What the DOTS trial of Staph bacteremia tells us: • Dalbavancin d1 and d8 vs daily IVs for WEEKS • No left-sided IE/CNS/prosthetics • Dalba not superior by DOOR endpoint, but similar clinical outcomes. Big implications for inpt care. More here! #IDSky tinyurl.com/3hjzkt96

Tremendous honor -- thank you so much @idsainfo.bsky.social and especially @darcy-id-doc.bsky.social #IDSky www.idsociety.org/education--t...

Update on the little guy -- plus one very interesting ID fact! (It's an ID blog, after all, not a dog blog.) #IDSky (See next post if it doesn't open on your phone NEJM Journal Watch is working out some bugs.) blogs.jwatch.org/hiv-id-obser...

New #LetsTalkID! ID physician and artist Ana Velez, MD, FACP, joins @paulsaxmd.bsky.social to share how art shapes her work in ID and brings new meaning to medicine. Transcript: bit.ly/3Iu863j Bid now to own her original artwork and support IDSA's mission: givebutter.com/c/pclXSb/auc...

Wrote this one with tears in my eyes 😢 blogs.jwatch.org/hiv-id-obser...

I'm doing another required learning module, and alas it's back to the usual grind: - start video - try to fast-forward (disabled) - run in background while doing other menial tasks - take exam to get "Certificate of Completion" Any evidence that this drudgery actually improves anything?

Still time to register! Reasons to attend: - updates on antibiotics and immunizations - "can't miss" diagnoses - expert approaches to C diff, H pylori, STIs, tick-related infections - viral hepatitis/HIV for PCPs ... and MORE! Live-streaming -- join us from anywhere! idprimarycare.hmscme.com

truly impossible to remember these criteria, who agrees? Lost Generation - 1883-1900 Greatest Generation - 1901-1927 Silent Generation - 1928-1945 Baby Boomer - 1946-1964 Generation X - 1965 - 1980 Millennial - 1981-1996 Generation Z - 1997-2012 Generation Alpha - 2013 - present

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...

An online required learning module that didn’t have me scrambling for the "fast forward" button? I’m stunned -- but impressed. Curious what module pulled off this miracle? Here are the details: blogs.jwatch.org/hiv-id-obser... #IDSky #MedSky

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...

When we care for PWH who have virologic suppression, but possible or confirmed NRTI resistance, can we switch them to a simple oral treatment -- once-daily BIC/FTC/TAF? This study says yes, with results strengthened by proviral DNA testing. #IDSky #HIVSky www.sciencedirect.com/science/arti...

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...

Before the @nejm.org blog, there was another ... and it wasn't pretty. My first blogging attempt fizzled before it even took off. But the experience taught me a ton, so I'm grateful to the organizers for the opportunity. #IDSky Read more: blogs.jwatch.org/hiv-id-obser...

My smart and funny pal @drlaurajwaters.bsky.social posted this on LinkedIn -- thought I'd share it here since it is filled with wisdom! #IDSky #HIVSky

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/...

I can now outsource required "Learning Objectives" to AI, which writes them faster and better than I ever could. But if that’s true … do we really need them? Thoughts in today’s post, with bonus Marx Brothers. #IDSky #MedEd blogs.jwatch.org/hiv-id-obser...

Prasad’s tenure at the FDA was brief--appointed for his contrarianism, dismissed for doing what we say we want regulators to do: demand evidence and protect us from harmful medical interventions. Unfortunately, politics, not medicine, may have driven both decisions. blogs.jwatch.org/hiv-id-obser...

Who gets referred to ID clinic? It's not always FUOs and Tsutsugamushi fever (though we’d take those too). Here's a field guide to outpatient ID consults -- diagnostic puzzles, fascinomas, and a whole lot of recurrent UTIs. @sigal-md.bsky.social blogs.jwatch.org/hiv-id-obser...

Ceftriaxone is a narrow antibiotic now. Plus: ID binomials, BCID magic, linezolid price madness, a Novak Djokovic apology (!), and more. 20 musings, mostly ID-related, bonus videos included. #IDSky blogs.jwatch.org/hiv-id-obser...

enjoying my moment as the esteemed Dr. Monica Slavin, courtesy my hospital's default search engine, Bing www.bing.com/search?q=edi...

Patient had recent surgery, abnormal labs, and clear signs of illness -- so he was admitted. He got better. That, apparently, was the problem. His insurance denied payment because he didn’t get sick enough. 🤷‍♂️ My "peer-to-peer" (& @glaucomflecken.bsky.social video) blogs.jwatch.org/hiv-id-obser...

100% this www.nytimes.com/2025/07/11/o...

"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...

Hello ID People Outside of USA: Looking for practical information on how to access to Uromune (MV140). Anyone know? Thanks! www.vax-before-travel.com/uti-vaccine-...

