'Clearly, the manifestation of MBL resistance (in vitro and in vivo) is complex and presents a unique opportunity for multiple disciplines to begin to systematically reassess our current microbiological, PK/PD, and clinical knowledge.'
Nicolau et Al #IDXposts

Super interesting 🔥
In the murine septicemia model, meropenem treatment resulted in protection from mortality(P < 0.0001). Meropenem MICs in the physiologic zinc concentration broth were 1- to >16-fold lower versus MICs in zinc-unadjusted broth (≥64 mg/L) #IDXposts

Vascular graft infection is a rare occurrence but with severe manifestations and complications. Optimal management requires a sophisticated collaborative model that involves multiple specialties working together in a collegial fashion and is best done in a high-volume center

Pivmecillinam is a European-approved, oral antibiotic with a unique mechanism of action that has been used outside of the US to treat uncomplicated UTIs for more than 40 years, with clinical cure rates of up to 95%. CIDRAP-ASP #IDXposts

'There isn’t an ID doc in this country who hasn’t been at the bedside of a patient who’s desperately ill & for whom we did not have an antibiotic.” IDSA President Dr. Cynthia Sears. #IDquotes #IDTwitter
Retweet if you ever had a patient with no #antibiotic to treat.

Are we overcalling resistance of beta-lactams in MBL producing isolates because of supra-physiologic zinc levels in the testing media? Really thought provoking findings from my lab colleagues Drs. Abdelraouf and Nicolau!

A total of 2,548 episodes of community-acquired bacterial meningitis were evaluated. Otitis was present in 696 episodes (27%)
The 1ry causative pathogen was
S.pneumoniae (615 of 696 [88%]), followed by S.pyogenes (5%) and Haemophilus influenzae (4%).
academic.oup.com/cid/advance-ar…

Image-guided Core Needle Biopsy(ICNB) yielded approximately 30% positive cultures and changed clinical management in over one-third of patients #IEwiki #IDXposts

🆕️⚡️⚡️large cohort
A histopathologic diagnosis of vertebral osteomyelitis was made in 68.4%(359/525) of biopsies microbiological cultures were (+) in 29.6%(169/570) & clinical management was affected in 37.5%(214/570) of patient cases
#IDXposts
#IDXposts
ijidonline.com/article/S1201-…

Information is scarce on clinical experiences with non-neutropenic patients with IFI receiving isavuconazole
🆕️⚡️⚡️Retrospective, observational multicentric study
Safety and effectiveness of isavuconazole in real-life non-neutropenic patients #IDXposts
ijidonline.com/article/S1201-…

ONE ANTIBIOTIC PK TABLE TO RULE THEM ALL

Absorption takes drug into blood from GI,
Vd spreads drug out to where bug calls home.
And after bacteria are doomed to die,
They’re mostly eliminated on the porcelain throne

In the Land of Notion where this table doth lie.
1/2

Pivmecillinam is a European-approved, oral antibiotic with a unique mechanism of action that has been used outside of the US to treat uncomplicated UTIs for more than 40 years, with clinical cure rates of up to 95%. CIDRAP-ASP #IDXposts

Pivmecillinam is the first new antibiotic approved in the United States for uncomplicated UTIs in over 20 years #IDXposts

Patrick Harris Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 Potentially true for many bugs-drugs-media, right? GAS & TMP-SMX, Gram negs & azithromycin.

Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 This has bothered me for a while ... if we have been getting susceptibility testing wrong for MBLs all this time - then requires a major re-think.

Patrick Harris Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 Tbh, our conventional antimicrobial susceptibility testing paradigm doesn’t really cut it at the margins of pan-resistance. What’s next? How will it be implemented?

Josh Osowicki Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 Yes - it's a big challenge ... we are going to have to find a way to incorporate the complexity of genomics and measure resistance phenotypes to better reflect clinical response. Not so sure MICs and our test methods are holding up that well any more..