How strong was the Bayesian prior?

How many were not E. coli or E. faecalis?

Would love to connect on this work! I can't send you a message, but if you can DM me, can provide email :)

I’m not sold. “Target trial emulation” = fancy way of saying “retrospective observational”

I never underestimate the power of fear to cause bad decisions.

Yay please @pamipenem.bsky.social

I can't imagine why. This is a well documented training method per Pavlov, et al ;)

But we are getting lots of pushback from ED. All other departments are fine with this. I think there are things that are just not being said (e.g., convenient when no other dx is apparent, can then do something and get a good review) as opposed to just "prescribing" watchful waiting.

Thank you!

We considered the UA only for patients without classic symptoms, but feel like this still influences clinician decision making (e.g., treating ASB), so the hope was to not have a selectable option that would encompass patients with AMS/weakness/confusion without systemic symptoms.

Yes!

Does anyone have formalized EMR interventions/protocols that have made it more difficult for certain care settings (ED) to order urine testing based on cloudiness/darkness of urine, altered mental status without systemic symptoms, etc. and are willing to share screenshots? #IDSky #MedSky

Has anyone else seen this with omadacycline? I have once. #IDSky

Untreated chlamydia has different implications than carriage of GAS, etc. in my opinion.

Well according to PROSTASHORT, a dose of oflox equal to 100 mg BID of levo treats febrile UTI (clinical cure 96%, 7 day duration). So yes!

And preferably not just criss crossed E-tests!

Great stuff, Betsy! Very interesting

Considering a large proportion of chlamydia cases are asymptomatic, hard not to screen right? Chlamydia infection increases risk for HIV acquisition, maybe prostatitis other issues you have already mentioned. Maybe it’s moot in the era of PrEP, but not sure how abundant daily adherence to it is.

🤣🤣🤷🏼‍♂️🤷🏼‍♂️

They also cherry picked data and said firmly that doxycycline should be avoided. Bad.

#IDSky

Perplexing that this made it through peer review without mention of an entire guideline published in the last 1.5 years directly relevant to the content… 🤔

#IDSky

What a study - nearly 15,000 people followed up 4-8 years after a *sole* antibiotic treatment and some *still* had disrupted gut microbiome diversity. Pretty incredible. We’ve always been taught that such disruptions are ephemeral.

#IDSky #MicroSky

We use cefazolin plus metronidazole in most situations where cefoxitin was historically used.

(3 g for >120 kg)

How fun! Don't know of any lit, but back-of-napkin math seems consistent with your findings & may support longer intervals especially in cases of severe renal impairment and exquisitely susceptible organisms. Suspect combo of in vitro concepts/no concerns of PTA led to minimal exploration of this?

@dremilymcd.bsky.social is a wealth of knowledge as she sits on the steering committee and has led a guideline publication. I led the UTI effort published in November 2024. Let me know how we can be helpful!

Enjoyed the discussion but disappointed that WikiGuidelines, which importantly addresses many of the shortcomings highlighted, was not even mentioned 🤔 #IDSky #MedSky

@erinmccreary.bsky.social
@cmicomms.bsky.social
@angelahuttner.bsky.social

Yes

It’s wild to me. Fidaxo is so outrageously priced.

And this entire trial “only cost” ~100-150 fidaxomicin courses to complete

If amputation takes place, the duration of treatment is either less than 5 (clear margins on pathology) or 3+ weeks (residual osteo). None of this 7-14 day nonsense.

If cure is the priority, cefazolin would be a great choice.