The latest in the controversy between 3 vs 2 drugs for HIV treatment -- now in advanced HIV disease, with the DOLCE study. @drlaurajwaters.bsky.social #IDSky #HIVsky blogs.jwatch.org/hiv-id-obser...

Today, a dermatologist called me and asked 6 weeks of Ertapenem OPAT for a case of « severe suppurative hidradenitis » I said no. That’s it. That’s the post. #IDsky

2025 US Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for PEP in Healthcare Settings 🤯lots of NAT, no ?

🤯Montreal 🚴

Bookmark option now available #BlueSky #IDsky

Long-acting cabotegravir/rilpivirine in viraemic people with HIV: bumpy raod to perfection ✅ Just Accepted #IDSky

Hepatitis B transmission, dalbavancin for staph bacteremia, alpha-gal allergy, vaccine policy shifts, too much screening in pt care ... Some end-of-summer ID musings, with scattered other thoughts silly and not ID-related at all. And tennis, of course! #IDSky blogs.jwatch.org/hiv-id-obser...

For us ID doctors, the CDC has been a rock. Data, guidelines, surveillance, travel advice -- all there, vetted by experts, referenced, reliable. Perfect? No. But watching its dismantling now breaks my heart. Some thoughts: blogs.jwatch.org/hiv-id-obser...

Some great comments -- both pro and con -- have come in response to this post about screening for anal cancer in PWH. Would welcome further opinion, especially from clinicians seeing patients regularly and/or experts in cancer screening. blogs.jwatch.org/hiv-id-obser...

Amazing case below #IDsky 🤯 ICU for presumed septic shock, purpura fulminans, DIC. Blood cultures (-) and no focus of infection. Blood smear flagged for «unsual» structures inside WBCs (see photo) ➡️ Can you guess the Dx ? (we did 😉, now confirmed by 16S rRNA of initial blood culture)

Rocky Mountain Spotted Fever (RMSF) in Quebec, 🇨🇦 from Dr Alex Carignan

The anal cancer screening guidelines for PWH recommend testing every 1-2 yrs. But the evidence base is thin, the tests are imperfect, and resources are limited. Here's why guidelines may be racing ahead of the data (and certainly the resources). #IDSky #HIVSky blogs.jwatch.org/hiv-id-obser...

Calling all HIV/ID providers: How many are able to do this screening for anal cancer according to IANS? Including the HRA and repeat screening every 1-2 years (!!) for normal results? Wow, that's a lot of screening tests in a lot of people! #IDSky #HIVsky onlinelibrary.wiley.com/doi/10.1002/...

Mind 🤯 HBV case ⬇️ #IDsky 🇨🇳 pegIFN Tx >15y ago, then TDF Under my care x 2021, TDF continued; F0-F1, HBV DNA undetectable HBsAg(+) ➡️ (-) (qHBsAg <10) antiHBsAg(-) ➡️ antiHBsAg(+) >10 HBeAg (+), anti-HBeAg (-) ⚠️TDF d/c x December 2024 (1/2)

First case of 🇺🇸 VRSA since 2015: 🧫 DFI wound culture at site of previously treated MRSA + E. faecalis 🧫 New co-infection VRSA + VRE 🧫 Mechanism: harboring VanA gene ✅ Successfully treated with Dapto 🧫 No contacts with VRSA colonization #IDSky

Me reading DOTS trial #IDsky #DOOR

Finally published 🆕🔥DOTS RCT Among participants with complicated S aureus bacteremia who achieved blood culture clearance, dalbavancin was not superior to standard therapy for achieving a more desirable outcome at day 70 #idsky jamanetwork.com/journals/jam...

Happy DOTS Day, to those who celebrate. jamanetwork.com/journals/jam...

Starting August 14; ➡️Tenofovir Alafenamide (TAF; Vemlidy) is now covered under the Public Prescription Drug Insurance Plan in Quebec, 🇨🇦. (as Tenofovir disoproxil fumarate & Entecavir...) 👍 Good news for patients living with #HBV #IDSky

In medicine, the capacity to manage & deal with uncertainty is essential.

