#IDsky#EMIMCC
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absteward.bsky.social
🆕🌟Excellent review article
P2Y12 inhibitors(eg clopidogrel,ticagrelor)in Staphylococcus aureus bacteraemia: current evidence and clinical implications
Coming soon: CLOPI-SNAP+ Clopido-SNAP #idsky #EMIMCC
www.thelancet.com/journals/lan...
P2Y12 inhibitors in Staphylococcus aureus bacteraemia: current evidence and clinical implications
Staphylococcus aureus bacteraemia presents a substantial clinical burden, with high rates of morbidity and mortality. Despite its severity, therapeutic advancements have been small in the past decade,...
www.thelancet.com
October 31, 2025 at 8:18 PM
pulmcrit.bsky.social
I continue to be shocked by how PCN allergies are misunderstood

This is from UpToDate on neutropenic fever

It's wrong

With PCN allergy, you can absolutely use cefepime, piptazo, or meropenem

The R-chain structure that determines allergy is different

emcrit.org/ibcc/penicil... #EMIMCC #IDsky
October 28, 2025 at 8:55 PM
absteward.bsky.social
🆕🌟Excellent review
Invasive candidiasis in intensive care medicine: shaping the future of diagnosis and therapy #IDSky #EMIMCC
link.springer.com/article/10.1...
October 23, 2025 at 11:18 PM
absteward.bsky.social
CDI recurrence affects about 14% to 16% of patients with CDI, and the risk of recurrence increases with each CDI episode
🆕💫🌟 JAMA Insights
Recurrent Clostridioides difficile Infections
🟢Epidemiology and Risk factors
🟢Diagnosis
🟢Treatment
#IDSky #EMIMCC
jamanetwork.com/journals/jam...
October 20, 2025 at 5:00 PM
absteward.bsky.social
🆕🔥Seminar
Community-acquired pneumonia @thelancet.com #IDSky #EMIMCC
www.thelancet.com/journals/lan...
October 19, 2025 at 9:26 PM
pulmcrit.bsky.social
antibiotic stewardship pearl:

Pneumonia patient on ampicillin-sulbactam

Blood grows Strep pneumo, sensitivity pending

Patient is improving

Sulbactam adds *nothing* to ampicillin for S. pneumo (resistance not mediated by beta-lactamase)

So you can immediately narrow to ampicillin #IDsky #EMIMCC
a close up of a woman 's face with the word skymed written on the bottom
ALT: a close up of a woman 's face with the word skymed written on the bottom
media.tenor.com
October 11, 2025 at 3:54 PM
absteward.bsky.social
This one flew under the radar, but trust me, it’s a must-read! The article raises a point we really need to talk about—something that might change your practice. What’s your take on it?
Let’s dive in #idsky #medsky #EMIMCC
December 18, 2024 at 11:19 AM
absteward.bsky.social
Is it time to retire the term ‘bloodstream infection’? ##idsky #medsky #EMIMCC
www.journalofinfection.com/article/S016...
Is it time to retire the term ‘bloodstream infection’? (Submitted as Letter to the Editor)
To the Editor,
www.journalofinfection.com
December 15, 2024 at 7:30 PM
drandrekalil.bsky.social
🆕💥“Baricitinib: The Immunomodulator of Choice for Severe COVID-19—The Verdict Is in”
Carlos Gomez and I just published this new article:
#IDSky #MedSky #PCCSky #ICUSky #emimcc #Ansky #EMSky #AMSSky #TxID #meded #Pharmsky #[email protected]@unmccom.bsky.social
👇
bit.ly/4gd1gdS
Baricitinib: The Immunomodulator of Choice for Severe... : Critical Care Medicine
An abstract is unavailable.
bit.ly
December 6, 2024 at 4:18 AM
drandrekalil.bsky.social
Truly honored to be the inaugural speaker for the Center for Sepsis Epidemiology and Prevention Studies (SEPSIS) at the Harvard Pilgrim Health Care Institute.
www.populationmedicine.org/research/SEP...
#IDSky #MedSky #PCCSky #ICUSky #emimcc #Ansky #EMSky #[email protected]@unmccom.bsky.social
www.populationmedicine.org
April 1, 2025 at 3:41 AM
pulmcrit.bsky.social
we managed to provoke a rant from Brad Spellberg on bluesky 😁

seriously, though, we sorely need more *evidence-based* antimicrobial stewardship

everyone tends to assume that narrow-spectrum equates with lower risk of inducing drug resistance, but that’s not scientifically valid #EMIMCC #IDsky
bradspellberg.bsky.social Brad Spellberg @bradspellberg.bsky.social · Jan 18
Thanks for the invite Dr Rosa! My first Bluesky rant!!!

So…
First, I’d definitely use CTX.
Why?
1) PCN costs 10-fold more
2) 6 times/d rather 2/day, much more work for nursing and pharmacy
3) less cost for iv tubing/iv bags
January 18, 2025 at 12:01 PM
absteward.bsky.social
I don't quite understand
90 days mortality
Sepsis screening ( intervention): 3.2
No sepsis screening: 3.1
Between group difference: 0.0%
Adj RR: 0.88
How sepsis screening "intervention" reduce mortality?
Am I missing something? #idsky #medsky #EMIMCC
jama.com JAMA @jama.com · Dec 11
Among hospitalized patients, electronic sepsis screening compared with no screening resulted in lower in-hospital 90-day mortality.

