How accurate is ceftriaxone at predicting susceptibility of enterobacterales isolates to oral higher-generation cephalosporins? | Antimicrobial Agents and Chemotherapy There is a growing body of evidence supporting early transition to oral antibiotic therapy to complete treatment courses for gram-negative bloodstream infections (GN-BSI) (1–3). Most available data focus on oral fluoroquinolones and trimethoprim/sulfamethoxazole (TMP/SMX) due to their high oral bioavailability (4–6). Although antimicrobial susceptibility testing (AST) results for these agents are generally available to clinicians, toxicities associated with fluoroquinolones (e.g., Clostridioides difficile infections, tendonitis, mental status changes, and prolonged QT intervals) and TMP/SMX (e.g., hyperkalemia, hypersensitivity syndromes, and cytopenias), and increasing resistance tempers enthusiasm for these agents (7). Oral beta-lactams are generally well-tolerated but underutilized for a variety of reasons, including lack of AST result availability, wide ranges in oral bioavailability across agents, unclear dosing regimens to optimize pharmacokinetic/pharmacodynamic (PK/PD) efficacy targets, and limited clinical effectiveness data for the treatment of GN-BSI (8).

Nice paper addressin good pts, honestly v helpful for the Peds space. Id assume adults use Bactrim and nitro more commonly but I’m always trying to make an argument for BL
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Is anyone already doing this (using CTX to predict)? I know CLSI states cefazolin as the surrogate mark etc
#IDsky #PharmSky

😭😭😭

Was recently asked if HIV PrEP protected against HBV acquisition - interesting "real world" study from Japan suggests good coverage for those that don't have HBV antibody titers. The one breakthrough infection while on PrEP was attributed to non-adherence.

pubmed.ncbi.nlm.nih.gov/36960800/

Kinda late to the party but would love to join 😅😅

Can you really call yourself infectious diseases without periodically debating these questions for hours? Haha

Cefadroxil and cephalexin pharmacokinetics and pharmacodynamics in children with musculoskeletal infections - PubMed Cephalexin, a first-generation cephalosporin, is the first-line oral therapy for children with musculoskeletal infections due to methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA). Cefadroxil...

I’ve consistently seen and done Cephalexin 1000 TID in pyelo w minimal recurrence
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Also pubmed.ncbi.nlm.nih.gov/38597672/ - there’s some peds data for cefadroxil in bone w lower frequency; if u can do it in 🦴 you can probs do it in 🫘 (kidneys)?

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Clinda vs Linezolid for NSTI - what a time at ASHP Midyear! Great time debating 🥊
@floralquinolone.bsky.social #ID