JD Talbot

Initial Vancomycin Taper for the Prevention of Recurrent C difficile Infection This randomized clinical trial tested whether a 4-week pulse and taper vancomycin regimen was superior to a 2-week pulse regimen for preventing recurrence among patients with a first episode or first ...

🔥Just published 🔥
TAPER-V RCT
In this RCT of 256, a 4-week vancomycin pulse and taper regimen *had a probability of 74% to be superior to a standard 2-week pulse regimen in patients a first episode or first recurrence of CDI
Vanco for 10d is obsolete! #IDSky #EMIMCC
jamanetwork.com/journals/jam...

What Mark Carney’s Davos speech says about dealing with bullies Prime Minister’s words can teach kids, and parents, important lessons about responding to a bully

Here's a great example of why the media & journalists should be speaking with, and requesting comments from, mental health professionals rather than political pundits in dealing with today's geopolitical challenges. www.theglobeandmail.com/life/advice/...

We’ve put to good use some efficiency tools in doing so :
• Simplified verification of all 6 units using a statistic tool derived from CLSI EP31
• SOP jumpstarted with MS Copilot GPT-5 (triple verified)

Photo credit : @sebpoule.bsky.social

𝗕𝗮𝗰𝘁𝗲𝗰 𝗙𝗫 @ 𝗦𝘁-𝗝𝗲𝗿𝗼𝗺𝗲

New device for BC next monday!

Main changes : 
1. New bottles w/ thin cap
2. Finally enough space for 4 bottles/pt! Bacteremia detection ability expected to go up by ~ 5%
3. We’ll start to use diversion to reduce contamination rates by an expected 60%

#IDSky #MicroSky

Impact of discontinuation of contact precautions on healthcare-associated ESBL-producing Escherichia coli in a large tertiary care hospital: an interrupted time-series analysis

✅ Just Accepted
🔗 https://bit.ly/47t7eEk

Assessing yield and impact of 5-day versus 10-day incubation time in suspected prosthetic joint infection: a prospective laboratory study Optimising laboratory processes is paramount in differentiating prosthetic joint infection (PJI) from non-infectious causes of joint dysfunction. Howe…

Link didn’t work for me. Think I found it however :

www.sciencedirect.com/science/arti...

With the steroids making their way in SOC, I wonder if the « anti-inflammatory » effect of macrolides will still be significant.

Would love to see a RCT b-lactam/steroids as base therapy with arms with vs without macrolides.

Isavuconazole 😉

No amoxi-clav for campylobacter?
#sparethecarba

Response adaptive randomization adjusts allocation probabilities over the course of a trial, based on accumulating data. RAR increases allocation to arms performing well, and decreases allocation to arms performing poorly. In multiple arm trials, this has advantages over fixed randomization.

Todd Lee, “The urine is innocent until proven guilty.”
Brad Spellberg, “The urine should file a class action lawsuit against the medical community for malicious prosecution.”
@infectedterran.bsky.social: “Has anything on earth been as unjustly demonized and blamed for problems as an abnormal UA.”

2- If the complication is osteomyelitis, the bone penetration of amix is 10-20%, depending on the study. Again, with MICs of 4-8, it might not be enough (I’m even unsure if MICs 1-2 are attainable).

For these specific situations, I’d welcome more clinical data.

For LZD, I wholeheartedly agree.

For amox, I have some nuances :
1- In the POET substudy, they note a good PTA using actual MICs, but the PTA using a BP of 4 was 75-85% (we usually want 90%+). This is the EUCATS BP. CLSI uses 8 as a BP. With MICs of 4 I’d be cautious, and I wouldn’t use it if 8

Nice!

No mention of sex in the algorithm. Do I (fore)see official IDSA endorsement of 7 days total for men with pyelonephritis?

We typically go for 1000/125 TID (combining amox/clav 500/125 + amox 500)

Usually well tolerated, although some GI disturbances do happen.

My first reflex would be to confirm with the lab that there really were a MSSA & MRSA in the blood culture.

If assumed true, I’d probably go for dapto+cefaz or LZD, transitioning eventually to LZD *or* tmp-smx.

Vanc MIC of 2 is of concern, esp. w/ a young adult.

No special concern for GNR.

I agree.

Yet I find it less troublesome since I :
- Use a weightlifting belt
- Have new shoes (UA Reign 6)
- Added hip thrusts to my routine

I feel much more stabilized and my squats are less dependent on my quads doing all the work

Pharmacokinetics of Cefadroxil and Cefaclor During an Eight-Day Dosage Period The concentrations of cefadroxil and cefaclor in serum were studied in eight healthy volunteers receiving 1,000 mg of both substances three times per day for 8 days. Intraindividual comparisons showed...

Only data I’ve ever found on cefadroxil 1g TID

pmc.ncbi.nlm.nih.gov/articles/PMC...

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a woman sitting in a car with the word blissfully unaware in yellow ALT: a woman sitting in a car with the word blissfully unaware in yellow

Ah, the ID Curse™

@sebpoule.bsky.social

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Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of Infective Endocarditis: A Retrospective Cohort Study Short time to blood culture positivity (TTP) was an independent risk factor of infective endocarditis in this large (N=1703) Staphylococcus aureus bacterem

🆕💫Retrospective Cohort Study
Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of IE
Short TTP was associated wit IE
NPV >95% suggests that TTP>13h can be used to risk stratify pts with SAB #idsky #EMIMCC
academic.oup.com/cid/article/...
academic.oup.com/cid/advance-...

Enfin, si c’est différent de la norme, il faut prévoir dans le syst. informatique et en formation nursing le scénario 2 ponctions.

Bref, c’est toute une gestion de changement d’implanter la ponction unique. Ça ne se fait pas « top down » en publiant un document directeur sans crier gare…

Je vois un enjeu pour les infections endovasc : comment différencier une contamination répandue à toutes les bouteilles d’une vrai bactériémie CoNS quand on est consultés et que le patient est déjà traité?

Je ne peux tout de même pas faire un TEP scan à tous mes patients avec pontage/valve/etc

Je suis peut-être cynique, mais je crois que mes bouteilles ne seront pas plus remplies que maintenant et que le nombre restera le même. On manque d’espace dans l’incubateur, on ne fait que 3 bouteilles…

Bref, pas d’avantage côté volume sauf si on perd l’accès veineux entre les 2 ponctions.

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🪩🍾Have a holiday party coming up? Need some conversation starters? Maybe this will help!

📲 www.idstewardship.com/peculiar-art...

❤️ Feel free to share & suggest additions!

🙏 Thank you to those who offered suggestions for this list.

#IDsky #PharmSky #MedSky #Medicine #Pharmacy

Effects of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: randomised controlled trial To determine whether remote, retroactive intercessory prayer, said for a group of patients with a bloodstream infection, has an effect on outcomes. Double blind, parallel group, randomised controlled ...

I love that one

pmc.ncbi.nlm.nih.gov/articles/PMC...