Scott Cohen
460 posts
@cohensa
MD-PhD Student | PhD in Epidemiology Infectious Disease Epidemiology + AMR + Causal AI
@ABsteward @DrToddLee I wish people would stop with this “target trial emulation” business. You did a retrospective observational study with propensity matching. Period. Be honest & call it that. Result won’t affect my practice. If atypical pna possible give azithro. If it’s a typical pathogen, don’t.
The equilibrium, already reached, is everyone writes and no one reads.
“A propensity score is used to simulate randomization” is something I said in a journal club when I was a resident I was wrong then and would be wrong now 1. PS scores cannot include unrecorded variables, namely clinician intention and discretion 2. PS does not align time zero
🆕🔥🧫 Three Days to Clear? Ertapenem Combo Therapy and Rapid MSSA Blood Culture Sterilization, AAC, 2025 🚀 What they did 🏥 Retrospective multicenter study of MSSA bacteremia patients receiving ertapenem combination therapy ⏱️ Defined rapid sterilization as blood cultures negative within ≤72 hours after ertapenem start 🔍 Compared rapid vs delayed clearance and explored predictors (severity, MICs, endocarditis) 🔥 Key findings 🚀 85% (167/197) achieved blood culture sterilization within 72 hours ⏰ Median time to ertapenem start: 4 days after initial blood cultures 🫀 47% had definite endocarditis — yet rapid clearance remained common ⚠️ Delayed sterilization linked to: Higher Pitt bacteremia score 📈 Oxacillin MIC ≥0.5 µg/mL 🤔👀 💊 Suggests early, potent synergy with ertapenem combination therapy ⚠️ Limitations Retrospective design No comparator group without ertapenem Clinical outcomes beyond culture clearance not fully assessed 💡 Takeaway For MSSA bacteremia started on combination therapy, most patients clear bacteremia within 72 hours — supporting a short, 3-day ertapenem course as a pragmatic antimicrobial stewardship strategy, rather than prolonged combination therapy CERT RCT is ongoing @DrToddLee journals.asm.org/doi/10.1128/aa…
Among adults hospitalized for community-onset #sepsis, broad-spectrum #antibiotic de-escalation at day 4 resulted in similar mortality, fewer antibiotic days, and shorter hospitalizations vs continued therapy. ja.ma/3LaeCxr
Read about new demographic data on applicants, matriculants and enrollment for this school year. ow.ly/f7rK50UCN19
At No. 10, the Vikings pick J.J. McCarthy. And now, for the first time in NFL history, five quarterbacks have gone in the first ten picks.
Let's give a 👏 round of applause 👏 to our PHHP Days student and faculty awardees! To see a full list of winners, read our wrap-up story: phhp.ufl.edu/2024/04/18/cel…
@SethWalder What is the breakeven conversion percentage?
