@josemolinagb.bsky.social
ID doc & Antibiotic Steward • • Clinical trials and #FOAMed believer • Now on @shorten2trial.bsky.social #AMSsky #IDSky #AMR Hospital Virgen del Rocío • Seville, Spain 🇪🇸
Although I'm not surprised that there is a huge disparity in the knowledge that antibiotics don't work against viruses globally, what is disappointing to see is there are still so many Americans who believe they do.
#IDSky #AMSSky
www.clinicalmicrobiologyandinfection.org/article/S119...
En infección urinaria, menos es más 👌🏻
Nuestro hilo sobre diagnóstico y tratamiento de la infección urinaria.
☝🏻 Bacteriuria asintomática
#EAAD #WAAW #AMSsky #MedSky #UTIsky
(🧵1/2)
bsky.app/profile/hosp...
👆🏻 #AMSsky
20.11.2025 00:17 — 👍 0 🔁 0 💬 0 📌 0
💡Applications for the 2026-2028 AMS Certificate Programme & EUCIC Certificate Programme are open! These training programmes are designed to strengthen your expertise in antimicrobial stewardship & IPC.
Learn more:
AMS: https://ow.ly/kYz550Xu6iW
EUCIC: https://ow.ly/zlsl50Xu6iU
#IDSky #clinmicro
#WinterIsComing 🥶
Un hilo con nuestras recomendaciones para acertar con tus tratamientos de consulta para las infecciones respiratorias.
☝🏻 Neumonías y EPOC reagudizado
#EAAD #WAAW #AMSsky #MedSky #PharmSky
(🧵1/4)
bsky.app/profile/hosp...
¿Trabajas en consulta?
¡Te necesitamos!
El uso prudente de los antibióticos es responsabilidad de todos. Durante toda esta semana, no te pierdas nuestros vídeos para hacer un uso prudente de los antibióticos.
💪🏻 ¡La lucha contra las resistencias empieza en tu consulta!
#EAAD #WAAW #AMSsky
¿Trabajas en consulta?
¡Te necesitamos!
Durante toda esta semana, no te pierdas nuestra serie de vídeos prácticos para hacer un uso prudente de los antibióticos en tus pacientes ambulatorios
👊🏻 La lucha contra las resistencias, empieza en tu consulta
#EAAD #WAAW #AMSsky #MedSky #PharmSky #SomosHUVR
¡Ya tenemos todo listo para el Día Europeo para el Uso Prudente de los Antibióticos!
Mantente atento a las redes de @hospitaluvrocio.bsky.social y @guiaprioam.bsky.social durante la semana que viene.
Tenemos un mensaje para ti… 😉
#EAAD #WAAW #AMSsky #SomosHUVR
DoxyPEP in MSM (n=362) led to 35.5% high-level tetracycline resistance vs. 12.5% in no-PEP (p=0.043). Cefixime susceptibility decreased (32.3% vs. 10.0%, p=0.033). AMR monitoring is essential.
#idsky
It’s SO #AMSsky… 😂😂😂
22.10.2025 14:32 — 👍 3 🔁 0 💬 0 📌 0
Dr Tamma mentions the ongoing GOAT trial (PI Tamma & Cosgrove)
This will be a most needed and important study. clinicaltrials.gov/study/NCT060...
#IDweek2025 #IDsky
New from IDSA, thanks to Dr William Werbel, resp virus vax in immunocompromised population:
- vax 2 weeks before or 3-6 months after immunocompromise expected
- expect blunted response if given within that window
- defer during acute rejection, illness
- adjust for viral circulation
#IDSky #IDWeek
🆕🔥🔥CloCeBa RCT
Cloxacillin versus cefazolin for MSSA Bacteraemia
Cefazolin has a non-inferior efficacy regarding mortality, microbiological or clinical endpoints and was associated with a lower rate of serious adverse events #IDSky
www.thelancet.com/journals/lan...
Fantastic - this will be an impactful study on treatment duration of blood stream Pseudomonas infection.
Our centre already mostly does 7 days (and my prediction is that this will be non-inferior) but it's RCT like these that will shift dial across the board with persuasive evidence.
#IDSky #AMR
The rationale of the RCT was testing the current standard (7d) in the specific setting of Pseudomonas BSIs.
The DURATIONS design is a relevant contribution, but it adds complexity and I wonder if a multi-arm (5?) approach is convenient when testing durations in such a narrow timeframe.
