Discover and read the best of Twitter Threads about #ShorterIsBetter
Most recents (4)
Just got done presenting at the 31st Annual Clinical Update in Geriatric Medicine, put on by @AHNtoday and @UPMC. Awesome attendees, as usual!
Was asked to talk about "Controversies in Antimicrobial Therapy"
Figured would share here.
#IDTwitter #MedTwitter
🧵
1/
Was asked to talk about "Controversies in Antimicrobial Therapy"
Figured would share here.
#IDTwitter #MedTwitter
🧵
1/
With a Geriatric audience, had to take the opportunity to focus first on the urine.
But also get into SSTI, Bactrim for Group A strep, if you need IV antibiotics for Lyme, dental prophylaxis for prosthetic joints, and duration of therapy.
First up - does +UA/UCx=UTI?
2/
But also get into SSTI, Bactrim for Group A strep, if you need IV antibiotics for Lyme, dental prophylaxis for prosthetic joints, and duration of therapy.
First up - does +UA/UCx=UTI?
2/
Emphatic NO on that one.
Need SYMPTOMS to diagnose a UTI.
I tell patients they need to tell us, we can't tell them.
Positive UCx without symptoms = asymptomatic bacteriuria.
3/
Need SYMPTOMS to diagnose a UTI.
I tell patients they need to tell us, we can't tell them.
Positive UCx without symptoms = asymptomatic bacteriuria.
3/
How long is long enough?🤔
I channeled my inner @BradSpellberg to give this talk on duration of therapy at the #ThreeRiversASP2022
Interested? Follow the 🧵 below
Not interested? Go Rx a zpak for a cold
#IDtwitter #MedTwitter #MedEd #pharmed #shorterisbetter
I channeled my inner @BradSpellberg to give this talk on duration of therapy at the #ThreeRiversASP2022
Interested? Follow the 🧵 below
Not interested? Go Rx a zpak for a cold
#IDtwitter #MedTwitter #MedEd #pharmed #shorterisbetter
Common question I get as an ID doc relates to duration of abx therapy
How do I decide?
Back in 2010, @PaulSaxMD revealed the secret "5/7 rule" in his @JWatch blog, causing panic in the ID community - Will we still get consults since our secret sauce was revealed??
How do I decide?
Back in 2010, @PaulSaxMD revealed the secret "5/7 rule" in his @JWatch blog, causing panic in the ID community - Will we still get consults since our secret sauce was revealed??
Ok so maybe we have come a long way since then with selecting durations (and consult volume has been fine, phew)
But why do we ❤ a 7 day week to define courses of abx therapy?🤔
Do seven 24 hr intervals of abx exposure have some biologic bacteria busting properties?
But why do we ❤ a 7 day week to define courses of abx therapy?🤔
Do seven 24 hr intervals of abx exposure have some biologic bacteria busting properties?
Esta semana se publica en @CMIJournal nuestro ensayo clínico #SHORTENtrial. Es el tercer ensayo que muestra que los esquemas de 7d son más eficientes que las pautas de 14d para tratar infecciones bacteriémicas por BGN.
📖 clinicalmicrobiologyandinfection.com/article/S1198-…
📖 clinicalmicrobiologyandinfection.com/article/S1198-…
El tratamiento corto de 7d consiguió reducir un 50% la exposición a antibióticos de los pacientes, manteniendo una efectividad similar a los esquemas tradicionales de 14d (siempre que tratemos infecciones con un buen control del foco).
#SHORTENtrial usa una metodología novedosa (DOOR/RADAR) que mostró cómo los tratamientos cortos tuvieron un 77.7% de probabilidad de mejores resultados que los tratamientos largos, si consideramos en conjunto eficacia, riesgo de efectos adversos y exposición a antibióticos.
My 3rd week of general ID @UNMC_ID has come to a close with #PasteurellasFellas, led by the wonderful @KellyCawcuttMD! Really appreciate her critical care insight on ID. We had some fascinating discussions this week. Time for another recap! #IDTwitter #IDPearls
A fundamental question this week was TB or not TB (sorry, not sorry for the pun @bergmanscott)
ncbi.nlm.nih.gov/pmc/articles/P…
ncbi.nlm.nih.gov/pmc/articles/P…
We discussed the differential diagnosis of miliary nodules on imaging. TB leads the list, but dimorphic fungi (histo, blasto, cocci) can be just as common in endemic areas. Malignancy as well.
atsjournals.org/doi/pdf/10.151…
ncbi.nlm.nih.gov/pmc/articles/P…
atsjournals.org/doi/pdf/10.151…
ncbi.nlm.nih.gov/pmc/articles/P…
