@microregistrar @venkat_id Hmm interesting - no idea! Wouldn't omp affect amox as well though?
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Vani Subbarao
688 posts
Vani Subbarao
@VaniSubbarao
Infectious diseases and microbiology doctor. #AMR #Maternal sepsis #pkpd. Currently at #royalfree.
Katılım Ocak 2019
371 Takip Edilen209 Takipçiler
@venkat_id Unfortunately vitek do not give the 1GC. My thoughts was OMP down regulation. Wouldn't narrow BL affect amoxicillin?
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@BradSpellberg @DrToddLee @ABsteward Dnt disagree - I suppose it would be good to go back with evidence. Say aside from enterobacter (like Heck-yes/morgane (sorry Brad) and someone was on piptaz for intraabd/urine BSI and in vitro piptaz sens - would you carry on(if needed Ivi/no oral)(and ref?)
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@DrToddLee @ABsteward You know, we have real problems to address. Why do people want to invent phantom problems to pile on?
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Battle of the mnemonics, SPACE, SPICE Vs HECK-Yes!
🆕💥🟢Cross-sectional,nationwide survey of ID clinicians to evaluate clinical & microbiologic practice patterns for infections caused by Enterobacterales at risk of inducible AmpC production #idxposts academic.oup.com/jacamr/article…
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@BradSpellberg @Staph_papers Bacteriostasis is BAD. CIDAL is good. That's right, hey?
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@VaniSubbarao @Staph_papers You feel correctly!
What does that mean?
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Ceftriaxone for methicillin-susceptible Staphylococcus aureus bloodstream infections is associated with increased short-term mortality: a systematic review and meta-analysis ift.tt/YaEzwNR
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@MushtaqBilalPhD I think Claude is starting to talk like Chat GPT though which I find hugely irritating. And I don't think it's output is quite as rigorous or accurate as it was a few months ago. (I'm on paid plan and having opus 4.7 adaptive)...
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Not often that #IDXposts traces me something I had no idea about but this was really a revelation: Quinolone cross-reactivity traditionally low. Thanks @KASIC_MDRO !
Still hate quinolones though
KASIC.MDRO@KASIC_MDRO
A 44-year-old female is on day 3 pip-tazo for a complicated UTI. Her urine culture grows P. aeruginosa and she is ready to go home. She has a history of rash to ciprofloxacin. Can she be discharged on levofloxacin?
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@ABsteward So - I guess the test of cure at 14 days was part of a secondary outcome for the clinical trial as this wouldn't be standard practice. would be interesting to know if he was symptomatic?
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The authors observed that the index isolate showed heteroresistance to TZP ( how?) ; a minor subpopulation of the cells were resistant, rather than the isolate being completely susceptible (as presumed by broth microdilution). Due to the low frequency of resistant cells (can be as low as 1 in 1 million cells), and as observed in this patient, heteroresistance often remains undetected in antimicrobial susceptibility tests, including broth microdilution.
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Super interesting cUTI case with Klebsiella pneumoniae treated with pip tazo.
Day 1:S to pip tazo
Day 7:R to pip tazo
👉 Classic reminder: heteroresistance can hide in plain sight
Even BMD may fail to detect it reliably
👉 Clinically linked to treatment failure in reported cases
thelancet.com/journals/lanmi…
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@vivax74 @parthaskar I love this temple. We got married there in the height of summer. Beautiful. And fantastic laddus....
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@parthaskar I was in Dudley too, but for visiting Balaji temple in Tividale. No such racism there (in temple premises), free meal and a calm surrounding.
GIF
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I have been told today to 'go back to the place where you were born'
I- again- would like to mention that I enjoy my job in Portsmouth
And no intention of joining the Diabetes team in Dudley
As good as it maybe.
Thanks.