Currently attending on a general medical service. Remarkable how often cases fall into one of these 4 categories. (Hint: You want to be in Box #1.) The Four States of Clinical Medicine, and a Movie Review (Sort Of) blogs.jwatch.org/hiv-id-obser...

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...

This is by far the most common vaccine I strongly recommend in ID adult clinical practice. As ID doctors, we see some truly severe cases of zoster, with post-zoster sequelae that may last months or even rarely be permanent. #IDSky doi.org/10.1093/cid/...

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...

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...

In the 3rd (and final) “How ID Doctors Get Paid” series, here are three less-visible salary sources for ID docs: • Infusion services • 340B pharmacy • Industry-sponsored clinical trials Plus--why is this topic so taboo in our field? (Bonus fleece vest&dog vid) #IDSky blogs.jwatch.org/hiv-id-obser...

Insanity of US Healthcare System, Exhibit #3,940,947: My patient's insurance denied coverage of rosuvastatin, which has been generic for years. It's $7 for a 3-month supply at @costplusdrugs.com.

44 years ago today. Still amazed it did not get "front page" news in MMWR in deference to two cases of dengue in US travelers to the Caribbean. But amazingly prescient reporting by CDC, incredibly what they got correct in the full text. #IDSky www.cdc.gov/mmwr/preview...

Excellent critique.

Before the ID salary talk, a quick protest: 3 recent vaccine-related actions — all alarming. Then in Part 2 of How ID Doctors Get Paid: - Infection control - Abx stewardship - Contracts for care - Telehealth - Travel clinics (+ dog video, of course.) #IDSky blogs.jwatch.org/hiv-id-obser...

Introducing Ethics Rounds, a new series in @cidjournal.bsky.social, headed by Drs. Olivia Kates and Tim Lahey. Wonderful to have these useful (and challenging!) discussions, as they come up frequently. doi.org/10.1093/cid/... #IDSky 1/3

Recent FDA actions on Covid vaccines: 1. Novavax approved (👏) 2. Narrowed indications for all (pros and cons) 3. Called for clinical trials (👍) No doubt we're relying too much on old data to inform clinical practice. Some thoughts on what we gain… and what we risk. blogs.jwatch.org/hiv-id-obser...

If anyone is looking for a true "start" of the effective ART era for HIV, I'd vote for Jan 1996 CROI, when 24 wk data from this study were presented for the first time. Indinavir joined ritonavir (🤮) and saquinavir (😑) with full FDA approval in March. So amazing. www.natap.org/1998/drug/03...

We love what we do. But yes, we’d also like to get paid. ID is a cognitive, consult-heavy specialty -- and often a “loss leader” in a fee-for-service world. A look at how the money actually flows (or doesn’t), Part 1. #IDSky blogs.jwatch.org/hiv-id-obser...

I wonder if he'll include this in his annual COI form www.nytimes.com/live/2025/05...

The new head of FDA’s CBER, Dr. Vinay Prasad, is undoubtedly brilliant. He'll oversee vaccines, gene Rx, monoclonal Abs, & blood products. Let's hope he can get along well enough with others to be an effective leader, as the stakes are pretty darn high! #IDSky blogs.jwatch.org/hiv-id-obser...

TB rule outs, Abx allergies, CMV, MSSA (of course), and more. Studies sent to an awesome ID fellow during 2 weeks of service — organized for subconscious absorption. 🧠 Link-o-Rama: Osmosis Edition #IDSky @mgb-id-fellows.bsky.social blogs.jwatch.org/hiv-id-obser...

One of the most challenging encounters in the outpatient practice of infectious diseases, summarized here wonderfully in @cidjournal.bsky.social by Drs. Advani and colleagues. Have already used this algorithm several times! doi.org/10.1093/cid/...

The SNAP trial may finally resolve some of the longest-running debates in SAB management (cefazolin vs semi-synthetic PCN? Is PCN really active vs PSSA?). Huge congrats to Drs. Joshua Davis, Steven Tong, & the global team who made this ambitious trial happen. #IDSky blogs.jwatch.org/hiv-id-obser...

If you're of a certain age or older, and have followed baseball your entire sentient existence, this will be a joy to behold www.thebaseballcube.com/content/news... h/t @craigcalcaterra.bsky.social

Remember ICAAC? Bad name, weirder pronunciation ("ick-kack"), ugly swag, and a classic case study in conference identity crisis. A look back—and where the big ID trials land now, which is #ESCMID Global, or whatever it's called. #IDSky blogs.jwatch.org/hiv-id-obser...

Dear Predatory Publishers, Gentle advice, at least if you're in the health field: Try to choose your fake names with a bit more care. With great affection for all the unintentional humor you've given me over the years, Paul

Hello #HIVSky and #IDSky. K103N was not exclusionary for injectable cab/rpv in pivotal trials. Are there data specifically addressing treatment response in those with known K103N? A post-hoc of ATLAS, FLAIR, or ATLAS 2M? Other reports? I can’t seem to find anything after a search! Thanks!