Daniel Muñoz

🆕💥🟢Population pharmacokinetics of total and free ceftriaxone in critically ill and non-critically ill hospitalised adults* Once-daily dosing was sub-optimal in normal or ARC 1 g q24H for ≤60** & 1 g q12H for >60 is recommended #idxposts sciencedirect.com/science/articl…

❌ La homeopatía no ha demostrado eficacia terapéutica El reciente informe de la @AEMPSGOB lo confirma: resultados comparables al placebo y sin evidencia en ninguna patología ⚠️ Principal riesgo: retrasar o sustituir tratamientos eficaces

Ya está publicado el informe sobre homeopatía. (aemps.gob.es/informa/docs/i…) 🔴No hay evidencia de que tenga ningún beneficio clínico. 🔴Puede desplazar a otros tratamientos y, por ello, perjudicar la salud de quien la toma. Afortunadamente, en España no se financia por parte del Sistema Nacional de Salud (en otros países sí, pero está en retirada y merece la pena leer en el informe algunas consideraciones sobre esos casos).

@ABsteward @BradSpellberg @ESCMID @olivaresinfecto

🔥 💥Late-Breakers |COBRA RCT 1-day of antibiotic treatment after adequate endoscopic biliary drainage is non-inferior to 4-7 days in adults with acute cholangitis. 💡 Shorter is better+source control Practice-changing? #ESCMIDGlobal2026

@ABsteward @olivaresinfecto

🆕🔥New OL Multi-center RCT N=70 Adjunctive betamethasone significantly shortened the duration of hypoxaemia in adults hospitalised with Mycoplasma pneumoniae CAP and hypoxaemia (SpO2 <93% & respiratory rate >20 breaths/min #ESCMIDGlobal2026 thelancet.com/journals/lanep…

CRE RESPOND is proud to invite you our 6th Annual Worldwide Precision Dosing Seminar on Thursday 28 May 2026! Join @jasonroberts_pk and international experts as they explore the latest advances in individualised antimicrobial therapy and the impact of precision dosing on patient outcomes and stewardship. Event Details 📅 Thursday 28 May 2026 🕐12:00 PM – 1:00 PM AEST 💻 Attend in-person or online 💲 Free to attend View the program and register: bit.ly/4cx9kWq #CRERESPOND #PrecisionDosing #AntimicrobialStewardship #ClinicalResearch

🔍Linezolid en infusión continua: nueva posología, viejos riesgos 👉Paciente crítico con infecciones por Gram + y variabilidad PK 👉Enfoque individualizado 👉PK no lineal y rx acidosis láctica, trombopenia 👉Auto-inhibición metabólica (3-6 días) academic.oup.com/jac/article-ab…

Meropenem dose in ventriculitis: 11 g/day needed to reach serum ~30 mg/L → translating to just ~4 mg/L in the CSF CNS penetration remains a major limitation—even with aggressive dosing. #ESCMIDGlobal2026

Who needs more evidence to stop placing central venous lines for short term vasopressor use with appropriate monitoring? Yet another study @JAMANetworkOpen shows low incidence of adverse events with avoidance of CVC in a substantial proportion of patients. jamanetwork.com/journals/jaman…

Should you delay anticoagulation for stroke patients in AF with large infarcts? This work took us a long time! From @OPTIMAS_UCL , @UCLStrokeRes , @JKRuffles . pubmed.ncbi.nlm.nih.gov/41906919/ #NeuroTwitter #NeuroX #Neurology

🧪💉👶 Monitorización farmacocinética de biológicos en enfermedad inflamatoria intestinal pediátrica Nuevo boletín @gteii_sefh con claves prácticas para optimizar tratamiento ▪️ TDM proactiva → ↑ remisión (82% vs 48%) ▪️ Ajuste precoz clave (↑ aclaramiento en niños) ▪️ Rangos de niveles por fármaco y fase de tratamiento 🔗 sefh.es/fichadjuntos/b…

