Infected Terran
@infectedterran.bsky.social
ID doc in Philly. Lover of all things infectious, medical education, ethics and Starcraft.
Its insane. We take a lot of IMGs and their profiles, scores etc are off the charts. And on top of it, most are incredibly charismatic/nice during interview. Personally, since I have a rare allergy to research, I don't worry about that too much. But man its hard to stand out.
November 17, 2025 at 4:02 PM
Its insane. We take a lot of IMGs and their profiles, scores etc are off the charts. And on top of it, most are incredibly charismatic/nice during interview. Personally, since I have a rare allergy to research, I don't worry about that too much. But man its hard to stand out.
Can't spell crap without CRP
November 14, 2025 at 3:16 PM
Can't spell crap without CRP
Oh absolutely. That is very true. I was trying to keep the numbers "clean" but your point is very well taken. I would love to do that study at our institution.
November 7, 2025 at 2:16 PM
Oh absolutely. That is very true. I was trying to keep the numbers "clean" but your point is very well taken. I would love to do that study at our institution.
Yes,I meant 9 percent of all meningitis (purulent and non purulent. It's 72 percent of the 13 percent of those that are bacterial.
November 7, 2025 at 1:53 AM
Yes,I meant 9 percent of all meningitis (purulent and non purulent. It's 72 percent of the 13 percent of those that are bacterial.
There is a treatment threshold formula that could help. sk.sagepub.com/ency/edvol/m...
Calculated as Risk/Benefit+Risk. We compare that number to say, the mortality of meningitis absent vanco. Its a bit more complicated but for anyone trying to really math this one out.
Calculated as Risk/Benefit+Risk. We compare that number to say, the mortality of meningitis absent vanco. Its a bit more complicated but for anyone trying to really math this one out.
Sage Reference - Encyclopedia of Medical Decision Making - Test-Treatment Threshold
<p>Decision making is a critical element in the field of medicine that can lead to life-or-death outcomes, yet it is an element fraught with complex and conflic
sk.sagepub.com
November 6, 2025 at 6:32 PM
There is a treatment threshold formula that could help. sk.sagepub.com/ency/edvol/m...
Calculated as Risk/Benefit+Risk. We compare that number to say, the mortality of meningitis absent vanco. Its a bit more complicated but for anyone trying to really math this one out.
Calculated as Risk/Benefit+Risk. We compare that number to say, the mortality of meningitis absent vanco. Its a bit more complicated but for anyone trying to really math this one out.
Pardon the typos. New keyboard.
November 6, 2025 at 6:28 PM
Pardon the typos. New keyboard.
So we would need to calculate harm from Vanco in those 3 scenarios but, intuitively, we should forego vanco until we know at least that its a purulent (poss bacterial) meningitis. Thoughts? @bradspellberg.bsky.social @jgpharmd.bsky.social @jonathanrydermd.bsky.social
November 6, 2025 at 6:27 PM
So we would need to calculate harm from Vanco in those 3 scenarios but, intuitively, we should forego vanco until we know at least that its a purulent (poss bacterial) meningitis. Thoughts? @bradspellberg.bsky.social @jgpharmd.bsky.social @jonathanrydermd.bsky.social
If I did my math right, if we give vanco to every LP that has "meningitis), we need about 1100 doses to catch 1 CRO resitance. For second scenario, we need about 130. For confirme Strep pneumo 1 in 100.
November 6, 2025 at 6:25 PM
If I did my math right, if we give vanco to every LP that has "meningitis), we need about 1100 doses to catch 1 CRO resitance. For second scenario, we need about 130. For confirme Strep pneumo 1 in 100.
If we run that just for bacterial meningitis (72% of that 13% of ALL comers with meningitis, call it you get pus on a tap), that means that 0.72% of bacterial meningitis will have CRO resistant Strep pneumo. And again, for all Strep pneumo, 1% will be resistant.
November 6, 2025 at 6:23 PM
If we run that just for bacterial meningitis (72% of that 13% of ALL comers with meningitis, call it you get pus on a tap), that means that 0.72% of bacterial meningitis will have CRO resistant Strep pneumo. And again, for all Strep pneumo, 1% will be resistant.
If we assume that 1% of all Strep pneumo cases (9.3% of all meningitis) will be CRO resistant (check your local data if you can), that means that of all comers with any meningitis, CRO resistant Strep pneumo is roughly 0.093%.
November 6, 2025 at 6:16 PM
If we assume that 1% of all Strep pneumo cases (9.3% of all meningitis) will be CRO resistant (check your local data if you can), that means that of all comers with any meningitis, CRO resistant Strep pneumo is roughly 0.093%.
The data I mostly got from this article and that is where we will start. Bacterial meningitis represents about 13% of all meningoencephalitis in the US. Of those, 72% (or 9.3% of the totality of cases) will be Strep pneumo
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Progress and Challenges in Bacterial Meningitis
This review summarizes current evidence on the epidemiology, diagnosis, and treatment of bacterial meningitis.
jamanetwork.com
November 6, 2025 at 6:11 PM
The data I mostly got from this article and that is where we will start. Bacterial meningitis represents about 13% of all meningoencephalitis in the US. Of those, 72% (or 9.3% of the totality of cases) will be Strep pneumo
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
I'm crunching some numbers to put out a spicy thread tomorrow. Stay tuned.
November 5, 2025 at 8:05 PM
I'm crunching some numbers to put out a spicy thread tomorrow. Stay tuned.
And a quick google search got me this FWIW (10 patients, 5 each group)
pubmed.ncbi.nlm.nih.gov/8067771/
pubmed.ncbi.nlm.nih.gov/8067771/
Antibiotic therapy and acute outcome of meningitis due to Streptococcus pneumoniae considered intermediately susceptible to broad-spectrum cephalosporins - PubMed
Children with meningitis due to Streptococcus pneumoniae isolates that are relatively or fully resistant to penicillin and have decreased susceptibility to broad-spectrum cephalosporins (MIC, > or = 2.0 micrograms/ml) who have failed treatment with broad-spectrum cephalosporins have been reported …
pubmed.ncbi.nlm.nih.gov
November 5, 2025 at 4:59 PM
And a quick google search got me this FWIW (10 patients, 5 each group)
pubmed.ncbi.nlm.nih.gov/8067771/
pubmed.ncbi.nlm.nih.gov/8067771/