a woman in a yellow jacket is talking to a man in a green chair . ALT: a woman in a yellow jacket is talking to a man in a green chair .

When infection isn’t confirmed, unnecessary IV antibiotics can do more harm than good. Judicious use of IV antibiotics is essential to minimize sodium & fluid overload. AMS isn’t just about resistance...it also protects CHF patients from avoidable harm #medsky #EMsky #IDsky #AMSky #pharmsky #RxSky

a man wearing sunglasses and a white t-shirt is holding something in his hands . ALT: a man wearing sunglasses and a white t-shirt is holding something in his hands .

Here’s a short skeetorial to raise awareness about the surprisingly high sodium content in some IV antibiotics...clinically important for patients with CHF. Judicious use matters!💧🧂 #emimcc #medsky #EMsky #IDsky #pharmsky #AMSky #FOAMed

Looking for people that have unrestricted linezolid at their institutions. Any increases in resistance? Better to just ease up on use criteria? Currently reviewing our own usage and seeing what we can do with rising tetracycline resistance in S. aureus #IDSky #AMSky

So energizing! Thanks to the committee for putting on such a great program and to all the speakers for the amazing content. I learned a ton and loved meeting everyone!
#IDSky #AMSky

Feeling quite refreshed after another awesome Nebraska Antimicrobial Stewardship Summit today! Always impressed by the speakers and enjoy the networking across the state at this annual event. Was great meeting @athorpe8.bsky.social @helennewland.bsky.social and many others! #IDSky #AMSky

Linezolid for odontogenic infections? Anyone doing this empirically? It feels like the data is there that LZD covers the relevant bugs, but there's no clinical data that I could find. Have to think LZD would be preferable to clinda #IDSky #AMSky

There are other standards in bronchiectasis that may promote resistance with limited evidence on net clinical benefits across several RCTs:
☑️ Combination therapy
☑️ Prophylactic nebulized antibiotics

Perhaps is it time to de-escalate? Seems a great field for #Pulmsky & #AMSky collaboration! 💪🏼 #IDsky

Caring for patients with bronchiectasis poses a challenge for both pulmonologists and #AMSky teams.

Standard 14d treatments for exacerbations lack good evidence support.

This small RCT favors shorter durations such as 8d 👉🏻 publications.ersnet.org/content/erj/... #IDsky @bradspellberg.bsky.social

👆🏻 #AMSky

Could stewardship interventions targeting steroids and PPI prevent HAIs and reduce antibiotic use in hospitals?

This study shows a time- and dose-dependent association between PPI & steroids and the incidence of HAIs: www.journalofhospitalinfection.com/callback?red...
#AMSky #IDsky #IPSky #PharmSky

In SHORTEN-2, immunocompromised hosts were not excluded if early clinical response and no unresolved source issues exist at randomization.
We hope to generate actionable data to guide the management of Pseudomonas BSI also in this population! 💪🏼
(🧵3/3) #AMSky #IDsky #TxID #IDOnc #ShorterIsBetter

We have evidence from several observational studies that show how, if adequately selected, uncomplicated infections may be safely treated with shorter courses, even in severely immunocompromised hosts like SOT or neutropenic patients.
(🧵2/3) #AMSky #IDsky #TxID #IDOnc

bsky.app/profile/jose...

SOT patients have been systematically excluded from most RCTs on treatment duration, leading to prolonged courses still being the standard of care in many centers, even for non-complicated infections.
(🧵1/3) #AMSky #IDsky #TxID

Just 23% of patients received AMS support in transplant units.
A lot to do for stewies in this field yet!
Let’s get to work #AMSky & #TxID! 💪🏼

How to safely use LLM (like ChatGPT) in your daily work, by @joserrapa.bsky.social.
Fantastic talk on AI use for antibiotic stewardship in #ESCMIDGlobal!
#AMSky

maybe we could kill two birds with one stone ALT: maybe we could kill two birds with one stone

Here’s a "shorter" (😅) tweetorial…why do we use a combination of beta-lactam + vancomycin for cellulitis or MSSA bacteremia?

If vancomycin covers both strep and staph, why not use it alone? Let’s dive in! 🧵 #medsky #pharmsky #EMsky #MedEd #IDsky #AMSky #nursesky

Aspiration pneumonitis resolves in 24-48h; if symptoms persist >48h, treat aspiration pneumonia with CTX

#medsky #pharmsky #EMsky #AMSky #MedEd #nursesky

For cellulitis, need anti-MRSA? also consider doxy or TMP-SMX PO to preserve IV vanco #MedEd #pharmsky #IDsky #AMSky #medsky #emimcc

#AMSky #IDSky

TLDR and take-home key points:

✅ PTZ 3.375g IV Q6H is effective for MIC ≤8 mg/L

✅ Neither standard nor high-dose achieves 90% PTA for MIC ≥16 mg/L w/ short infusions

✅ Extended infusions are key for high-MIC infections!

#medsky #pharmsky #EMsky #IDsky #MedEd #AMSky #emimcc

One antibiotic PK table to rule them all. This is amazing 🙌 #medsky #pharmsky #AMSky #idsky #MedEd

The Clinical Relevance of Plasma Protein Binding Changes - Clinical Pharmacokinetics Controversy reigns as to how protein binding changes alter the time course of unbound drug concentrations in patients. Given that the unbound concentration is responsible for drug efficacy and potenti...

Could this altered binding and faster clearance affect the efficacy of time-dependent beta-lactams, where time > MIC is critical? 🤔 Something to consider if antibiotics aren't as effective

link.springer.com/article/10.1...

#medsky #pharmsky #IDsky #AMSky #MedEd #emimcc /2

Happy New Year! Here’s to 2025! 🎉🥂 Let’s chat #pharmacokinetics …tricks of the trade! Part 2 of the PK series…the often forgotten utility of half-life (t1/2). Let’s dive in!👇 #medsky #EMsky #pharmsky #nursesky #GPsky #MedEd #AMSky

We submit but I admit haven’t spent time trying to understand the reports from AR module. It looked more like data I already knew from antibiogram. Is there benchmarking I’ve missed?

I’m curious how others use/what they find useful. #IDSky #AMSky #PharmSky

Not always Pseudomonas…
#AMSky #IDSky

A picture of me looking kinda scary, and my friend replies "If you say Vanc Mero Mica three times in the mirror in the ICU bathroom this creature comes for you"

Is this really what ICU folks think about us? 😱😱 #IDsky #AMsky

(yes before you even ask, 100% sober 🙄)

Chocolate with antimicrobial stewardship slogans

Happy World Antimicrobial Awareness Week! Look what our amazing stewardship pharmacist Kristi made! 😍 #WAAW #AMR #AMSky @gurujosh.bsky.social How are you celebrating?

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#TBsky #AMSky folks November be like: