@ritikaprasad.bsky.social @stanfordasp.bsky.social @marisa-holubar.bsky.social: The inpatient mandatory indication field outperformed the ICD-10 in inferring dc abx indications, and can be used to assess abx appropriateness without needing manual chart review. doi.org/10.1017/ash....

🌟 ABX Pearl of the Day: ❓ Q: My patient is growing yeast in blood cultures. Is this Candida? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: ❓ Q: My immunocompromised patient is admitted to the ICU and starting ABX for presumed CAP. Do they need empiric MRSA and Pseudomonas coverage? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: ❓ Q: I’m looking for oral ABX options for UTI. When might oral fosfomycin be appropriate? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: ❓ Q: Can I use piperacillin-tazobactam to treat an Enterobacter cloacae intra-abdominal infection? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: ❓ Q: Can I use piperacillin-tazobactam to treat an ESBL E. coli intra-abdominal infection? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: ❓ Q: How do I tell if my gram-negative rod (GNR) is an extended-spectrum beta-lactamase (ESBL) producer? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: UTI in males ❓ Q: My male patient with dysuria is growing E. coli (>100,000 CFU/mL) on urine culture. He has no systemic symptoms or signs of pyelonephritis or prostatitis. Does he have a complicated UTI? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: penicillin allergies ❓ Q: My patient reports a reaction to penicillin (acute, self-limited rash) over 10 years ago. Can they safely receive cefazolin for their MSSA infection? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: sputum interpretation ❓ Q: My patient has 4+ growth of an organism on respiratory culture. Does this mean he has pneumonia? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: ertapenem hypoalbuminemia ❓ Q: My ICU patient with hypoalbuminemia has ESBL E. coli pyelonephritis, resistant to PO abx. He improved (afeb, WBC WNL, off pressors) after 3d of meropenem. Should I avoid narrowing to ertapenem? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: ABX CNS penetration ❓ Q: Which antibiotics have "good" CNS penetration for the treatment of bacterial meningitis/ventriculitis? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: Corynebacterium in resp cultures- do I treat? ❓ Q: My patient’s sputum culture is growing Corynebacterium species in addition to normal respiratory flora. Do I need to treat this? 💡 A: In most cases, no tx is necessary. #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: Coverage in septic BMT patient ❓ Q: A BMT recipient is in the ICU with septic shock. She is on IV posaconazole for antifungal prophylaxis; should we add/switch to an IV echinocandin empirically for Candida coverage? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: TMP-SMX and cytopenias ❓ Q: My immunocompromised patient is experiencing severe cytopenias while on PJP prophylaxis with trimethoprim/ sulfamethoxazole (TMP/SMX). How might I address this issue? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

🌟 ABX Pearl of the Day: revisiting Vancomycin Zosyn nephrotoxicity ❓ Q: Is the combination of vancomycin and piperacillin-tazobactam safe for the kidneys? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: ongoing fevers in febrile neutropenia (FN) but cultures negative ❓ Q: My patient with FN on IV cefepime is hemodynamically stable but continues to have fevers. Do we need to switch empiric antibiotics to IV meropenem? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: empiric vanco in IAI ❓ Q: My patient is admitted for an intra-abdominal infection. Is empiric IV vancomycin needed to provide coverage for MRSA and enterococcus? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: Positive UCx but unable to verbalize UTI symptoms ❓ Q: My elderly patient had a fall with altered mental status, and UCx is growing pan-S E. coli (>100K CFU/mL). They are unable to verbalize UTI symptoms. Should I treat for UTI? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: meningitis/ventriculitis dx tips 💡 ❓ Q: I am working up my patient for healthcare-associated bacterial meningitis/ventriculitis. What are some tips on diagnostics? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day ❓ Q: Candida only grew in 1/4 bottles. Is this a contaminant? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: QTc risk with FQ ❓ Q: My patient has a QTc of 450 ms, and I want to prescribe a fluoroquinolone. Would this be appropriate? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: Linezolid drug interactions ❓ Q: I'd like to prescribe linezolid but my patient is on serotonergic agents. What is the incidence of serotonin syndrome with this combination? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day (Outpatient): Cough- infectious vs non-infectious causes. ❓ Q: What are the common infectious causes of cough? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: "static" vs "cidal" ABX💊 ❓ Q: I am treating an MSSA abscess with TMP/SMX. This is a “static” antibiotic - should I switch to a “cidal” agent like cephalexin? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: Candida in urine cx💊 ❓ Q: My patient is growing Candida albicans in his urine, do I need to treat him? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: Candida in respiratory cx💊 ❓ Q: My patient has isolated yeast (not Cryptococcus) from respiratory culture. Do I need to treat this? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: ABX initiation in osteomyelitis💊 ❓ Q: In a patient with suspected osteomyelitis, should I start empiric antibiotics or withhold antibiotics to improve diagnostic yield? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: combo ABX for SSTI? 💊 ❓ Q: Do I need combination therapy (e.g., TMP-SMX and cephalexin) to cover both Group A β-hemolytic Strep and MRSA when empirically treating non-purulent cellulitis? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: bilateral LE erythema = cellulitis? ❓ Q: What are common mimickers of cellulitis? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: Nasal MRSA PCR in pneumonia💊 ❓ Q: If my patient with pneumonia has a positive MRSA nasal PCR but respiratory cultures are negative for MRSA, do I need to continue vancomycin for a full course of therapy? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: urinalysis and the diagnosis of urinary tract infections (UTIs) 💊 ❓ Q: If the urinalysis (UA) has elevated WBC or bacteria, does this mean the patient has a UTI? #IDsky #Medsky #AMSsky #SkyRX #MedEd