#CCRdownunder @criticalcarereviews.com

https://ja.ma/4f8BlTC
Figure 2. Results of Prespecified Subgroup Analyses of the Primary Outcome (90 Day In-Hospital Mortality)
December 11, 2024 at 8:05 AM
absteward.bsky.social
Finally published, long awaited !
Practice changing?! #idsky #EMIMCC #medsky
absteward.bsky.social Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · Dec 10
🔥The ADAPT-Sepsis RCT🔥
Daily PCT-guided protocol 🔽 total antibiotic duration & had noninferior all-cause mortality compared with standard care.
No difference was found in total Abx duration between standard care & daily CRP-guided protocol
CRP failure #idsky #EMIMCC
jamanetwork.com/journals/jam...
Biomarker-Guided Antibiotic Duration for Patients With Suspected Sepsis
This clinical trial assessed whether treatment protocols for monitoring C-reactive protein or procalcitonin safely reduced the amount of time critically ill adults with suspected sepsis received antib...
jamanetwork.com
December 10, 2024 at 3:49 AM
imcrit.bsky.social
#medsky #idsky #emimcc
January 22, 2025 at 4:34 AM
drandrekalil.bsky.social
🆕💥“Sepsis: A Summary of the SEP-1 Quality Measure and Future Considerations"
Our new article was just published:
#IDSky #MedSky #PCCSky #ICUSky #emimcc #Ansky #EMSky #AMSSky #TxID #meded #Pharmsky #Pharmed #RXSky #MicroSky #ClinMicro @unmc.bsky.social @unmccom.bsky.social
👇
bit.ly/3VTAE9L
Sepsis: A Summary of the SEP-1 Quality Measure and Future Considerations
bit.ly
December 22, 2024 at 5:41 PM
starmd.bsky.social
Great thread on sepsis heterogeneity! Is a one size fits all paradigm really in our patients' best interests?

#Medsky #Surgsky #IDsky #EMIMCC
bbiebelberg.bsky.social Brett Biebelberg, MD @bbiebelberg.bsky.social · Dec 17
🦠We call a lot of things “sepsis”

🔎Our #AnnalsofIM study examined how broad this grab bag really is

⚠️Among ~75,000 patients with sepsis, we found remarkably wide spectrum of presentations & outcomes across infection source & organ dysfunction patterns

Thread ⬇️
#medsky #emimcc #idsky #pharmsky
Annals of Internal Medicine: Heterogeneity of Sepsis Presentations and Mortality Rates
December 17, 2024 at 4:39 PM
absteward.bsky.social
I think in sepsis/ esp bactremia after BALANCE RCT fixed 7d is the best strategy
This RCT should convince ICU folks 7d is enough for non staph bactremia
Neither PCT nor CRP would shorten duration < 7d
Data doesn't trump fear #EMIMCC #idsky
December 11, 2024 at 8:04 PM
absteward.bsky.social
🆕💫 Retrospective multicentre
study #JAC
Temocillin efficacy against AmpC β-lactamase-producing Enterobacterales: a relevant alternative to cefepime? #idsky #medsky #EMIMCC #utisky
academic.oup.com/jac/advance-...
Temocillin efficacy against AmpC β-lactamase-producing Enterobacterales: a relevant alternative to cefepime?
AbstractIntroduction. Temocillin is a semi-synthetic β-lactam with a narrow spectrum but high stability against hydrolysis by β-lactamases, including AmpC.
academic.oup.com
December 23, 2024 at 10:51 AM
absteward.bsky.social
Plenty of critiques floating around X platform about the design of this adaptive RCT—what are your thoughts?
#idsky #EMIMCC
April 22, 2025 at 7:34 PM
absteward.bsky.social
The knowledge of local epidemiology and most common resistance mechanisms may guide empirical therapy, but targeted antibiotic therapy should be re-evaluated as soon as susceptibility testing profile is available and selected according to Pseudomonas aeruginosa phenotype 💯 #idsky #EMIMCC #medsky
absteward.bsky.social Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · Dec 18
Fantastic 🆕️🔥Review
Not all carbapenem-resistant Pseudomonas aeruginosa strains are alike: tailoring antibiotic therapy based on resistance mechanisms #idsky #EMIMCC #medsky #utisky #AMssky
journals.lww.com/co-infectiou...
December 18, 2024 at 12:37 AM
absteward.bsky.social
Is it time to retire the term ‘bloodstream infection"? #idsky #EMIMCC #medsky
December 15, 2024 at 7:28 PM
absteward.bsky.social
Strategies to rapidly de-escalate unnecessary MRSA coverage (often intravenous vancomycin) could minimize potential harms, including antimicrobial resistance, nephrotoxic effects, and increased pharmacy monitoring costs. #idsky #medsky #AMSsky #EMIMCC
December 9, 2024 at 4:52 PM
absteward.bsky.social
This is the study I’ve been waiting for!
A small study, but it fills a critical knowledge gap and challenges current practices. Let’s dive in! #idsky #EMIMCC
December 17, 2024 at 2:24 PM
absteward.bsky.social
Totally get that! Isavuconazole is often the go-to for its perceived favorable safety profile. But even the 'safe' ones can throw us a curveball—sometimes medications like to throw in a twist. #idsky #EMIMCC
January 15, 2025 at 1:43 PM
poggial.bsky.social
Pain in ACS:time for a patient-tailored approach?
Can lidocaine be the winning drug for unstable patients?
More on EMpills, Italy’s leading emergency medicine blog. Worth reading—ChatGPT can help translate!😉
#EMIMCC #pulmsky #IDsky #Cardiosky #Medsky #Critcaresky
www.empillsblog.com/il-dolore-ne...
Il dolore nella sindrome coronarica acuta - EMpills - Pillole di medicina d'urgenza
Come trattiamo il dolore di un paziente con sindrome coronarica acuta? Vecchie abitudini e nuove tendenze...
www.empillsblog.com
March 13, 2025 at 2:00 PM