Apologies, typically for MSSA.

We do this often, on a MWF schedule we generally do cefazolin 2g/2g/3g post-HD.

Another Mastery Monday: Sometimes, the sodium content of antibiotics matters. Just last week, there was a CHF patient with pneumonia who wasn’t improving as expected. It turns out that the culprit wasn’t infection severity; it was likely the sodium load from Zosyn (piperacillin–tazobactam). Patients with CHF are often restricted to < 2 g sodium/day. Sometimes, Zosyn alone pushes them past that (especially if mixed in normal saline, which varies by institution). Add in maintenance fluids and other IV medications, and sodium can add up quickly. It's just another thing you need to keep an eye on, especially if patients are not improving as expected and are critically ill or have kidney or heart disease. I built this chart directly from package inserts (some sources assume a standard diluent, I did not). Since diluents vary by institution, you can use it to calculate your own total sodium load.

Sometimes, the sodium content of antibiotics matters. Just last week, there was a CHF patient with pneumonia who wasn’t improving - It turns out that the culprit wasn’t infection severity; it was likely the sodium load from Zosyn (piperacillin–tazobactam). Check out our "fry scale."

Debulking influenza and herpes simplex virus strains by a wide-spectrum anti-viral protein formulated in clinical grade chewing gum - PubMed Lack of Herpes Simplex Virus (HSV) vaccine, low vaccination rates of Influenza viruses, waning immunity and viral transmission after vaccination underscore the need to reduce viral loads at their tran...

The secret ingredient? FRIL, a protein from lablab beans. In lab tests, 40mg of FRIL gum reduced >95% of herpes & flu virus particles in saliva within 15 minutes of chewing.
Pretty cool
✅ Non-invasive
✅ Room temp stable
✅ FDA-safe
✅ Works across multiple viruses
pubmed.ncbi.nlm.nih.gov/39663701/

While Karius can detect 203 different fungi, its sensitivity for IFI in IC patients is not great. But pretty high specificity is encouraging. Much better for Mucor than Aspergillus #IDSky @cidjournal.bsky.social

But did you click on the link?

It is as close to “truth” as we can achieve—the pursuit of which, I think, is one of the most profound and beautiful ways we can spend our time.

In the ongoing war on scientific inquiry, and the nonsensical opposition of “natural” remedies to “scientific” ones, it hurts to state the obvious: everything in nature IS science in action. Science is our understanding of all that is magical about the cosmos.

More studies like this, please.

Dr. Durand is also a treasure, and taught me what an Ahmed valve is. Incredibly important review for these often devastating infections.

Thank you for showing us the skeet way.

A great figure from the new WikiGuidelines group UTI consensus statement re: UTI prevention strategies:

Clear recommendations for vaginal estrogen (❤️), increased water intake (1.5L), methenamine and cranberry (proanthocyanidin 36 mg).

jamanetwork.com/journals/jam...

“The patient lives with his fiancée, golden retriever and 32-year-old desert tortoise, Daisy.” The highlight of my day was writing this sentence.