Clopidogrel is superior to aspirin for cardiac outcomes beyond 1-year up to 5-years. Results from the STOPDAPT-2 ACS and STOPDAPT-2 Total Cohort. Should it be a lifelong maintenance therapy? @HirotWatanabeMD @MNatsuaki @KoYamamoto7 ahajrnls.org/3PlxLhD

🏥 Who should be admitted to the ICU? A question without simple answers. A comprehensive review on ICU admission criteria and severity of illness highlights one of the most complex aspects of critical care: decision-making under uncertainty. 🔍 Key messages: • There are no strict admission criteria—decisions rely on clinical judgment, physiology, and prognosis � • ICU care is resource-intensive and must be allocated to patients most likely to benefit • Severity scores (NEWS-2, APACHE II, ICNARC) are useful but cannot predict individual outcomes reliably 📊 Clinical triggers for ICU admission typically include: • Shock (e.g., sepsis, cardiogenic) • Respiratory failure • Acute renal, neurological, or hepatic failure • High-risk postoperative patients. ⚖️ The decision is guided by the four pillars of medical ethics: • Autonomy • Beneficence • Non-maleficence • Justice 👉 ICU admission is not just about survival It is about meaningful recovery and quality of life 📖 A fundamental read for intensivists, anesthesiologists, and emergency physicians doi.org/10.1016/j.mpsu… #CriticalCare #ICU #MedicalEthics #Anesthesia #EmergencyMedicine

🫀 Vasopressin in Cardiogenic Shock: Are we underusing a key tool? A recent ESC Heart Failure review provides a comprehensive analysis of vasopressin in cardiogenic shock, covering pathophysiology, clinical evidence, and therapeutic applications. While traditionally associated with distributive shock, vasopressin may play a crucial role in selected cardiogenic shock phenotypes. 🔍 Key takeaways: • Cardiogenic shock is a heterogeneous syndrome requiring phenotype-driven therapy • Vasopressin offers a non-adrenergic mechanism, potentially improving perfusion pressure while reducing catecholamine-related adverse effects • Particularly relevant in: – Low SVR / mixed shock states – Post-cardiac arrest shock – Tachyarrhythmia-related cardiogenic shock • Important to recognize scenarios where vasopressin may be detrimental. 🎯 The message is clear: We should move toward physiology-guided, individualized vasopressor strategies rather than a one-size-fits-all approach. 📖 Highly recommended reading for intensivists and cardiologists managing shock. ESC Heart Failure (2026) 13, xvag053 doi.org/10.1093/eschf/… #CardiogenicShock #Vasopressin #CriticalCare #Cardiology #Hemodynamics #ESC #ICU

@isamar1027 sharing interim data from her double-blinded RCT assessing magnesium for atrial tachydysrhythmias @sccm Mag > placebo for rate control (p = 0.0088)

RPH:Patient ratio > 15 associated with increased risk of mortality. I am SO proud to have been an OPTIM investigator. Thank you @SESmithPharmD for presenting these results and the rest of the core team for affording so many of us the opportunity to contribute! #SCCM2026

@LeonardoSotoMu Gracias Leonardo ! 🙌

Felicitaciones crack! @dfmunozp pubmed.ncbi.nlm.nih.gov/41847755/

Las intoxicaciones representan hasta un 10% de ingresos en UCI. Revisión práctica y basada en evidencia: 
✔️ Manejo ABCDE
✔️ Claves diagnósticas
✔️ Cuándo escalar (antídotos, depuración, ECMO)
✔️ Algoritmos útiles para la práctica doi.org/10.1007/s00134…

Pleased to share our new review in JAC: Continuous linezolid infusion: the new way to dose, the old risks to fear pubmed.ncbi.nlm.nih.gov/41847755/ @ABsteward @BradSpellberg @UGAPharmacy @jasonroberts_pk @DIFARCLI