Treatment options for recurrent NDM-Pseudomonas bacteremia 2/2 UTI? Resistant to all the normal things. Previously treated with cefiderocol with MIC of 4, colistin MIC of 2. Aztreonam/avibactam an option here? Any luck getting FEP + taniborbactam or nacubactam? #IDSky

🆕🔥🔥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...

we're under-utilizing aminoglycosides for urosepsis in patients with good renal function rising % ESBL is pushing us to use carbapenems for empiric therapy... leading to more resistance (CDiff, CRE) aminoglycosides have minimal gut penetration = low CDiff risk & protect microbiome 🧵 #1/4 #EMIMCC

Looking for people that have unrestricted linezolid at their institutions. Any increases in resistance? Better to just ease up on use criteria? Currently reviewing our own usage and seeing what we can do with rising tetracycline resistance in S. aureus #IDSky #AMSky

Linezolid for odontogenic infections? Anyone doing this empirically? It feels like the data is there that LZD covers the relevant bugs, but there's no clinical data that I could find. Have to think LZD would be preferable to clinda #IDSky #AMSky

Innoviva Specialty Therapeutics’ antibiotic is the first and only FDA-approved cephalosporin indicated to treat Staphylococcus aureus bacteremia, including right-sided endocarditis, caused by the methicillin-resistant Staphylococcus aureus. #IDsky #Medsky

Derived from the PEN-FAST allergy decision tool, the CEPH-FAST version was developed and validated in this study. www.journalofinfection.com/article/S016...   #IDsky #pharmsky

@steventong.bsky.social presents the results of the PSSA domain of the SNAP 🫰 trial - the worlds largest trial of staph aureus bacteremia - at #ESCMID2025 fluclox resulted in higher mortality and more AKI compared to penicillin for PSSA

📝Here are my cliff notes for the recently FDA approved drug #gepotidacin #blujepa www.idstewardship.com/drugs/gepoti... 🤔 Still wondering where the name comes from? It’s a yellow tablet… Kind of sounds like Jet Blue 🤷‍♂️ Anything to add? #IDsky

If your institution has a Clinical Decision Unit for intermediate patients who may or may not need inpatient care, do they primarily use IV or PO antibiotics? Trying to push for more PO in this setting but also trying to anticipate challenges #IDSky #Pharmsky

‼️The @idsainfo.bsky.social cUTI guideline 📄 draft is now available for public comment🗣️! This version has been reviewed by 15+ orgs & revised according to extensive feedback provided to us. www.idsociety.org/practice-gui... UTIsky IDsky Medsky PharmSky

An inpatient antimicrobial stewardship team driven penicillin allergy delabeling protocol for minimal and low-risk penicillin allergic patients #IDsky bit.ly/3EDPPOP

#IDSky preferred approach to recurrent MDR Pseudomonas? Respiratory isolate, currently on ceftazidime monotherapy. Susceptible only to tobramycin. Avycaz, Zerbaxa and Recarbio sensis not done yet but previously resistant. @bradspellberg.bsky.social @dralicehan.bsky.social @idiots-pod.bsky.social

Breaking news🔥 US FDA approves EMBLAVEO (aztreonam and avibactam) for complicated intra-abdominal infections (cIAI) in adult patients who have limited or no alternative options #idsky

Reading through some IV vs Oral endocarditis papers and loved this excerpt from Heldman 1996, "we felt that we could not ethically require orally treated subjects to undergo the central venous catheter insertion and maintenance...only to deliver intravenous vehicle without active drug" #IDSky

All of human medicine rests on Streptomyces being kind of a dick neighbor

Does your institution dose adjust micafungin for obesity? Clinical outcome data is lacking but what's there seems mixed overall, nothing really conclusive. I don't think I've ever used or seen 200mg daily personally #IDSky #PharmSky

As if 6 months wasn't good enough. Lenacapavir is already poised to be a game-changer in HIV PrEP, but once yearly?! I can't imagine how much this will improve access

How much is everyone using single dose aminoglycosides for cystitis? Just Enterobacterales? Or Pseudomonas as well? Good option to prevent admission for more resistant organisms? Always sucks admitting a stable patient solely due to resistance profile. #IDSky #PharmSky

we updated our metronidazole dosing across UPMC system over a year ago based on Sunish's prelim work and now the final evaluation is published! so proud of him!! #idsky #amssky #pharmsky #medsky www.sciencedirect.com/science/arti...

