Ask and we shall answer!

METRONIDAZOLE DOSING IS A NIGHTMARE AND MAKES NO SENSE

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#IDSky

Safety of early oral ambulatory treatment of adult patients with bloodstream infections discharged from the emergency department | Antimicrobial Agents and Chemotherapy Randomized trials have unanimously shown the benefits of oral antibiotic treatments for stable patients with bacteremia (1). However, transition to oral therapy has been usually performed after several days of intravenous treatment—frequently up to 7 days (2)—highlighting the need for evidence of the safety of earlier oral treatments (3).

Can we treat patients with low-risk BSI discharged from the ED with a fully-oral course of antibiotics?

[Spoiler: Yes!]

🆓🔓Our recent article on #OralIsTheNewIV! 👉🏻 journals.asm.org/doi/10.1128/...

Food for thought for #AMSsky #IDSky

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Absence of Cross-Reactivity between Sulfonamide Antibiotics and Sulfonamide Nonantibiotics | NEJM The safety of sulfonamide nonantibiotics is unclear in patients with prior allergic reactions to sulfonamide antibiotics. We conducted a retrospective cohort study using the General Practice Resear...

My Top 5 Antibiotic Allergy Papers - #3
Cheating.... best cross-reactivity
▶️Strom. NEJM 2003
❌ cross-reactivity b/w antibiotic- & non-anti "sulfurs"
www.nejm.org/doi/10.1056/...
▶️Picard. JACI In Prac 2019
Meta-analysis, 2% cross-reactivity. All great Romano📜
www.jaci-inpractice.org/article/S221...

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🤔Why does chronic hepatitis C infection "require" the intermediary of cirrhosis in order to cause hepatocellular carcinoma (HCC)?

Chronic hepatitis B can "skip" this step, going directly from chronic infection to HCC.

Why the difference?

Slidedeck from an internal presentation on diabetic kidney disease 👇

Nephrologist's take on the effect and impact of SGLT-2 inhibitors, GLP-1 RAs and ns-MRA on #Kidney Disease in people with #diabetes #flozin #sglt2i #MRA #GLP1RA
#MedEd #MedSky #NephSky

www.slideshare.net/slideshow/ne...

ICYMI: Stability of clinical prediction models

We raise the concern that many models exhibit instability in the model and its predictions - and recommend instability plots should be presented

-> tinyurl.com/tjnddxr8

#StatsSky #statistics #machinelearning #EpiSky

Another #MedSky #Skeetorial

Iron deficiency is relatively frequent and seen by all types of physicians.

For years, iron supplements were given multiple times a day.

Now we know that should never happen.

So why the change?
1/n

#NephSky
🎯Target emulation trial, nationwide 🏴󠁧󠁢󠁳󠁣󠁴󠁿

❓To stop vs not metformin in patients with DM type2 and incident eGFR<30ml/min?

⛔stopping metformin- associated with ⬇️ 3-year survival HR 1.26, 95% CI 1.10 to 1.44

⚖️No difference in MACE

🚫Limitation: residual confounding
www.ajkd.org/article/S027...

Time to turn off the toxins: adjuvant suppression of group A streptococcus Streptococcus pyogenes, or group A streptococcus, remains a major global pathogen, responsible for a wide spectrum of diseases ranging from pharyngitis to severe invasive group A streptococcus (iGAS) ...

In Lancet ID www.thelancet.com/journals/lan... Shiranee Sriskandan & I discuss what observational data can & can't tell us about anti-toxin therapy in Invasive Group A Strep & why we need to find ways to deliver trials that can truly answer these questions. @drtoddlee.bsky.social

💉Extended infusion vs intermittent infusion of betalactams for febrile neutropenia: 🤼‍♀️ draw0️⃣➖️0️⃣
#IDSky

Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections This consensus statement creates a clinical guideline for the diagnosis and management of urinary tract infections that addresses the gap between the evidence and recommendation strength.

My first #IDSky post will be a shameless promotion of our new UTI WikiGuideline!

jamanetwork.com/journals/jam...

Of 37 questions, only 6 had enough data to fully meet criteria for a clear recommendation!