Erica Little, PharmD, BCIDP @cefiderica

Health Experts ‘Deeply Concerned’ After Drug-Resistant Bacteria Increase 460 Percent in U.S.: ‘Lives Will Be Lost’ The CDC reported a surge in NDM-CRE, dangerous bacteria that are “resistant to some of the strongest antibiotics.” The U.S. saw a 460% increase in infections of NDM-CRE between 2019 and 2023.

people.com/drug-resista...

25.09.2025 23:38 — 👍 5 🔁 5 💬 0 📌 0

Clinical consequences of delaying implementation of long-acting antiretroviral therapy for people with HIV and persistent viremia in the US CAB/RPV for people with HIV and persistent viremia in the US would lead to more viral suppression and fewer deaths compared to oral-based ART regimens. Inc

Clinical consequences of delaying implementation of long-acting antiretroviral therapy for people with HIV and persistent viremia in the US

✅ Just Accepted
⭐ Editor's Choice
#IDSky

13.08.2025 23:54 — 👍 5 🔁 6 💬 1 📌 1

Evaluating the Use of Lower Dose Flucytosine for the Treatment of Cryptococcal Meningitis: A Clinical Trial In this phase II trial, reduced-dose flucytosine (60 mg/kg/day) demonstrated inferior cerebrospinal fluid fungal clearance compared to standard dosing in c

Evaluating the use of lower dose Flucytosine for the Treatment of Cryptococcal Meningitis: A Clinical Trial.

✅ Just Accepted
#IDSky

14.08.2025 23:06 — 👍 1 🔁 5 💬 0 📌 0

Multidrug-resistant bacteria amid health-system collapse in Gaza Gaza's health-care system has faced widespread destruction during the ongoing Israeli military invasion that began in October, 2023, leading to a proliferation of disease outbreaks.1,2 During this tim...

#AMR infections are surging in Gaza as health care collapses. 60% of lower-limb wounds come from explosive weapons, driving infections amid medicine shortages and destroyed labs. MSF & WHO warn: zero fully functional hospitals. #Gaza #infectiousdisease

www.thelancet.com/journals/lan...

15.08.2025 04:09 — 👍 28 🔁 18 💬 0 📌 2

🆕🔥Prospective,multinational PK study by 🌟 Prof. Roberts
Meropenem & pip/tazo optimised dosing regimens for critically ill patients receiving RRT
Dosing nomograms developed to inform dosing for different RRT settings, urine outputs & target conc #idsky
link.springer.com/article/10.1...

14.08.2025 17:45 — 👍 7 🔁 2 💬 0 📌 0

Aztreonam–avibactam for the treatment of serious infections caused by metallo-β-lactamase-producing Gram-negative pathogens: a Phase 3 randomized trial (ASSEMBLE) The Phase 3 ASSEMBLE study investigated aztreonam–avibactam versus best available therapy (BAT) for treatment of complicated intra-abdominal infection (cIAI), complicated urinary tract infection (cUTI), hospital-acquired/ventilator-associated pneumonia (HAP/VAP) or bloodstream infection (BSI) caused by confirmed MBL-producing multidrug-resistant pathogens.MethodsThis prospective, multicentre, randomized, open-label, central assessor-blinded study randomized hospitalized adults 2:1 to aztreonam–avibactam [+ metronidazole (cIAI)] or BAT for 5–14 (cIAI, cUTI and BSI) or 7–14 (HAP/VAP) days. Primary endpoint was clinical cure at test-of-cure (TOC) visit on Day 28 ± 3 [microbiological ITT (micro-ITT) analysis set]. Secondary endpoints included microbiological response at TOC, 28-day mortality and safety. No formal hypothesis testing was planned.ResultsFifteen patients were randomized [aztreonam–avibactam, n = 12; BAT, n = 3 (ITT and micro-ITT analysis sets)]. Most frequent baseline pathogens were Enterobacterales; Klebsiella pneumoniae was most common [aztreonam–avibactam, 6/12 (50%); BAT, 2/3 (67%)]. MBL subtypes/variants identified in the aztreonam–avibactam group were NDM-1 (n = 7), NDM-5 (n = 3), VIM-2 (n = 2) and L1 (n = 3); and for BAT were NDM-1 (n = 2) and NDM-5 (n = 1). Clinical cure rates at TOC were 5/12 (42%) for aztreonam–avibactam and 0/3 (0%) for BAT. Per-patient microbiological responses were generally consistent with clinical responses. Twenty-eight-day all-cause mortality rates for aztreonam–avibactam and BAT were 1/12 (8%) and 1/3 (33%), respectively. Aztreonam–avibactam was generally well-tolerated, with no treatment-related serious adverse events.ConclusionsThese Phase 3 data provide support for aztreonam–avibactam as a potential therapeutic option for difficult-to-treat infections caused by MBL-producing Gram-negative bacteria.

