#ECCMID2023 Tom Harrison, keynote masterclass in the management in cryptococcal meningitis: how a wood-rot fungus leads to such serious disease; major burden of disease, >100,000 deaths /year, 19% of AIDS related death, >60% mortality in the past No dec. in cases in Sub-Saharan Africa outside SA, despite ART; IDSA standard of 2w AmpB + 5-FC based on studies from 1990s e.g. nejm.org/doi/full/10.10… but AmpB is hard to find in many countries, needs IV, hard to administer and monitor - Flucon monotherapy not as effective

#ECCMID2023 1/3. Alex Soriano: PO the new IV? Need to consider oral bioavailability, pathogen MICs, delays to Cmax, inter-individual variability in BA etc 2/3 Numerous RCTs now demonstrate short course therapy is adequate for most syndromes; RCT of oral switch in severe CAP is safe and reduced LoS pubmed.ncbi.nlm.nih.gov/17090560/

Thomas Louie: so what is ADS024 I hear you say?? Let's see.... New treatment for C. difficile - novel oral single strain LBP (Bacillus velezensis) ; anti-inflammatory and anti-toxin activity nature.com/articles/s4159…

Trish Peel from 🇦🇺🐨🦘 : ASAP trial of Abx prophylaxis for prosthetic joint surgery. #ECCMID2023 pubmed.ncbi.nlm.nih.gov/31685516/ Inc. rates of MRSA and MR-S. epi , need to add glycopeptide to prophylaxis? Needed an RCT. Double blinded superiority RCT undergoing joint replacement / revision surgery. Imbedded staphylococcal carriage study (nasal/skin swabs); primary outcome SSI up to 90d

Sara Grillo (Barcelona) SAFO trial: S. aureus bacteraemia, standard of care is mono therapy with beta-lactam in MSSA; adding fosfomycin? in vitro synergy and anti-biofilm effects; clot + fosfo vs clot alone ; 19 hospitals, superiority trial, randomised within 72h combo given for first 7 days; TOC at 12 weeks; sample 183 for 86 vs 74% treatment success at day 7 with endpoint composite of alive + stable / improved SOFA, no fever + neg BCs for MSSA; 215 randomised; ITT included 104 vs 110