Roger Struble, MD, MPH @jazzscrubs.bsky.social · 02/12/2024Before you start ordering 7-day courses for everyone, here’s the fine print: Staph aureus? Excluded. Indwelling devices? Excluded. Severely immunocompromised? Yep, excluded. This is for gram-negative bacteremia without major complications. Keep your judgment hat on. 🧠👨⚕️ 110
Roger Struble, MD, MPH @jazzscrubs.bsky.social · 02/12/2024Real-world reality check: 23% of "7-day" patients got extra antibiotics anyway (vs. 11% in the 14-day group). Docs often extended treatment based on clinical judgment. This trial supports shorter intended courses, not rigid rules. ⚖️ 140
Roger Struble, MD, MPH @jazzscrubs.bsky.social · 02/12/2024The hospital is full of tough calls. For stable, improving, immunocompetent, gram-negative bacteremia (not Staph aureus), 7 days of antibiotics is likely enough. Safe. Effective. Gut-friendly. More patient and system-friendly. 🦠🚫 040