🧪 Phase 3 ASSEMBLE study: aztreonam–avibactam (12 pts) vs. BAT (3 pts) for cIAI, cUTI, HAP/VAP, BSI. Cure rates: 42% vs. 0%. 28-day mortality: 8% vs. 33%. Well-tolerated.

#idsky

28.07.2025 23:00 — 👍 4 🔁 2 💬 0 📌 0

Mapping the interaction between science and misinformation in COVID-19 tweets. Publication from @luzuzek.bsky.social, Juan Pablo Bascur, @annabertani.bsky.social, @ricgallotti.bsky.social. This project is supported by European Media and Information Fund. Abstract: During the COVID-19 pandemic, scientific understanding related to the topic evolved rapidly. Along with scientific information being discussed widely, a large circulation of false information, labelled an infodemic by the WHO, emerged. Here, we study the interaction between misinformation and science on Twitter (now X) during the COVID-19 pandemic. We built a comprehensive database of 407M COVID-19 related tweets and classified the reliability of URLs in the tweets based on Media Bias/Fact Check. In addition, we use Altmetric data to see whether a tweet refers to a scientific publication. We find that many users find that many users share both scientific and unreliable content; out of the 1.2M users who share science, also share unreliable content. Publications that are more frequently shared by users who also share unreliable content are more likely to be preprints, slightly more often retracted, have fewer citations, and are published in lower-impact journals on average. Our findings suggest that misinformation is not related to a ``deficit'' of science. In addition, our findings raise some critical questions about certain open science practices and their potential for misuse. Given the fundamental opposition between science and misinformation, our findings highlight the necessity for proactive scientific engagement on social media platforms to counter false narratives during global crises.

New preprint! 🚨

We study the interaction between misinformation and science on Twitter during COVID-19 based on ~407M tweets. Both science and misinformation featured prominently during the pandemic, but the interaction between the two has not been studied on this scale before.

🧵 (1/10)

04.07.2025 10:37 — 👍 102 🔁 41 💬 4 📌 5

First doctors graduate after completing new part-time course A group of twenty who worked in other areas of healthcare while studying, have now qualified as doctors.

Fabulous idea. So many people who would make great doctors have traditionally missed out. Well done Edinburgh www.bbc.com/news/article...

06.07.2025 11:11 — 👍 26 🔁 6 💬 0 📌 0

Measles cases surge to record high since disease was declared eliminated in the US | CNN There have been more measles cases in the US this year than any other since the disease was declared eliminated a quarter-century ago.

"There have been more measles cases in the US this year than any other since the disease was declared eliminated a quarter-century ago."

#MedSky + #IDSky + #PedSky via @cnn.com -

www.cnn.com/2025/07/05/h...

