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Oral vs IV antibiotics Oral #Antibiotics are more cost-effective and may be safer than IV antibiotics for most infections in stable adults TI Therapeutics Letter 155: 👉 ti.ubc.ca/letter155 TI Best Evidence webinar: 👉 ti.ubc.ca//antibiotics-w… (free registration)

Neil Stone I think the table is at 125 RCTs spamming 100+years and over 1.8M patients last I check

🆕🌟Super interesting! IDSA guidance recommend against the use of CAZ for the treatment of S. maltophilia Ceftazidime retains in vivo efficacy against strains of Stenotrophomonas maltophilia for which traditional testing predicts resistance Brad Spellberg journals.asm.org/doi/10.1128/ms…

Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 Brad Spellberg Pretty interesting. I think guidelines should refrain from making abx recommendations for Steno until RCT data is published.

"In summary, CAZ may remain an important therapeutic option for the treatment of S. maltophilia, particularly for strains resistant to other antibiotics, even when traditional laboratory testing suggests high MICs in rich media" #IDXposts

The study confirm that traditional testing mischaracterizes strains as resistant when they are actually susceptible to CAZ in nutritionally depleted media in vitro & effective in treating infection in vivo. These results suggest that CAZ may remain an effective therapeutic option

Brad Spellberg Thank you sooo much for your wonderful talk! Very entertaining and educational!! Really appreciate your time. 😊

Meet Julia Goto, Nurse Manager of 7B. With 28 years of LA County service, she leads with compassion and mentors new nurses. This AANHPI Heritage Month, we celebrate her dedication to patient care, teamwork, and cultural inclusion.

These data suggest MBL-mediated resistance in standard CAMHB may not reflect in vivo activity in metal-depleted conditions Time to revisit antibiotics traditionally thought to be deactivated by MBLs—some may still work against MDR pathogens like S.maltophilia More work is needed!

Another 🔥 take: There’s an overconfidence in clindamycin and its role in practice. For most indications: A) better options often exist (linezolid) OR B) better questions should be asked (are you REALLY allergic to the primary treatment options?) AND C) resistance a problem

#IDXposts #IDTwitter I was honored that I can present #UTI #Wikiguidelines on congress about urinary tract infections and urosepsis. Thank you Brad Spellberg Todd C. Lee Emily McDonald and others about creating such amazing movement.

Rounded with two medicine teams today. With both, I made a joke re Al Bundy from Married with Children. With both, the residents looked at me silently, wondering what I meant (& whether it was time to place me in SNF). Mark May 24th, 2025 as the day I officially was elected old.

Our crowd-sourced spreadsheet of controlled vaccine RCTs just hit 189 trials - spanning Adenovirus to Zika & 2.1 million participants. Every row links to the primary paper. More to come... docs.google.com/spreadsheets/d… cc Brad Spellberg

It is a fascinating study in the shift of semantic range that the term “chemotherapy”, both in professional and lay speech, is now used almost exclusively to refer to cytotoxic chemotherapy for cancer rather than its original, broader meaning.

I recently evaluated a pt with a fever of 40.5 C, WBC 15,000, & hypotensive/tachycardic. I was really torn. Could the pt have inflammation of some kind? I wasn't sure. But then, thankfully, I saw that someone had ordered a CRP. And that's when I knew there was inflammation.

Brad Spellberg Thank you, my friend! We’ve got a great team! And thanks to Neal Fox, Abhay Dhand, Alí Sebastian Meza, Alejandro Diaz, Dr. Adam Lauring, and all the Anonymous contributors out there!

Brad Spellberg Definitely case-report material for The Journal of Zombie Diagnostics. Inflammation confirmed only after the ancient ritual of ordering a CRP.

Brad Spellberg Alasdair MacLullich As a patient I'm scared of doctors who just don't think you have an infection when your a CRP value is not elevated (yes there are those doctors, at least in Czechia)... Thankfully my primary care provider does not think so, he is aware of poor sensitivity and specificity of CRP.

Brad Spellberg Alasdair MacLullich because the CRP value is only 5." Please looked at the whole patient, not just the (poor specificity and sensitivity) CRP numbers!