Nikhil Singh

Recruitment and follow-up in our @shorten2trial is officially complete. Our team is finishing database polishing, and we expect to have results ready in the next months! #ShorterIsBetter #IDXposts

Are we treating “febrile neutropenia”? Probably not, but rather a patient with a fever who is neutropenic. Language matters: the case of “febrile neutropenia Other terms for the condition (1.) Neutropenic fever (2.) Fever and neutropenia (3.) Fever in neutropenia (4.) Febrile episode in neutropenia (5.) Fever during neutropenia Another ambiguous term is “septic arthritis" #IDXposts link.springer.com/article/10.100…

Just published today! A comprehensive set of evidenced based consensus guidelines for the management of neutropenic fever. Includes recommendations for paediatric patients, infection prevention, complex issues such as recurrent and persistent fever, and…a dedicated section for AMS including allergy Mx! onlinelibrary.wiley.com/toc/14455994/2…

I learnt a lot recording this @BloodCancerTalk episode on CMV in Hematologic Malignancies with the stellar Infectious Disease team at @PeterMacCC @GemmaKReynolds!

Remarkable. Double blind placebo controlled trial shows large reduction in COVID-19 incidence and limited fanfare. Really is 2025. Imagine same thing in 2020. Very impressive trial. High rates of COVID-19.

@IDPharmacometrx @sarubactam @ABsteward @OFIDJournal @BradSpellberg @DrToddLee @WesKufel @Inox94 @jasonroberts_pk @IDstewardship @InfectiousDz @tonybai16 clinicaltrials.gov/study/NCT04793…

@sarubactam @ABsteward @OFIDJournal @BradSpellberg @DrToddLee @WesKufel @Inox94 @jasonroberts_pk @IDstewardship @InfectiousDz @tonybai16 awesome. if there is a clinicaltrials.gov (if that even exists anymore) or a Canadian equivalent, would love to see the info.

🆕💫 @OFIDJournal @IDPharmacometrx A large cohort of internationally represented adult patients N=17,711 Big Data Bayesian Truths: No Vancomycin Trough Concentration Target is Sufficiently Precise for Safety or Efficacy #idxposts @BradSpellberg @DrToddLee academic.oup.com/ofid/article/d…

@IDPharmacometrx @DrToddLee @KathrynDaveson @legg_wamy @tonybai16 Are there any data/studies to support that midpoints provide greater accuracy than troughs with Bayesian? We are currently trying to decide whether or not we continue taking only trough levels for when we implement AUC monitoring.

@IDPharmacometrx showing trough just doesn’t reliably predict AUC, and the AUC can be in range, despite trough concentrations that seem ‘low’ (<15mg/L). Is there any trough target we can use in practice? Maybe not if clinical stakes are high! #ESCMIDGlobal2024

@gushamilton @jasonroberts_pk @jpogue1 @davidantibiotic More & more trials are like this, right? To prove benefit for a small group you can’t readily identify you must apply an intervention broadly & 🙏 to stats Gods. Then attention shifts to better tools for identifying the group likely to benefit, cost-benefit, and reducing costs…

Collaborative, interprofessional (partnered) medication charting and prescribing models are being introduced at many Australian hospitals. These models reduce the risk of medication errors at admission and discharge, and reduce patients’ length of hospital stay. One high-risk error may be prevented for every three patients who receive partnered charting. Explore more: buff.ly/3Jyr05K #pharmacists #charting #prescribing #medicinesafety #PPMC

We are delighted to have @AusAntibiotics ASA President A/Prof Louise Cooley and Vice-President Dr Iain Abbott present a 2-part series on #antimicrobial susceptibility testing for our March NCAS Seminar Series. Register here: lnkd.in/gJZVD2GE

Thanks to coauthors (@AbbyPDouglas, @NCAS_Aus, @gabhaeusler and @monicaslavin) and collaborators (@NAPSurvey, @NCICancer) for making this possible.

Meropenem use was often ‘guideline non-compliant’ but still assessed as ‘appropriate’ indicating that current guidelines may not adequately address all situations where meropenem should/should not be used (e.g. persistent/recurrent fever).

Higher inappropriate use of gentamicin, meropenem and vancomycin were observed; particularly in the paediatric and private hospital cohorts. This highlights the need for improved AMS resourcing in these settings.

Guideline compliance and appropriateness for pip-taz and cefepime were high, however pip-taz underdosing was observed (8-hrly instead of 6-hrly).

Despite upfront dual therapy (beta-lactam + aminoglycoside) being debunked in the early 00’s, an Australian survey in 2009 still demonstrated high rates of use. We found that overall, gentamicin (and vancomycin) use is still steadily decreasing. pubmed.ncbi.nlm.nih.gov/21272175/

This may reflect improving adherence to national guidelines which recommend against their upfront use (in the absence of systemic compromise). This supports that practice change lags years behind emergence of new evidence. onlinelibrary.wiley.com/doi/10.1111/j.…

Using ≈9 years of NF prescription data from @NAPSurvey, we analysed trends in antimicrobial use, guideline compliance and appropriateness.

Excited to share our paper, editor's choice in the latest JAC. We analysed a national dataset of prescriptions for neutropenic fever (NF). What did we find?🧵 @BSACandJAC

@MicroLukas @joeyzacks Interesting. Is that why antibiotics less active against Enterococci are more associated with CDI (e.g. clindamycin and cephalosporins)? Antibiotic-Specific Risk for Community-Acquired Clostridioides difficile Infection in the United States (asm.org)

Did you know Enterococci may aid C. difficile colonisation and increase toxin production? Fascinating talk from @joeyzacks at #CombattingCDIConference nature.com/articles/s4158…

Do clinical trials of antimicrobial agents give clinicians the information they need in order to change guidelines and revise their prescribing patterns? A thread on a new way to analyze clinical trial results