Nate Shively Profile picture
ID doc at @AHNtoday. Med. Director, ASP at Allegheny Valley. Husband and father of 3. Prefers being outdoors. Used to be a good bowler. Opinions my own.

Oct 22, 2022, 12 tweets

Oral Therapy for Bacteremia and Endocarditis

@IDwithNWD giving talk for @BradSpellberg

"No, you're not in the wrong room, and @BradSpellberg did not get younger and more handsome."

#IDWeek2022
#IDTwitter

Historical lesson first.

Where did the myth that we need IV for IE come from?

Have to go back a ways.

#IDWeek2022

The dooming quote.

#IDWeek2022

Oral antibiotic blood levels.

#IDWeek2022

Reality check - no data that IV is better, and it's riskier.

#IDWeek2022

Score card of trials. Doesn't look good for IV.

#IDWeek2022

Here's the data for oral vs IV in osteo.

#IDWeek2022

And the data for bacteremia.

#IDWeek2022

And finally, endocarditis.

I cut off the funnel plot on the one, sorry.

#IDWeek2022

Chutzpah.

#IDWeek2022

Summary.

Bunch of RCTs for oral, no contrary studies for IV.

#IDWeek2022

Finally, when to switch.

Fantastic talk from @IDwithNWD, standing in flawlessly for @BradSpellberg.

#IDWeek2022
#IDTwitter

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