05.07.2025 15:14 — 👍 21 🔁 12 💬 0 📌 0

Clinical efficacy, safety and pharmacokinetics of novel β-lactam/β-lactamase inhibitor combinations: a systematic review Antimicrobial resistance is a global public health threat that requires urgent solutions. One strategy to decrease resistance of Gram-negative bacteria (GNB) to β-lactam antibiotics (BL) is their combination with β-lactamase inhibitors (BLI).ObjectivesThis systematic review analyses the outcomes, safety and pharmacokinetics (PK) of recently approved or under clinical development BLI and BL/BLI combinations.MethodsThe systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PubMed, Embase, and Cochrane electronic databases were used to search for articles from January 2010 to November 2024. The studies were retrieved and screened on the basis of predefined exclusion and inclusion criteria. A quality assessment of the included studies was conducted following the New Castle-Ottawa Scale.ResultsA total of 191 articles addressing clinical research regarding the efficacy, safety, tolerability, and PK of new BL/BLI combinations with avibactam, durlobactam, enmetazobactam, nacubactam, relebactam, taniborbactam, tazobactam, vaborbactam and zidebactam were included. According to the published literature, clinical research supports the novel BL/BLI combinations for the treatment of complicated urinary tract infections, complicated intra-abdominal infections, and hospital-acquired and ventilator-associated pneumonia (HAP/VAP) caused by GNB. In spite of that, the development of new BLI effective for class B metallo-β-lactamases (MBL) is still challenging, being aztreonam/avibactam the only approved combination active against MBL-producing bacteria.ConclusionsAlthough there has been extensive research to develop new BLI and BL/BLI combinations, only a few have reached the market. More evidence of its usefulness in the real world is still needed.

🦠 Antimicrobial resistance is urgent. This review analyzed 191 studies on new β-lactam/β-lactamase inhibitor combos for GNB. Only aztreonam/avibactam targets MBLs. More real-world evidence needed.

#idsky

23.06.2025 22:30 — 👍 1 🔁 1 💬 0 📌 0

Understanding the mechanisms of resistance to azole antifungals in Candida species AbstractCases of Candida infection have been on the rise in recent years. A comprehensive and clear understanding of the mechanisms of antifungal resistance is fundamental for developing novel therapies to address the current and emerging threat of fungal diseases. Certain Candida species can cause superficial or invasive infections in immunocompromised hosts, and invasive Candida infections are major contributors to infectious disease deaths. As fungi are eukaryotes like humans, there are only a limited number of unique molecular targets available for antifungal drug development. Until recently, there have only been four primary classes of antifungals used to treat systemic fungal infections. Among these, azole antifungals are globally used because they are both inexpensive and effective. Due to various factors, resistance to antifungal drugs—especially azole antifungals—has developed in many Candida species, posing a significant public health threat. This review discusses the known mechanisms of azole antifungal resistance in Candida albicans, Candida auris, Nakaseomyces glabrata, Candida tropicalis, Candida parapsilosis and explores strategies to overcome the resistance problem.

📈 Cases of 🦠Candida infections are rising. Azole antifungal resistance is a major public health threat. This review covers resistance mechanisms in key species like C. albicans & C. auris.

#idsky

23.06.2025 23:00 — 👍 2 🔁 2 💬 0 📌 0

Enterococcus faecium bacteraemia: a multicentre observational study focused on risk factors for clinical and microbiological outcomes Among modifiable clinical factors in patients with E. faecium BSI, source control and the execution of follow-up blood cultures demonstrated a protective effect on 30 day mortality.

Enterococcus faecium bacteraemia - find the source, remove it, do better.

(TBH, this is appilicable to all blood stream infections!)
#IDSky #ClinMicro #AMR

24.06.2025 16:43 — 👍 6 🔁 1 💬 1 📌 1

Vaccine RCT spreadsheet aims to show the data, dispel myths about vaccines

Jake Scott is a hero. @jakescottmd.bsky.social #idsky #vaccines #MAHA
www.cidrap.umn.edu/adult-non-fl...

20.06.2025 14:16 — 👍 6 🔁 3 💬 1 📌 0

Fosfomycin for the treatment of patients with bacterial prostatitis: a systematic review - European Journal of Clinical Microbiology & Infectious Diseases Background Bacterial prostatitis is a common infection affecting the patient’s quality of life. It is caused by various bacteria, including multidrug-resistant Enterobacterales. Fosfomycin is active a...

Oral fosfomycin could work for chronic prostatitis and as oral transition after lead-in betalactam tx in acute protatitis.