🌟 ABX Pearl of the Day: cefepime and ongoing fevers in febrile neutropenia (FN) 💊 📋 Q: My patient with FN on IV cefepime is hemodynamically stable but continues to have fevers. Do we need to switch empiric antibiotics to IV meropenem? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: Yeast coverage in intra-abdominal infections 💊 📋 Q: My patient has an intra-abdominal infection. Should I add empiric coverage for yeast? What if they have a gastrointestinal perforation? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: Febrile neutropenia (FN)- vancomycin de-escalation 💊 📋 Q: ❓ Q: I started vancomycin + cefepime for a patient with FN admitted with shock. On day 3, no pressors, cultures are negative, unclear source. Can I discontinue vancomycin? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: Treatment Options for Influenza in ICU Patients 💊 📋 Q: My patient is admitted to the ICU with influenza. What are treatment options? #IDsky #medsky #meded #pharmsky #skyRX

🌟 ABX Pearl of the Day: Susceptible-Dose Dependent (SDD) 💊 📋 Q: What does it mean when the lab reports my isolate as being “susceptible-dose dependent” (SDD)? #IDsky #MedSky #PharmSky

🌟 ABX Pearl of the Day: drug interaction carbapenems + valproic acid 💡 Q: I’d like to start meropenem for an ESBL E. coli infection in my patient who is also on valproic acid (VPA). What should I be aware of? #IDsky #Medsky #MedEd #PharmSky #SkyRX

🎉✨ Happy New Year! Let’s kick off the year with an important ABX Pearl for suspected pneumonia in patients from SNF: 📋 Q: My immunocompetent patient is admitted from a SNF. Do they need empiric MRSA and Pseudomonal coverage for pneumonia (community-acquired)? #IDsky #MedSky #PharmSky #skyRX #MedEd

🌟 ABX Pearl of the Day: empiric yeast coverage in intra-abdominal infections (IAI) 💡 Q: My patient has an IAI. Should I add an antifungal agent? #IDsky #Medsky #MedEd #PharmSky #SkyRX

🌟 ABX Pearl of the Day: ABX for SBP ppx in UGIB 💡 Q: What’s the recommended antibiotic of choice and how long should we treat patients with cirrhosis + acute upper GI bleed (UGIB)? #IDsky #MedSky #PharmSky #SkyRX #AMSsky #MedEd

🌟 ABX Pearl of the Day: empiric anaerobic coverage in intra-abdominal infections (IAI) 💡 Q: My patient is admitted with an acute biliary infection. Is empiric anaerobic coverage needed in this and other IAI? #IDsky #MedSky #PharmSky #SkyRX #AMSsky

🌟 ABX Pearl of the Day: 💡 Q: My patient’s blood cultures are growing Streptococcus mitis. What is the risk of infective endocarditis (IE) with Strep species? 🔍 A: Consider the Strep species, degree of bacteremia, and risk factors. S. mitis/oralis is generally considered “high-risk” for IE. #IDsky

🌟 ABX Pearl of the Day: ESBL cystitis 💡 Q: Can I use amoxicillin/clavulanate to treat ESBL E. coli cystitis if the micro reports it being susceptible? #IDsky #MedSky #PharmSky #SkyRX #AMSsky

🌟 ABX Pearl of the Day: AmpC or ESBL? 📋 Q: How can I quickly spot the difference in AmpC and ESBL resistance patterns? 🤔 🩺 A: Step 1: Look at the organism. Step 2: Check ceftriaxone susceptibility. Here’s a quick & handy decision tree to inform ABX Rx 👇 #IDsky #MedSky #PharmSky 🔗 IDSA AMR Guidance

🌟 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

Hurray! Our Peds ID/ASP colleagues are here!! @stanfordpedsasp.bsky.social

Hurray! Our Peds ID/ASP colleagues are here!! @stanfordpedsasp.bsky.social

The look I get from SICU when I tell them they can stop ABX 24 hours after early GI perf repair 👀👽 #IDsky #pharmsky #AMSsky

🌟 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