Reducing Antimicrobial Use at the End of Life url:https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2838657. Thank you for the opportunity to write this commentary on a great piece by Jeong-Han Kim and colleagues in South Korea, @eliowa.bsky.social.

Colleagues- in case this was missed during summer vacation, please share. I just went to the Bowl again last week and saw Yo-Yo Ma and Angelique Kidjo. The Bowl is not the only reason to be in LA....but it is pretty spectacular. Also my ASP team is just the bee's knees.

I was reading a handwritten timed essay I wrote on Hamlet in AP English. My teacher, who in hindsight was a saint, gave me an A- for ideas and a B+ for structure and cautioned me against superfluous citations. (I learned so much from her.) Handwritten essays may be one way to mitigate AI influence.

Really important Med Ed piece in NEJM. "Diagnosis-related group and payment models based on relative value units (RVUs) incentivize volume over value, with little focus on collaboration or coordination efforts" www.nejm.org/doi/full/10....

#TeachID #idsky #idmeded #meded #idfellows #idfellowship @cidjournal.bsky.social State-of-the-ART Reviews: STAR reviews are great for new fellows/faculty: Abx at End of Life academic.oup.com/cid/article/...

There are many important perspectives and ideas to share in medicine at this moment that are more important than mine. But this is a reminder of why I keep doing what I do, despite everything. I would be honored if you took the time to read it. www.nejm.org/doi/full/10....

Took my kids to their first protest. 1000s showed up in our sleepy little part of LA County. It was beautiful and peaceful. My favorite chant was "We stand united. We'll never be divided." 🇺🇸🗽

Please consider joining our incredible faculty and ASP program at UCLA Health. Los Angeles is an incredible city and always will be. recruit.apo.ucla.edu/JPF10331

Working on this chalk talk at home and feeling some graduation vibes. 🎓 Share feedback or your own examples of what I am trying to impart here.

You've Got a Friend in Me: Curbside Questions Infectious Diseases Clinicians Ask Infectious Diseases Pharmacists ✅ Just Accepted #IDSky

Because I am on Bluesky today: Phosphate binders (dosed TID in patients on HD!) are a major problem for PWH on INSTIs (most!). But it is NOT discussed often enough. In my experience it has been very hit or miss whether it impacts the VL. I welcome thoughts from my #IDbluesky PharmDs and HIV MDs.

87% of NBA basketball players are between 6 feet 3 inches and 7 feet tall. About 14% of males in the United States are over 6 feet tall. 0.002% of all US college athletes are transgender. Maybe we should ban tall people from competitive sports to give the short people a chance.

So much to say here. The FFS/RVU with benchmarking also merits quantity over quality. I love all my ID colleagues. They definitely care. But I worry that some may succumb to the plug and chug, copy forward approach. Many notes have become unreadable these days. (It is not just us.)

State-of-the-Art Review: Modern Approach to Nocardiosis ⭐The duration of antibiotic treatment is understudied and based on few data ➡️ can be shortened if harms begin to outweigh potential benefits ⭐~5% develop recurrence ➡️ close monitoring needed doi.org/10.1093/cid/... #IDSky

Breaking News: A federal prosecutor interrogated the The New England Journal of Medicine — which is considered the world’s most prestigious medical journal — in what its editor described as a “vaguely threatening” letter.

“Such anti-LGBTQ legislation, including the censorship of accepted medical terminology, can have several downstream effects on patients, including dissuading patients from seeking care, resulting in higher rates of sexually transmitted infections and human immunodeficiency virus (HIV) acquisition.”

Reposting this State-of-the-Art review, and adding an accompanying editorial I wrote to honor and celebrate those who persist and to show compassion for those who remain silenced. academic.oup.com/cid/advance-...

🚫Inhaled corticosteroids treat or cure measles. 🚫Clarithromycin (an antibiotic) can treat measles. With so much information out there, it can be hard to know what’s true. Learn the facts: www.idsociety.org/public-healt...

