From a talk on clinician job security in the AI era

There may be compelling use cases driven by need & product suitability, but they are a cover for profit-driven uses

Inspired by UPMC Infectious Disease Connect, Telehealth docs who undercut local clinicians for a contract at an urban NC hospital

Big Pharma Needs to Get Off the Sidelines The industry can’t continue to sit idly by while Robert F. Kennedy Jr. guts the nation’s public health agencies.

Noticeably silent amid the upheaval at HHS? Big pharma. Every new drug has NIH somewhere in its DNA--and NIH funding supports the training of their workforce. Now they're finding out FDA isn't safe, either. Wrote about how keeping quiet isn't working My latest @opinion.bloomberg.com (gift link):

Determining the Optimal Ceftriaxone MIC for Triggering Extended-Spectrum β-Lactamase Confirmatory Testing | Journal of Clinical Microbiology ABSTRACT As routine testing of clinical isolates for extended-spectrum β-lactamase (ESBL) production (screen plus phenotypic confirmatory testing) is no longer required by the Clinical and Laboratory ...

#IDSky #MedSky #PharmSky @idsainfo.bsky.social @cidjournal.bsky.social @ofidjournal.bsky.social @sidpharm.bsky.social

🔥 Ceftriaxone MIC cutoff of 8 μg/ml is an excellent predictor of ESBL production; PPV and NPV approaching 100% and 99.5%, respectively.

doi.org/10.1128/JCM.00716-14

Scientists have just cured pancreatic cancer in some patients with personalized mRNA vaccines. Pancreatic cancer. And this Trump administration wants to throw it all away.

They’re throwing away a cure for cancer.

Blood culture–negative endocarditis has been associated with worse outcomes when compared with blood culture–positive endocarditis, because pathogen‐directed antimicrobial therapy and other management aspects have been difficult to achieve #idsky

Cefazolin may be an empiric treatment option for complicated urinary tract infections in those institutions with high susceptibilities for common UTI pathogens.
#pharmsky #idsky

rdcu.be/edSSG

In patients presenting with cUTI (including acute pyelonephritis) who are improving clinically on effective therapy, we suggest treating with a shorter course of antimicrobials, using either 5-7 days of a FQ or 7d of Non FQ rather than 10-14d
14 days for cUTI is obselete! #idsky #medsky #EMIMCC

Fluconazole step-down therapy versus echinocandins for the treatment of Candida glabrata invasive candidiasis with candidaemia AbstractObjectives. Candida glabrata is the second most common species responsible for invasive candidiasis, including candidaemia. Echinocandins are typic

Echinocandin Vs fluconazole step down in patients with candida glabrata candidaemia?!
🆕💫Retrospective, single-centre cohort study #JAC
No significant difference in treatment duration ,incidence of persistent candidaemia or 30-day clinical failure between 2 gps #idsky
academic.oup.com/jac/advance-...

fear of inadequate empiric coverage leads to excessive use of broad-spectrum antibiotics. to reassure you that it's OK to get it wrong (sometimes), we looked at clinical outcomes when empiric antibiotics were insufficiently broad and needed to be escalated
doi.org/10.1093/cid/...

Year In Review: Top Infectious Diseases Articles From 2024 In this article a selection of notable peer-reviewed publications from 2024 are provided. Article Selection by: Bassam Ghanem, Pharm.D., MS, BCPS Article Construction by: Timothy P. Gauthier, Pharm.D....

🔥🔥 NEW 🔥🔥
Year In Review: Top Infectious Diseases Articles From 2024
Our new post, a great collaboration with my friend
🌟 @idstewardship.bsky.social
1️⃣6️⃣⚡️🆔 RCTs
7️⃣Syst Reviews/Meta
3️⃣🌏Guidelines ✨️Wiki_Guidelines
#idsky #EMIMCC #medsky #utisky
EnJoy
Share plz!
www.idstewardship.com/year-review-...

Seems like $ will drive it. If a hospital may already have cefiderocol formulary with broader utility and/or cefta-avi w/ aztreo around it’s a small niche. I like they addressed loading, but regimen throws me in terms of dose vs vial size. Therapeutic need for load in some of those renal strata??

In their defence avibactam is a much better BLI than the 1st gen BLIs.

Lower ratios required for inhibition, less likely to encounter Rx failure through Beta lactamase hyperproduction.