This SR of observational studies shows:
✅ Clinical cure >70%
⚠️ Relapses up to 50% at 6 month
💩 Frequent diarrhea

link.springer.com/article/10.1... #AMSsky #UTIsky #IDsky

25.05.2025 13:16 — 👍 25 🔁 6 💬 4 📌 0

Trump administration shuts down federal advisory committee on infection prevention

Trump shuts down #HICPAC, advisory group formed in 1991 to prevent the spread of IDs
www.cidrap.umn.edu/healthcare-a...
Members have expertise in IDs, infection prevention and control, healthcare epidemiology, nursing, public health, and other areas of health and medicine #IDsky #Medsky

08.05.2025 21:26 — 👍 1 🔁 1 💬 0 📌 1

Infectious disease specialists keeping it social on #Bluesky - #IDSky getting some serious use over here!

#MedSky #pedsky #cardiosky #cansky #obgynsky #immunosky #episky #nephsky

08.05.2025 10:28 — 👍 44 🔁 10 💬 4 📌 1

Time to reappraise the antibiotic treatment for methicillin-susceptible Staphylococcus aureus infective endocarditis: data from the experimental model Traditional treatment of methicillin-susceptible Staphylococcus aureus (MSSA) native valve endocarditis is based on cloxacillin/cefazolin monotherapy. Antibiotics with high activity against MSSA such as ceftaroline and daptomycin have been marketed last years, but there are no clinical trials evaluating them as monotherapy or combination therapy in patients with MSSA endocarditis.ObjectivesTo compare the efficacy of cloxacillin, ceftaroline and daptomycin monotherapies and daptomycin combinations with beta-lactams in a rabbit model of MSSA endocarditis.MethodsEndocarditis was induced in rabbits using two strains of MSSA. After 24h of infection, they received human-like doses of cloxacillin, ceftaroline or daptomycin or combinations of daptomycin plus either cloxacillin or ceftaroline. Isolates recovered from vegetation, spleen and kidney were retested for daptomycin non-susceptibility (DNS) post-treatment.ResultsMSSA vancomycin MIC did not influence the efficacy of any antibiotic treatment. Cloxacillin, ceftaroline and daptomycin had similar activity (25-50%) in sterilizing vegetations. However, 13% of rabbits treated with daptomycin developed DNS. The addition of daptomycin to cloxacillin or ceftaroline was synergistic and bactericidal, showing significantly more activity and higher rates of sterile vegetations (≥90%) than any monotherapy Combinations also showed better activity in spleens and kidneys compared with daptomycin monotherapy and prevented the development of DNS in all tissues. There were no differences between the two daptomycin combinations.ConclusionsIn the MSSA experimental endocarditis model, daptomycin combinations with beta-lactams had significantly better activity than either their monotherapies in sterilizing valve vegetations and preventing DNS development. These findings support their use in clinical practice and to perform clinical trials.

In a rabbit model of MSSA endocarditis, daptomycin combos with beta-lactams showed ≥90% sterile vegetations vs. 25-50% for monotherapies. Daptomycin monotherapy had 13% DNS. 🐇💊

#idsky

08.05.2025 12:00 — 👍 3 🔁 1 💬 0 📌 0

New @thelancet.bsky.social - Treatment options to support the elimination of hepatitis C: an open-label, factorial, randomised controlled non-inferiority trial

www.thelancet.com/journals/lan...

#hepsky #liversky #medsky #idsky

08.05.2025 13:03 — 👍 1 🔁 1 💬 0 📌 0

Los Angeles declares hepatitis A outbreak Los Angeles has declared an outbreak of hepatitis A virus based on “elevated virus levels” in wastewater surveillance and a “sustained increase” in cases over the last year, health officials announced.

Los Angeles declares hepatitis A outbreak

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

#hepsky #idsky #liversky #medsky via @gohealio.bsky.social

08.05.2025 13:15 — 👍 1 🔁 3 💬 0 📌 0

NEW in ICHE:

▶️ Critically ill opioid use disorder (OUD) patients face high MDRO infection rates (22.5%), with MRSA most common

▶️ Key risk factors include housing insecurity, lack of OUD meds, HCV status, and recent IV antibiotic use.