We are hiring #TxID #TxIDSky faculty at @ucla-id-fellowship.bsky.social @domucla.bsky.social - come join our dynamic and collaborative group to battle infection in sunny Los Angeles! @ast-idcop.bsky.social See link for description and please reach out with questions! recruit.apo.ucla.edu/JPF09517

Drug-resistant #gonorrhea is an urgent issue, threatening our empiric treatment options. Resistance to ceftriaxone is rapidly increasing in the Asia-Pacific region. Happy to share our study from Vietnam, now out in @jidjournal.bsky.social academic.oup.com/jid/article/... #IDsky #STIsky #AMR

My friend's @nottheogdrv.bsky.social fb post was heartbreaking. She went to an international #HIV conference, where #NIH & #CDC collaborators were notably absent. #HIV disproportionately affects vulnerable populations--and the word "vulnerable" has been targeted. This is so shameful. #medsky

"Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons." Secretary Kennedy correctly emphasizes this in his HHS statement. www.hhs.gov/about/news/2...

This State-of-the-Art review could not be better timed. academic.oup.com/cid/article/.... We were thrilled to have Nick Van Sickels & colleagues (from Kentucky, Hawaii & Louisiana) write this excellent piece, highlighting the importance of inclusive care & informed consent. @cidjournal.bsky.social

Real question for my ID community. The appointment of RFK Jr, the take down of websites, & the slow editing of science are devastating. But I want to ask about the NIH & FDA nominees Jay Bhattacharya & Marty Makary. Can we be deliberate in our rage? Can we work w some to restore & elevate science?

@idsainfo.bsky.social Why aren't we doing this? We have an obligation to our profession and our patients to continue to provide evidence based care despite political interference.

What is more American than litigation? I would support and testify, @idsainfo.bsky.social. We have clear consequences for each of these directives (disease, death from preventable, treatable infections).

How many incredibly moving articles about the fallacy of RVU based care do we need to enact change (even in this incredibly chaotic time period when we just want stability)? If you are going to take time to read one, read this one from today: www.nejm.org/doi/full/10....

Friends. I am not going to give up. I wrote this 6 years ago. It is hard to re-read. But I am not going to give up. www.nejm.org/doi/10.1056/...

My sister, a tv & film director, lost her lovely home in our beautiful southland. She & her family are staying with us. Her interview from a few months ago: "Loss is inevitable as is the new life born within it." festival.sundance.org/blogs/give-m...

1. Intravenous tobramycin for pseudomonas (low prob infection) 2. Fourteen days of TMP-SMX for "I can't tell if it is an infection or not" (UA had 5 WBCs, and creatinine was newly high) and no follow-up BMP. Clinicians assume that antibiotics have no harm. But they can be as toxic as chemotherapy.

Me, ID doc, Dec 31: weird that Trader Joe's is completely out of eggs. Me, ID Doc, Jan 5: wow, still out of eggs. Weird. Kids' sitter to me: So, are you (an ID doc) seeing a lot of bird flu in the hospital? The prices of eggs are crazy. Me, ID doc: 💡🫣 www.latimes.com/california/s...

The part of my job that gives me immense gratification when it works and deep anxiety when it doesn't is keeping my patients out of the hospital. It is really hard work. But caring for patients in clinic does not reimburse as well as caring for patients in the hospital. And this is a problem.

Latest State-of-the-Art Review in @cidjournal.bsky.social comes from Dr. Miriam Barshak et al on ocular infections. (I had the pleasure of precepting Miriam in clinic around 20+ years ago --but who's counting! -- and she is brilliant and awesome.) @nottheogdrv.bsky.social doi.org/10.1093/cid/...

@idsensei.bsky.social convinced me to join. I left that other platform a bit ago. I wrote something in Newsweek I wanted to share to a broader audience and I thought I would try this. It was originally titled "My Blue State." www.newsweek.com/i-grew-democ...