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@CatrionaWaitt @At_The_EQUATOR @IDIMakerere @NIHRglobal @wellcometrust Woop wooop! Yes to all this Catriona! Well done! Xxxx
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The #MILK_CENTRE @At_The_EQUATOR team can now celebrate! I very much look forward to the next few years of generating evidence to support the safest and most effective use of medicines in breastfeeding mothers and their infants
@IDIMakerere @NIHRglobal @wellcometrust
Mr.MAGOOLA@MagoolaJohnson
Finally saw the light of the day🎉🎉🙏😍. Congrats, Professor Catriona Waitt and Professor Khuzwayo Chidiwa Jere. #MILKCENTER news.liverpool.ac.uk/2026/04/15/nih…
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@DiorIzzy @JulienPrvost5 @BradSpellberg @JLimHospMD I totally agree with your sentiments! The problem is that the clinician sees that the redness&pain has only partially improved, has a high crp and therefore deduces that 7 days (of invariably Ivi) not enough...
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My institution created an order set to guide abx treatment for outpatient cellulitis. While for non-purulent cellulitis duration default is 5d, when MRSA suspected default is set to 7d. Curious what ID folks think @BradSpellberg
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@BradSpellberg @JLimHospMD So trying to get the parent clinician to stop feels like a battle. I'd be curious as to what you might define a successful end point that we can use to stop the madness?
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@BradSpellberg @JLimHospMD How do you guys define success in these patients regardless of the pathogen? My view is that the actual redness can take a long time to resolve sometimes, and the responsible clinician often does crp (I know, your favourite!) which invariably ends up being around 130 or so.
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@BradSpellberg @DrToddLee @LAGeneral_ID Are you serious?! I'm currently in a small dgh until September but we'll instate the big guns if you guys come!
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It was awesome to have the legendary Immortal Time Lord @DrToddLee as Visiting Professor at LA General today. Everyone loved it. I highly recommend to others out there, invite him over! Great case conference discussion, awesome on rounds, great lecture! Thank you! @LAGeneral_ID
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@IdVilchez @BradSpellberg @DrToddLee @ABsteward @dralicehan @JamesWilsonDO1 @BJegorovic What's your / can you ask for Mero MIC? (Depending on where the infection is?)
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#IDtwitter does anyone feels that this is becoming more prevalent? I have seen 2 in the past 6 months. Now I am getting paranoid and on top of the azithromycin I add linezo empirically until I confirm S @BradSpellberg @DrToddLee @ABsteward @dralicehan @JamesWilsonDO1 @BJegorovic
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Paradoxical worsening on olorofim in patients undergoing treatment for invasive fungal diseases - Clinical Microbiology and Infection clinicalmicrobiologyandinfection.org/article/S1198-…
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🆕💫Dual β-lactam synergy in Enterococcus faecalis and its relationship with penicillin-ceftriaxone infective endocarditis treatment outcomes #IDXposts #IEWiki academic.oup.com/jac/article/do…
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For those who are interested or who missed it, here's the link:
youtu.be/EOD4igxbFbg?si…
Comments and engagement welcome
Particularly excited about @DrEmilyMcD 's dabi-snap trial getting started soon
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Todd C. Lee@DrToddLee
Giving a talk on <i>S. aureus</i> this week - topics will include: *Adjuctive therapy and the boulevard of broken dreams *Early oral switch *Antithrombotic therapy *Cefazolin as MSSA SOC *Cefazolin in CNS disease I think it's being recorded, if so, I'll post a link.
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@DrToddLee @ABsteward @AnilMakam @BradSpellberg @DrEmilyMcD Wasn't there a modelling paper recently that showed sun optimal dosing for current cefazolin dosing strategies for cns infection - but increased conc with higher doses?
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@ABsteward @AnilMakam @BradSpellberg @DrEmilyMcD Watch my talk. The last ~15 mins or so is on this topic.
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More participants from the cloxa group had an AKI at the end of the study treatment than the cefaz group.
However, a limited ⏏️ in creatinine levels was observed, raising the question of their clinical significance, particularly in patients with typical baseline creatinine levels
Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟@ABsteward
🆕🔥🔥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 #IDXposts Thanks @Inox94 thelancet.com/journals/lance…
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