#IDSky

📄: doi.org/10.1017/ice....

08.05.2025 13:40 — 👍 4 🔁 3 💬 1 📌 0

Contemporary antimicrobial treatment rationale of Stenotrophomonas maltophilia infections: a narrative review Stenotrophomonas maltophilia is an opportunistic pathogen most commonly isolated from patients with complex/life-threatening disease or cystic fibrosi…

🆕💫 New narrative review challenges the longstanding reliance on TMP-SMX for the treatment of Stenotrophomonas infections—citing PK/PD concerns and rising resistance. Also questions mono vs combo use. Clinical data still limited. Worth a close read #idsky
www.sciencedirect.com/science/arti...

06.05.2025 15:39 — 👍 10 🔁 4 💬 2 📌 2

Invasive Fungal Disease in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation in China: A Multicenter Epidemiological Study (CAESAR 2.0) This study (China Assessment of Antifungal Therapy in Hematological Diseases [CAESAR 2.0]) aimed to provide updated epidemiological data on invasive fungal disease (IFD) in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT).MethodsThis multicenter, real-world, observational study was conducted at 12 allo-HSCT centers in China between January and December 2021. Consecutive adult patients (aged ≥18 years) who underwent allo-HSCT with antifungal prophylaxis were included. IFD was diagnosed according to the 2019 criteria of the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG). Follow-up was completed by 31 December 2022.ResultsA total of 2015 patients were included. Mold-active antifungal prophylaxis was used in 76.08%, most of whom received voriconazole (44.37%) or posaconazole (31.71%). The cumulative incidence of IFD (proven or probable) 1 year after allo-HSCT was 6.3%. Pathogens were identified in 47.97% of IFD cases and mainly included Candida spp. (17.89%), Mucorales (13.01%), Aspergillus spp. (8.94%), and Pneumocystis jirovecii (6.5%). Multivariate analysis identified the following factors associated with IFD: disease at advanced stage (hazard ratio, 2.55 [95% confidence interval, 1.58–4.12]; P < .001), absolute neutrophil count engraftment (≤28 days) (0.37 [15–.92]; P = .03), platelet engraftment (≤28 days) (0.41 [.27–.62]; P < .001), and acute graft-vs-host disease grade III–IV (2.97 [1.97–4.49]; P < .001). The IFD-attributable mortality rate was 48.28%.ConclusionsDespite the widespread use of mold-active prophylaxis, the risk of IFD after allo-HSCT remains high. The most common pathogens are Candida spp., Mucorales, Aspergillus spp., and P. jirovecii.

In a study of 2015 allo-HSCT patients, IFD incidence was 6.3%. Main pathogens: Candida (17.89%), Mucorales (13.01%). IFD mortality rate: 48.28%. Prophylaxis used in 76.08%. 🦠💔

#idsky

01.05.2025 07:30 — 👍 2 🔁 1 💬 0 📌 0

Anyone else calculating the decreased life expectancy we will see in the US in the next decade? #idsky #publichealth

01.05.2025 14:25 — 👍 4 🔁 1 💬 0 📌 0

Time for Outpatient Parenteral Antimicrobial Therapy (OPAT) Coordination: Difficult to Quantify Due to Heterogeneity in OPAT Care Models To the Editor—We read with interest the recent article by Schranz et al [1], which quantified the unbillable time for coordination of outpatient parenteral antimicrobial therapy (OPAT) at 27 minutes per week. We commend them for this seminal and important work, which takes some first steps toward quantifying the necessary time for OPAT services. Due to difficulty billing for remote monitoring services, reports such as this are welcomed and demonstrate some of the resources required to provide OPAT patients with high-quality care. However, the authors did not address the specifics of their OPAT practice model, the antimicrobials used, or the difference in coordination of care with patients on vancomycin as compared to daptomycin.

Schranz et al. found OPAT coordination takes 27 min/week. Their work highlights unbillable time for remote monitoring, but lacks details on practice models & antimicrobial differences.