On this day in 1981, a landmark paper in NEJM described four patients with evidence of immunodeficiency associated with PJP pneumonia, disseminated CMV, and Kaposi sarcoma. The disease would come to be known as HIV/AIDS. Revisit the paper: nej.md/41iekKD #MedSky #IDSky

#IDSky community, what are you/what do you see being used routinely for community SSTI? Are you still seeing SMX/TMP + cephalexin? Having trouble convincing my colleagues on SMX/TMP monotherapy when MRSA and Streptococcal coverage is wanted

🆕 #Breakpoints Episode: Drs. @annegretemartson.bsky.social, Megan Wimmer, and Evan Clemens join me to discuss all things (Val)ganciclovir!!! #idsky #pharmsky #amssky @sidpharm.bsky.social 🎧 sidp.pinecast.co

Endocarditis therapy has long been based on opinions of eminent experts rather than high-quality evidence 🔥PUBLISHED🔥 Our editorial with Dr.Spellberg✨️ @dremilymcd.bsky.social @drtoddlee.bsky.social Endocarditis Therapy: The Move From Expert Opinion to Evidence www.sciencedirect.com/science/arti...

Really shows that resistance isn't just about usage; mechanism and evolutionary/fitness costs play a huge part as well #idsky

Oral cephalosporins for pyelonephritis?! 🆕️⚡️⚡️COPY-ED Multicenter, retrospective study N=851 No difference in 14-day pyelonephritis treatment failure for oral cephalosporins* vs FQ/TMP-SMX for outpatient pyelonephritis in the ED #idsky #medsky * Mostly cephalexin www.sciencedirect.com/science/arti...

🌟 ABX Pearl of the Day: Duration of treatment in intra-abdominal infections (IAI)! 💊 💡 Q: How long should I treat IAI after source control? 🔍 A: While STOP-IT trial calls for 4 days post-source control, there are notable exceptions. See infographic for details 👇 #IDsky #AMSsky #MedSky #Pharmsky

What did I do this morning? Fill out quick surveys about CDI! They’re quick and support very important research! #IDSky redcap.link/guubtkxs @connorprosty.bsky.social @drtoddlee.bsky.social @dremilymcd.bsky.social

Hi #IDSky! I’m putting together my usual top 10 ID papers of this year list again (this time will post here not in the other world). Please tell me your candidate papers - practice changing paradigm shifting or dogma challenging!

happy #antibioticawarenessweek!🦠 sharing a paper I ❤️ from Dr. Dinh, a lovely human who told me they noticed in their RCTs that some patients were getting exclusive PO treatment for CAP (dealers choice!) They explored these pts and its worth a read #idsky #pharmsky pubmed.ncbi.nlm.nih.gov/38734138/

IDSKy This is one way of creating an anonymous poll using poll.blue @sebpoule.bsky.social @kartikacharyaid.bsky.social

Vaccines do work… #MedTwitter #MedSky #IDSky #MedEd  🧪 #EMSky #EMedSky

Back to the basics 😄✍️ #IDSky

Interesting! SubQ meropenem. “Subcutaneous meropenem appears to be well tolerated and has a favourable pharmacokinetic profile. Either 1.5 g twice daily or 3 g as a 24 h subcutaneous infusion could be considered for future evaluation.” academic.oup.com/jac/advance-...

First paper to share here Delightful to have been part of the all new UK guidelines on the diagnosis of and management of eosinophilia! www.journalofinfection.com/article/S016...

Interested in SIDP’s Antimicrobial Stewardship Certificate Program? To see the program description and to register, please visit buff.ly/3NXfAKW' #IDSky #MedSky @sidpharm.bsky.social

Just to be very clear about things that work.

Can colleagues amplify this appeal to journals and journal editors to open accounts on Bluesky, please? @MicrobioSoc @TrendsMicrobiol @CellCellPress @JBacteriology @jbiolchem @Nature @ScienceMagazine @PNASNews @MolMicroEditors @NAR_Open @NatureMicrobiol @NatureComms @ASMicrobiology 🙏 🦠🧪🧫🧬

IDSky continues to grow rapidly We are now >300 users, which means we are on a third Starter Pack IDSky Starter Pack 1 go.bsky.app/LnAQjdq IDSky Starter Pack 2 go.bsky.app/JNfSvQT ID Starter Pack 3 go.bsky.app/FeogT7o Check back on the most recent one often as it is updated frequently

Is there really any role for clindamycin left? Linezolid just seems to be better for the few niches clinda had left. Oral, anti-toxin, and is better in regards to dosing, CDI, and resistance rates. Is there anything you'd still prefer clinda for? #IDSky #MedSky #PharmSky

Toxicologist here for any fluoride concerns! The amount of fluoride added to water to prevent tooth decay is so minuscule that—no matter your age, size, or health status—you would die from water poisoning long before you could ever even start getting toxicity from fluoride. Fluoridated water is safe

Good news: Our community is growing! The IDSky Starter Pack has exceeded the max 150 accounts, so I’ve started on another (pls share here and the other place, and LMK if I missed you) IDSky starter pack 1 go.bsky.app/LnAQjdq IDSky starter pack 2 go.bsky.app/JNfSvQT

Along the lines of what others have started, here's a #SkyRx starter pack - if I'm missing you let me know! go.bsky.app/DTkEEWG

My first #IDSky post will be a shameless promotion of our new UTI WikiGuideline! jamanetwork.com/journals/jam... Of 37 questions, only 6 had enough data to fully meet criteria for a clear recommendation!