Christopher A Jankowski

🔥Just published🔥 Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026 : Critical Care Medicine #IDXposts share.google/VN4AfbchzDiRr7…

🔥🔥🔬 New paper in Journal of Antimicrobial Chemotherapy We evaluated the activity of established vs. new β-lactams against AmpC-hyperproducing Enterobacter cloacae complex and Klebsiella aerogenes from 314 clinical isolates collected in 8 Spanish hospitals.

Usas la #Vancomicina para #Cdifficile 💩en pulso o en “táper”❓En @JAMA_current Ensayo clínico donde #”Taper” (125 mg/6 h 14 días y después pauta descendente)💊📉fue SUPERIOR a #pulsos (125 mg/6 horas 14 días)📸👇🏻con MENOS recurrencias📉🔁 🔗🆓 jamanetwork.com/journals/jaman…

New article out on cUTIs and the debate on cephalosporin efficacy. Im still not convinced cephalsoprins are inferior but this is a good read bit.ly/4aLGZuA

Revision📚@CMIComms #TETRACICLINAS űtiles x amplio espectro📸👇🏻 incluidos #multirresistentes🛡️y #MicobactNOtbc 1️⃣Tetraciclina Oral/IV 2️⃣Doxiciclina Oral/IV 3️⃣Minociclina Oral/IV 4️⃣Tigeciclina IV 5️⃣Eravaciclina IV 6️⃣Omadaciclina Oral/IV Piensa en ellas! 🔗🆓sciencedirect.com/science/articl…

🆕🔥Excellent review article Advances and updates in antibiotic combination therapy: Expert Review of Anti-infective Therapy/ 2025 ESCMID VS IDSA guidelines GNB🌟 Advantages/ challenges of Abx combo Recent RCTs/ studies combo GN GP #IDXposts share.google/jaZ9F1UUdMa7Bl…

Evidence on the PK/PD perspective to optimizing antimicrobial therapy with beta-lactams in critically ill patients is ever growing. 🆕⚡Excellent review PK-PD perspective to optimizing therapy with beta-lactams in critically ill patients: an update thanks @Inox94 #IDXposts tandfonline.com/doi/full/10.10…

Treatment of pulmonary mucormycosis: current concepts doi.org/10.1080/147872…

β-lactamases 101 (Ambler classes): A: ESBLs (CTX-M) & KPC → common in E. coli, Klebsiella; non-carbapenem β-lactams fail. B: MBLs (NDM/IMP/VIM) → hydrolyze almost all β-lactams; monobactams spared(Aztreonam) C: AmpC → hydrolyze most penicillins/cephs; cefepime & carbapenems retain activity. D: OXA carbapenemases ( OXA48)→ hydrolyze carbapenems , key drivers of DTR pathogens.

🆕⚡🌟Excellent review article Current Management of Serious Infections due to Vancomycin-resistant Enterococci(VRE) 🟢Linezolid 🟢Daptomycin 🟢Dual β-lactam regimens:ampicillin + ceftriaxone,others 🟢Persistence/recurrence 🟢Echo in bactremia #IDXposts sciencedirect.com/science/articl…

Is It Time to Use Single-Dose Amphotericin B for HIV-Related Cryptococcal Meningitis? 🆕⚡pre-post cohort study( N=60) @BradSpellberg et Al The AMBITION protocol* had similar mortality and cryptococcal meningitis recurrence rates compared with guideline-compliant treatment, with significantly fewer adverse events and less frequent patient-directed discharges. *single-dose liposomal amphotericin with 2 weeks of fluconazole and flucytosine jamanetwork.com/journals/jaman…

【Houston collaborative ID core curriculum @TXMedCenter】 CMV and EBV @MDAndersonNews So many clinical pearls and landmark studies presented by Dr. Chemaly! @ChemalyRoy #IDMedEd #IDFellow #IDCoreCurriculum @UT_Infectious @BCMIDFellowship @HMH_IDfellow @IchsGlobal

In this pre-post study, the authors found that people with HIV with CM had better recurrence- and severe adverse event–free 90-day survival when receiving the AMBITION protocol compared with control patients who received a guideline-concordant, daily lipid-based amphotericin regimen. The improved outcome was primarily driven by decreased adverse effects, specifically metabolic abnormalities and cytopenia

Que ATB es mejor en #Pielonefritis? @IJAA_ISAC #Metanalisis💻con cinco comparaciones📸👇🏻: #Quinolon, #Blactamicos,#Cefalosp,#Penicilina, #Aminogluc y #TMP/SMX NO DIFERENCIAS en curación,🫵🏻elige según #ResistenciasLocales, #FactoresPaciente y #Toxicidad 🔗🆓sciencedirect.com/science/articl…

Eravacycline 🧬 A synthetic tetracycline with broad activity vs MDR Gram-negatives, including ESBL- and carbapenemase-producing Enterobacterales. Engineered to evade classic tetracycline resistance (TetM/TetO ribosomal protection; TetA/TetB efflux). ⚠️ Resistance: • Not significantly affected by tetracycline-specific efflux pumps • Mainly driven by RND efflux systems (AcrAB-TolC, OqxAB, MacAB) • Regulators RamA and SoxS implicated (esp. K. pneumoniae) • Higher MICs in CRE vs carbapenem-susceptible isolates • Prior antibiotic exposure ↑ risk • In-vivo resistance emergence appears uncommon but understudied

🆕⚡🌟Narrative Review @CMIJournal Mechanisms of resistance to newer drugs against Gram negative bacteria in Enterobacterales #IDXposts clinicalmicrobiologyandinfection.org/article/S1198-…

Klebsiella pneumoniae: Host interactions, virulence mechanisms, and novel therapeutic strategies | Microbial Pathogenesis (sciencedirect.com/science/articl…)

🆕⚡💊 COPAT RCT: Cutting the Line — Early Oral Antibiotic Transition Is Safer, CID, 2025 🚀 What they did • 🧪 Pragmatic RCT (COPAT) across 5 hospitals • 👥 Adults needing ≥2 weeks of antibiotics (excluding CNS infections) • ⚖️ Randomized 2:1 to early oral (COpAT) 🆚 IV-only • 🎯 Outcomes at 3 months: safety superiority & efficacy equivalence • 📢 Trial cases shared in multidisciplinary forums to drive practice change 🔥 Key findings • 🛑 Trial stopped early after ~two-thirds enrollment due to a significant safety benefit with early oral therapy ⚠️ • 🛡️ Lower adverse event rate with oral switch:   🔹 3.2% vs 6.5% (P = 0.02) ✅ • 📉 Marked reduction in first antibiotic-related AE:   🔹 HR 0.24 (95% CI 0.08–0.75)   🔹 Benefit evident by day 10 ⏱️ • ⚖️ Therapeutic efficacy equivalent to prolonged IV therapy • 🔄 Practice transformation observed: rising COpAT : OPAT consult ratio (R² = 0.54) ⚠️ Limitations • 🌍 Single rural health system • 🧪 CNS infections excluded • 🧠 Implementation effects may not fully generalize 💡 Takeaway Early oral transition isn’t merely acceptable — it’s safer, convincingly so. 👉 COPAT shows how pragmatic trials can end IV inertia, improve patient safety, and rapidly reshape institutional practice @BradSpellberg #IDXposts academic.oup.com/cid/article/do…

🔥Just published🔥 @TheLancetInfDis British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases: 2025 update #IDXposts Thanks @Inox94 thelancet.com/journals/lanin…

"Antibiotic IV to Oral Step-Down Guidance" rightdecisions.scot.nhs.uk/media/2390/ant…