#idsky

01.05.2025 14:30 — 👍 5 🔁 1 💬 0 📌 0

Could stewardship interventions targeting steroids and PPI prevent HAIs and reduce antibiotic use in hospitals?

This study shows a time- and dose-dependent association between PPI & steroids and the incidence of HAIs: www.journalofhospitalinfection.com/callback?red...
#AMSky #IDsky #IPSky #PharmSky

01.05.2025 14:53 — 👍 6 🔁 2 💬 0 📌 0

Stay tuned for the first @cmicomms.bsky.social & #Breakpoints collaboration episode on Sun, May 4th 6PM US EST/Mon May 5th 12 AM CET. Hosts Angela Huttner & Erin McCreary interview SNAP trial investigators, Steven Tong &Joshua Davis, on PSSA and MSSA domain results shared at 2025 ESCMID Global.

29.04.2025 22:01 — 👍 36 🔁 14 💬 2 📌 0

"An antibiotic with supporting clinical trial data, administered at the right dose, by the right route, at the right time, and for the right duration, along with source control, is preferred."

#IDsky

01.05.2025 17:21 — 👍 5 🔁 1 💬 0 📌 0

Warmer Winters Are Fueling a Surge in Tick-Borne Illnesses Andrew Lover, MPH, PhD, MS, discusses the shifting landscape of tick-borne illnesses during Tick-borne Disease Awareness Month

Warmer winters are extending tick seasons, spreading Lyme disease to new areas. Dr. Andrew Lover discusses the challenges of tracking tick-borne illnesses and prevention methods. #TickBorneDiseaseAwareness #LymeDisease #IDsky #MEDsky

Listen here: www.contagionlive.com/view/warmer-...

01.05.2025 18:11 — 👍 4 🔁 3 💬 0 📌 1

Don’t forget to register if you haven’t already! 🦠🧫🤓 #IDSky

01.05.2025 22:38 — 👍 2 🔁 2 💬 0 📌 0

Clinical Outcomes and Perspectives of People With Human Immunodeficiency Virus Type 1 Twelve Months After Initiation of Long-acting Cabotegravir and Rilpivirine in an Observational Real-world US Study (BEYOND) Long-acting cabotegravir plus rilpivirine (CAB + RPV LA) administered monthly or every 2 months is recommended by treatment guidelines for maintenance of virologic suppression in people with human immunodeficiency virus type 1 (HIV-1). In clinical trials, CAB + RPV LA demonstrated noninferiority versus United States (US) Food and Drug Administration–approved daily oral therapy, and outcomes in real-world settings can supplement these results. We present month 12 results of BEYOND.MethodsBEYOND is an ongoing, 2-year, multicenter, prospective, observational real-world study of adults initiating CAB + RPV LA in the US. Key outcomes included reasons for initiating, virologic outcomes, adherence, and patient-reported outcomes related to treatment satisfaction and treatment challenges at baseline and month 12.ResultsIn total, 308 participants (median age, 45 years; 83% identified as male; 39% identified as Black) initiated CAB + RPV LA most commonly because of treatment fatigue, adherence anxiety with daily oral therapy, and/or convenience. Of participants with baseline viral load data, 97% (194/200) had a viral load <50 copies/mL for their most recent test reported at month 12. Mean treatment satisfaction scores increased significantly from baseline to month 12 and 97% (223/229) of participants preferred LA versus oral treatment at month 12. Proportions of participants reporting “always” or “often” experiencing challenges related to HIV-1 treatment (fear of disclosure, adherence anxiety, reminder of HIV-1 status, and feeling stigmatized) decreased from baseline to month 12.ConclusionsMonth 12 results from the real-world BEYOND study support the effectiveness of CAB + RPV LA for maintenance of virologic suppression and as a preferred treatment option for people with HIV-1.

In the BEYOND study, 308 adults (45 yrs avg, 83% male, 39% Black) started CAB + RPV LA. At 12 months, 97% had viral load <50 copies/mL, and 97% preferred LA over oral therapy. 📈💊

#idsky

30.04.2025 03:30 — 👍 1 🔁 1 💬 0 📌 0

Erica Little, PharmD, BCIDP

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