Daniel Rampersad, PharmD, BCIDP
@rampicillinID/ASP PharmD | Brooklyn, NY | PGY-2 Infectious Diseases @sunydownstate | PGY-1 @maimopharmres #TwitteRx #IDTwitter Views/Tweets are my own.
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MYCOPLASMA PNEUMONIAE This cheeky little intracellular bacteria seems to be up to mischief with kids in the USA at the moment A quick thread on this bug, what's going on, and what to do (or not do!) about it 1/🧵
When seeing virally suppressed pts, there's a certain "inertia" to just refilling the current ART regimen - "if it ain't broke, don't fix it". While that is true (to an extent,) here's a few situations in ART management that should prompt at least a conversation w/ the pt:
Linezolid is superior (not just non inferior) to vancomycin for SSTI. pubmed.ncbi.nlm.nih.gov/34143418/
1/2 Dr. Shruti Gohil @UCIrvineHealth presented INSPIRE data on intra-abdominal infections (IAIs) at #IDWeek2024. IAIs involve diverse organs/spaces. Yet, only 1% (+) for MRSA and another 1% (+) for Pseudomonas, despite 63% of patients getting empiric broad-spectrum abx treatment.
More is not always better. Adding vancomycin to cefazolin as surgical prophylaxis in patients undergoing arthroplasty does not improve outcomes in patients not known to be MRSA colonized. Outcomes WORSE for knee arthroplasty. Just don't. nejm.org/doi/10.1056/NE… #IDWeek2024
@IDPharmD_Kate crushing it & getting everyone talking about, is this really AKI when it comes to vanco + pip/tazo? And coining the term fake-KI 🤩 Her key lesson…we probably don’t need vanco (or pip/tazo) for most patients! #IDWeek2024 #SIDP2024
Me on ICU rounds when someone says we can’t use linezolid because the patient is on an SSRI
It's your favorite post of the month- the articles of interest for August! With a few from June and July 😊🦠
Learned something new today 😳
Used to see this at the VA years ago. Some hospitals used ping pong balls to treat tuberculosis (TB) by inserting them into a patient's chest cavity- plombage. If I'm wrong, I'll try to stick to cardiology 🤷
If you’re wondering, “But wait, how do I know the pre-test probability for bacteremia in common infectious diseases?” Well, @ValeriaFabreMD covers some of these in this must-read scoping review! academic.oup.com/cid/article/71…
Now that we’re on the topic: Isolated fever is a POOR predictor of bacteremia. Shaking chills are better indicators. HOWEVER, you also need to consider the pre-test probability based on the syndrome in question. jamanetwork.com/journals/jama/…
💩 additional evidence that cefepime causes more CDiff than piptazo 💩theoretically piptazo has anaerobic coverage so you might assume that it should cause more CDiff.. but it doesn't 💩 this is why we need EBM, not handwaving about saving the anaerobes sciencedirect.com/science/articl…
It's here! 100th #Breakpoints Episode: Drs. Jeffrey Pearson & Jason Pogue join Dr. Jeannette Bouchard as they take on all things tetracyclines. Do not miss this one! This podcast was supported by an unrestricted grant from Paratek Pharmaceuticals Inc. 🎧 sidp.pinecast.co
Yesterday, at the International AIDS Conference (#AIDS2024) in Munich, we got one of those thrilling moments you hope for when attending a scientific conference -- but don't usually get! Here's what happened. @LindaGailBekker @drmoupali blogs.jwatch.org/hiv-id-observa…
Most often, the best « agent » against S.maltophilia is a good I.D. doc who says « this is not an infection, it’s colonization (probably selected because of the unjustified ATB overuse over the last few weeks »)
3 daily rants in one week? A new record! It's a fair question. And the answer is, no. Even in immune suppressed patients there is no evidence that cidal vs. static means anything. Why?
Can I ask whether the old-fashioned concept of static and cidal has any bearing in choosing antibiotic regimens in severely immunosuppressed patients?
🆕️⚡️⚡️Study #JAC challenges IDSA recommendations! w @ryankshields Initial micafungin treatment does not improve outcomes compared to fluconazole treatment in immunocompromised & critically ill patients with candidaemia We need to dissect this study! academic.oup.com/jac/article-ab…
Fresh blog: Why the new study associating piptazo with increased mortality is wrong ☠️Raw data is negative ☠️Mortality differences emerge late (only after 75 days) ☠️Confounding by indication ☠️Inconsistent with ACORN ☠️Inconsistent with Cochrane emcrit.org/pulmcrit/pipta…
Most patients with sepsis don't need anti-anaerobic antibiotics. But most get them anyway. Why not, what's the harm? I worry the harm is considerable. Our new study in @JAMAInternalMed: using a 15-month pip-tazo shortage to answer this question. 1/n jamanetwork.com/journals/jamai…
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