Thread by @NateShivelyMD

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."

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Historical lesson first.

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

Have to go back a ways.

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The dooming quote.

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Oral antibiotic blood levels.

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

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

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

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And the data for bacteremia.

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And finally, endocarditis.

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

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Chutzpah.

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Summary.

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

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Finally, when to switch.

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

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