Writing this was a ton of fun (and TBH a great excuse to get Erin and Julie in my co-author pokedex of ID rockstars). Particularly want to highlight the modern MSK infection RTCs table, which points to how much early PO switch has become standard among the people who do run Ortho ID clinical trials.

The new expression of academic collegiality is when you start a zoom call with your Canadian/European peers and make pained/apologetic noises while they kindly inquire about your plans to leave the country.

👀 In a large national VA cohort, oral antibiotic prophylaxis following 2-stage for PJI not only was not associated with fewer reinfections, but led to those recurrent infections being caused by more resistant pathogens (ie with more limited suppression options) pubmed.ncbi.nlm.nih.gov/40051754/

Have been fiddling with EuropePMC all morning and seems like a suitable replacement for PubMed- actually casts a wider net, including preprints and abstracts by default. Would love to see even an ID journal letter to the editor published with some quantitative comparisons (assuming PubMed survives)

Ending the work of USAID and PEPFAR amounts to a mass killing. Just morally depraved. I don’t understand how you could value human life and do this thing.

So @asm.org if I publish in one of your journals (like AAC or CMR) do you reserve the right the change the publish text of my peer-reviewed work at any time without telling me? Let us know

As someone who is very familiar with both the US and Canadian systems, I can confirm that PHAC is a great source of info, especially regarding guidance and easy to access facts. It doesn’t replace American data lost at CDC in the great purge but it does provide reliable health & medical information.

@germhuntermd.bsky.social cyberbullying the IDSA into saying dismantling the CDC might be bad

Such a fun episode to make with old & new friends! As always, we get nerdy 🤓 this time about biofilms 🧫 The innovative non-pharmacologic agents in the PJI space are fascinating. It’s much more than 🦴 cement! @cortes-penfield.bsky.social @sidpharm.bsky.social #Breakpoints #IDSky #AMSSky #PharmSky

“HAL, stop prescribing gentamicin bladder instillations. This patient has a suprapubic catheter, he will have pyuria and bacteruria until the day he dies.” “I’m sorry Dave, I can’t do that.”

This is one of the most important and thoughtful papers about med ed I've ever read

My 2024 holiday splurge was on a gaming laptop, which inexorably (and within a couple weeks) instead became the Microsoft Excel / systematic review laptop. Sigh.

I spent an hour at work instead of with my family on Christmas Eve because I took over services and had to “fix” my colleagues’ perfectly serviceable A&Ps so that they “flowed right”. I love my pathological ID neuroticism, just wish I could turn it off once in a while. Sigh.

The cutoff for what constitutes “Acute PJI” is inconsistently (and somewhat arbitrarily) defined, but this recent cohort study of >5000 DAIR procedure out of Australia suggests that treatment outcomes deteriorate when DAIR is performed more than 4wk postoperatively pubmed.ncbi.nlm.nih.gov/39710215/

UPMC & Pitt are looking for a Medical Director, System Antimicrobial Stewardship! This person will partner with Dr. Graham Snyder, Tina Khadem, & myself to lead 37 US-based hospitals' antimicrobial stewardship and infectious diseases quality efforts. #idsky #medsky cfopitt.taleo.net/careersectio...

Most serious academics have career goals like publishing in JAMA or Science or Nature. My career goal is to get published in a Christmas issue of the BMJ.

Almost ready to start writing - just need to quickly read everything that has ever been, or will ever be, documented about this topic

Here is a nice pre/post cohort study reporting the Stanford Ortho ID group’s experience implementing routine PO switch. They achieved a 45% increase in discharge on PO abx with no diff in 90d clinical outcomes, shorter LOS, and trend toward fewer IV-related AEs: pubmed.ncbi.nlm.nih.gov/39660026/