Definitely disagree there. The algorithm pushes political stuff and arguments. Still some good ID content though

Same cure because neither needed?

🔥🔥Just published 🔥🔥
ATS CAP guidelines 2025
Diagnosis and Management of Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline
Free access pdf #IDsky#EMIMCC
www.atsjournals.org/doi/10.1164/...

Nitrites for Urinary Tract Infection This Viewpoint examines the urinary nitrite test and questions its effectiveness and relevance in distinguishing between urinary tract infection and asymptomatic bacteriuria.

🆕💫 Viewpoint JAMA
Nitrites for Urinary Tract Infection—Time to Say Goodbye?
#idsky #EMIMCC #UTIsky
jamanetwork.com/journals/jam...

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Interesting 🤔

Are you able to share this? I can't access it via any of my usual options.

I agree, better dosing, better kinetics, but it's one of those odd things that my institution has been against switching to. I might need to revisit and see if I can make it happen..

Will read these today. Thank you both for sharing.

Will be great to see!

Agreed. Several are pushing it as blanket statement QID for specific indications and TID never. But I suppose that leans on the safer side, if the patient takes it.

I receive a lot of pushback on TID dosing from the ID community here (Mostly other institutions). Several of the docs and pharmacists really push for 1g QID even for things like pyelo, uncomplicated GNB (who had IV lead-in) , cellulitis.

I've always avoided Cephalexin for Osteomyelitis. But I attended a lecture this weekend and the speaker said they commonly use it for osteo/septic joint. Anyone else doing this? If so, 1g QID? TID? #IDSky

Anyone at HCA or another Meditech facility and able to share their CAP or Cellulitis order set? I'm trying to increase our use of the sets, but I think our build/layout is the problem... #IDSky

Vancomycin Taper trial presented by @dremilymcd.bsky.social #ESCMID2025. In people who get better by day 10 should we stop or give taper? Reduced recurrences by primary outcome timepoint but the KM suggests it may be just delaying rather than truly preventing recurrence? #IDSky

Thanks to @absteward.bsky.social for finding 2 RCTs of shorter (1 IM dose) vs. longer (3 weekly IM doses) of PCN for "Early Syphilis"! Added to the Shorter Is Better Table. 23 distinct conditions now reported in the table!
References at
www.bradspellberg.com/shorter-is-b...

🔥A sneak peak on the upcoming IDSA guidelines for cUTI🔥
Public Comment: IDSA Guideline on Management and Treatment of Complicated Urinary Tract Infections
So it's still not published yet ! #idsky #medsky #utisky
www.idsociety.org/practice-gui...

In patients with cUTI (including acute pyelonephritis) treated initially with parenteral therapy who are clinically improving,able to take oral medication,and for whom an effective oral option is available,we suggest transitioning to oral antibiotics rather than continuing IV Abx #idsky #EMIMCC

We are delighted to announce that we have begun to assemble a team for Bacteremia WikiGuideline.
Join us to create guidelines with the humility of uncertainty.

Anyone using cefazolin/metronidazole over ceftriaxone/metronidazole for appendicitis? #IDSky

In this specific case, we do an enterococcus, but I think strep is what we are really dealing with

@bradspellberg.bsky.social The osteo wikiguidelikes trials look like the all did BID with this dosing but TID seems logical and I believe there are someone studies looking at higher bone penetration. Thoughts?

With my small N, yes. Assuming compliance

For diabetic foot osteomyelitis, Amox/clav 875/125, do you typically go with BID or TID? Assuming the patient is not obese nor underweight. #IDSky

ONE ANTIBIOTIC PK TABLE TO RULE THEM ALL

Absorption takes drug into blood from GI,
Vd spreads drug out to where bug calls home.
And after bacteria are doomed to die,
The drug’s eliminated on the porcelain throne

In the Land of Notion where this table doth lie…

#idSky #microsky #pharmsky #medsky

Vanco/PipTazo/Clinda or Linezolid/PipTazo. Would love to make the switch to Linezolid + Ceftriaxone but a hard sell here.

Well, it’s official folks. We’re on BlueSky full time. You want to interact with us? Do it here, don’t message on X/twitter.

Don’t want to interact with us? Perfectly understandable, continue to ignore us, probably the best thing for all concerned.

Trying to explain this is such a hard sell at my facility.

Though "Oral is the New IV" with antibiotics (h/t @bradspellberg.bsky.social), it's not always easy to convince reluctant inpatient clinicians -- especially (in my experience) surgeons, who want to treat "aggressively".

Interesting dynamic ...
blogs.jwatch.org/hiv-id-obser...

🆕🔥Just published 🔥🆕
Updates on the Treatment of Drug-Susceptible and Drug-Resistant Tuberculosis(TB)
An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline #idsky #TBsky
www.atsjournals.org/doi/full/10....