Favorite midlife crisis activity; 🏃‍➡️with my kids

“We’re asking the wrong question. Let’s use fundamental PK. Let’s get the drug to where the bug is, at a high enough concentration to kill the bug, and not worry about whether we label the drug static or cidal”. As said by @bradspellberg.bsky.social 🤩😇 Fabulous conversation! #IDSky #MedSky #AMSSky

On AIMEboko #Mboko 🎾 🇨🇦

State-of-the-Art Review: Anal Cancer Screening in People With HIV

I’m currently outside of the country but I have an important prescheduled virtual talk to give. I will be somewhere with no access to a private room/WiFi and I don’t want to trust my cellphone network. ➡️ Regus.com Meeting room location; ✅ Very nice ! 👍 👌 (unsolicited advertisement)

Shut up and take my money ❤️ @wrexhamafc.co.uk

For adult inpatients with severe CAP who reach clinical stability, we suggest 5 or more days of antibiotics, rather than less than 5 days of antibiotics (strong recommendation,low-quality evidence). #idsky

🔥🔥Just published 🔥🔥 ATS CAP guidelines 2025 Diagnosis and Management of Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline Free access pdf #IDsky#EMIMCC www.atsjournals.org/doi/10.1164/...

most men aren’t complicated, it turns out (at least as it pertains to UTI)

🔥Finally published🔥 IDSA Guidelines on the Treatment and Management of Complicated Urinary Tract Infections (cUTI) #idsky www.idsociety.org/practice-gui...

SNAP trial update ➡️ The DSMC provided a recommendation to close the ADJUNCTIVE domain (Clindamycin), due to a statistical trigger for futility being met. #IDsky

Yes, DO-IT results is a good reason not to DO-IT!

The much anticipated DO-IT trial shows no impact of switch from TAF + INSTI to DOR (with TAF or TDF) on weight in people with obesity. Considering switching ART only to address weight change? DON'T DO-IT..... #IAS2025 @iasociety.bsky.social

IMPALA results at #IAS2025 1 incident HBV infection in the CAB/RPV arm No evidence of HBV reactivation (note people with detectable cAb but sAb <10 were excluded) @iasociety.bsky.social @profchloeorkin.bsky.social @tristanjbarber.bsky.social

New @nejm.org report shows a rapid rise in tetM-carrying Neisseria gonorrhoeae strains in the U.S. jumping from <10% in 2020 to >30% by early 2024. Why? Likely linked to our increased use of doxycycline both for STI treatment and DoxyPEP. #MedSky #IDSky www.nejm.org/doi/full/10....

Visiting Geneva, Switzerland🇨🇭 « Must take » pictures @ WHO and UN ; ✅

Check out @bookmark.cool Good workaround Just send a skeet via private message to that account and the skeet will appear on your private bookmark feed

#IDsky 👍

"What’s it like to have lived through both HIV and COVID as an ID doctor?" A new intern asked me that last week. I didn’t answer it fully then -- but I did here. #IDSky blogs.jwatch.org/hiv-id-obser...

Me making dumb memes adds significant time to my rounds. Worth it.

💬 Describe antibiotic stewardship — in at least two words. #IDSky

The isolated hepatitis B core antibody: HBsAg ⛔ anti-HBs ⛔ anti-HBc ✅ What does it mean, and what should you do? A mystery solved (mostly). Plus, a poll and a couple of great videos. #IDSky blogs.jwatch.org/hiv-id-obser...

Brand new book #IDsky @fungaldoc.bsky.social

Things I dislike in life; Climbing six flights of stairs 🏥 to see a patient, but he’s receiving hemodialysis on first floor.

Supporting the best. (of any league 😉) @wrexhamafc.co.uk

#IDsky 👇

Watching list #HIVsky #IDsky Efficacy, Acceptability and Safety of Event-driven HIV PrEP Using TAF/​FTC in MSM in Thailand and France. (SimpPrEP) TAF/FTC 1:1 TDF/FTC 2:1:1 clinicaltrials.gov/study/NCT058...

The federal HIV guidelines face a shutdown. A trusted, living resource -- used by clinicians, programs, and public health agencies for decades -- may disappear due to “budget decreases and revised priorities.” Big mistake. #IDSky blogs.jwatch.org/hiv-id-obser...

A bit of positive news today. FDA has just approved Lenacapavir for PrEP in the US. In clinical trials one injection every 6 months was close to 100% effective in preventing HIV transmission. PrEP is for everyone who needs it. www.usatoday.com/story/news/h...

The head of HHS said he’d preserve ACIP. Then he fired the entire committee. Now a new panel -- with mostly unclear expertise in clinical trials, vaccines, and ID -- is in place. Time for high alert for changes that could seriously affect public health. #IDSky blogs.jwatch.org/hiv-id-obser...