We’ve done an episode on it, link to the show notes here for the interested:
idiots.notion.site/44-Beta-Lact...

And importantly, they gave NO IV LEAD IN to most patients in the oral arm. Started oral on day 1. Further busting the myth that some magical amount of IV lead in is necessary.

Intravenous Antimicrobials: Is It Time to Push? Intravenous (IV) push is an attractive option to administer antimicrobial therapy to patients in an efficient and effective manner in a variety of clinical settings. While many advantages to IV push a...

In the latest Bench to Bedside Column @sidpharm.bsky.social Dr. Jordan Chiasson and Dr. Kristen Zeitler, discuss IV push administration including safety profiles, PK/PD characteristics, and clinical data for IV push administration prior to utilizing it in specific populations. #Idsky

👇 Scripts/talking points for UTI #diagnosticstewardship #IDSky #MedSky #antimicrobialstewardship #healthcareepidemiology

Not in the clinic setting, but I know of Tobra IM on some occasions for UTI in ED. With the similar PK and PD, same dosing and same concentration, seemingly shouldn’t pose major issues to sub out was how i’ve thought about it!

Prophylaxis Against Pneumocystis jirovecii Pneumonia in Adults This JAMA Insights Clinical Update discusses current recommendations regarding prevention of Pneumocystis pneumonia in patients who are immunocompromised.

ID rule of thumb is to prophylax against PJP when high-dose steroids are used (i.e. 20mg or more of prednisone daily) for 4 or more weeks. Prophylactic regimens and other indications for prophylaxis are reviewed nicely in the linked JAMA article.

www.doi.org/10.1001/jama...

Interested in the use of antibiotics at end of life? Join our #ESCMID webinar on the topic next Wednesday 9-11am EST!
I'm honored to be speaking among the international panel.

You can register here! #IDSky

docs.google.com/forms/d/e/1F...

Effectiveness of ceftazidime–avibactam versus ceftolozane–tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study Treatment with ceftolozane–tazobactam resulted in higher rates of clinical success compared with ceftazidime–avibactam for invasive infections due to multidrug-resistant P aeruginosa. Differences were...

🦠 New insights from CACTUS: Ceftolozane-tazobactam shows higher clinical success rates than ceftazidime-avibactam for multidrug-resistant Pseudomonas aeruginosa pneumonia. A crucial step in optimizing treatment!

www.thelancet.com/journals/lan... #InfectiousDiseases

MRPKG | Product MRPKG Rationale Document Package

🔗 References:
1. CLSI M100 ED34:2024, Table 2A-1, Table 2D, Appendix E, Table 2 Dosages
2. Rationale document clsi.org/standards/pr...

Beta-Lactams Toxicity in the Intensive Care Unit: An Underestimated Collateral Damage? Beta-lactams are the most commonly prescribed antimicrobials in intensive care unit (ICU) settings and remain one of the safest antimicrobials prescribed. However, the misdiagnosis of beta-lactam-rela...

#IDSky #MedSky #PharmSky @idsainfo.bsky.social @cidjournal.bsky.social @ofidjournal.bsky.social @sidpharm.bsky.social

🚨 According to this publication beta-lactams with the highest seizure potential include: 1) Cefazolin, 2) Cefepime, and 3) PCN-G (Table 1).

doi.org/10.3390/microorganisms9071505

🆕💫 Narrative Review @cmicomms.bsky.social
@jeffpears0n.bsky.social
Tetracyclines, the Old and the New
🔹Tetracycline 1953
✨Doxycycline 1967
🔹Minocycline 1971
🔹Tigecycline 2005
🔹Eravacycline 2018
🔹Omadacycline 2018
#IDsky #EMIMCC
www.sciencedirect.com/science/arti...

I wonder if you could start with ampho + vori and request ampho sensi since the isolate looks so ugly. Vori doesn’t seem ideal, but looks to be the best azole option from a pkpd standpoint at that MIC factoring in protein binding and some leeway in dosing with weight-based.

Trial of Early, Goal-Directed Resuscitation for Septic Shock | NEJM Early, goal-directed therapy (EGDT) is recommended in international guidelines for the resuscitation of patients presenting with early septic shock. However, adoption has been limited, and uncertai...

www.nejm.org/doi/full/10....