There was a session at ESCMID 2025 on macrolides for CAP and this paper was heavily featured (lead investigator was panelist). Patient population in this trial was much “sicker” than in other studies. I was convinced of their role and benefit, but not for every hospitalized pt (icu only perhaps)
18.10.2025 13:26 — 👍 3 🔁 1 💬 1 📌 0
Totally agree. Definitely not for any CAP.
I was also shocked by the mean age (>80y) and Charlson. Probably this was a major driver for the high mortality, beyond the severity of the infection itself — mean CURB65 was 2-3, the setting for recruitment were Internal Medicine wards instead of ICUs…
I have the same concern!
In this RCT, 25% of patients received steroids in both arms.
The subgroup analysis showed benefits independently (and apparently superior) to the use of steroids, but this relevant question was not primarily addressed by the trial
pdf.sciencedirectassets.com/271247/1-s2....
Full protocol: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0277333
Recruitment for SHORTEN-2 is officially complete!
Our team is now wrapping up follow-up and polishing databases. Hope to have results ready in the first half of 2026!
Hats off to this awesome research team! 🥳
#AMSsky #IDsky @seimc.bsky.social @ciberisciii.bsky.social @ibis-investigacion.bsky.social
I think REMAP-CAP has ongoing domains to adress this question, hopefully we’ll get new data soon to confirm the hypothesis
🤞🏻 www.remapcap.eu/domains/
Ref: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(23)00412-5/abstract
Ref: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(23)00412-5/abstract
Ref: https://www.sciencedirect.com/science/article/pii/S0924857924003224?via%3Dihub
I’ve always been skeptical on the antinflammatory role of macrolides too, but ACCESS RCT made me reconsider.
Results seem consistent across all endpoints and subgroups, and biologically plausible 🤔
A post-hoc analysis suggested the effect is independent -maybe superior- to steroids #AMSsky #IDsky
New on The SHEA Podcast!
Dr. Jonathan Ryder and Dr. Aditi Ramakrishnan discuss the intersection of sexually transmitted infections and antimicrobial stewardship.
Listen now: bit.ly/488Ar9I
Heat map of countries funding ID clinical trials and countries where ID clinical trials are conducted.
Our new paper in @cmijournal.bsky.social led by the brilliant Hadrien Moffroid, a junior colleague in Melbourne. We examined international funding flows in ID RCTs published in selected high-impact journals over a 10-year period.
doi.org/10.1016/j.cm...
@steventong.bsky.social #IDSky
We are now accepting applications for the role of Guidelines Director. This honorary position is responsible for overseeing the entire ESCMID Guidelines portfolio with the support of the Guidelines Counsellor and Subcommittee. Learn more and apply today! ow.ly/Oz2a50WTNSC
#IDSky #clinmicro
We all need some good news
👏🏽👏🏽👏🏽
“The revolutionary HIV prevention tool, injectable lenacapavir, will be available at a cost of US$40 a year in 120 low- and middle-income countries starting in 2027”
@unitaid.bsky.social CHAI Wits RHI
unitaid.org/news-blog/le...
Prolonged IV antibiotics aren’t just a patient safety issue - they generate considerable CO₂e
#AMS is climate action
doi.org/10.1093/jaca...
#JACAMRNews #Stewardship #Sustainability #IDSky @saiedali.bsky.social
📈 Imported cases are rising:
1,700 in 2015 → 5,100 in 2023
Now we’re also seeing more local transmission.
👩⚕️ ECDC is running weekly enhanced surveillance across the EU/EEA - tracking cases and supporting public health action, including for substances of human origin (#SoHO).
#IDsky #EpiSky
Agree!
Also, max dose isn’t always about GI tolerance: absorption matters too.
Hydrophilic drugs like BL need transporters in intestinal epithelium that saturate. So beyond a certain dose (e.g.1g amoxicillin), more drug ≠ more exposure!
A review on the topic 👉🏻 www.sciencedirect.com/science/arti...
The absolute risk difference of relapse for oral BL is low (<5%) in most studies pointing this problem, and it didn’t seem to be confirmed in works specifically assessing high-dose oral BL (🧵1/4).
www.clinicalmicrobiologyandinfection.com/article/S119... #UTIsky #AMSsky #IDsky
You’re right, maybe the term isn’t ideal here.
I think they mean oral cipro can maintain exposure thanks to higher doses than IV.
But oral BLs usually mean lower total doses than their IV equivalents (cefazolin 2g/8h, amox/clav 1g/200mg/8h…).
I had a slide on this from a previous ESCMID Global! 😉
