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Antibiotic Steward 🅱️C🆔🅿️🌟

@absteward.bsky.social
2.8K followers 2 following 1.3K posts

Stay up-to-date in Infectious Diseases, Clinical Pharmacist, Antibiotics, #IDTwitter t✨p influencer #interstellar #dune 🌹❤️Misk #idsky #medsky #AMSsky #idxposts Bassam Ghanem,PharmD MS BCPS BCIDP

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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 09/09/2026
🔥🔥Back online🔥🔥 IDSA/ESCMID 2026 Guidelines on Staphylococcus aureus Bacteremia: Risk Stratification, Diagnostic Evaluation, and Management of Adults and Children Part-1 #idsky www.idsociety.org/practice-gui...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 08/09/2026
🔥Just published 🔥 Infective Endocarditis: Diagnosis, Antibiotic Therapy, and Management: A Scientific Statement From the American Heart Association #idsky www.ahajournals.org/doi/10.1161/...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 13/08/2026
🔥Wow. Our article is published with the legend @bradspellberg.bsky.social 🎉🔥 A journey that started with a simple question: What’s in a name? Today, I’m incredibly grateful to see our article published in @cmicomms.bsky.social EnJoy! #idsky www.cmi-comms.org/article/S295...
cmi-comms.org
What’s in a Name? The Rise of Klebsiella pneumoniae: From Friedländer to Klebs
Within the family of Enterobacteriaceae, few species have evolved in parallel with the history of clinical microbiology and infectious diseases as closely as Klebsiella pneumoniae. First described in ...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 05/08/2026
What's in a name? The story of Coccidioides begins with a medical trainee, a mistaken identity, and a discovery that changed medical mycology. More than a century later, that trainee would have a species named in his honor. And yes—there's a reason it's called "Valley fever." #IDsky
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 30/07/2026
🔥🔥IDSA AMR Guidance 2026🔥🔥 🔺Notable Updates from the 2024 IDSA AMR Guidance Document 🔺Meropenem dosing update: individualized dosing approach (1–2 g IV q8h) with higher doses considered in selected clinical scenarios. #idsky www.idsociety.org/practice-gui...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 30/07/2026
🔥 Update 🔥 The IDSA AMR Guidance 2026 link is now back online. You can access the guidance through the original link below. I'll be sharing the Notable Updates from the 2024 IDSA AMR Guidance Document soon. #idsky
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 29/07/2026
🆕🔥🔴ISLEND-1 RCT Among persons with virologically suppressed HIV-1, once-weekly oral Islatravir–Lenacapavir was noninferior to once-daily oral bictegravir emtricitabine tenofovir alafenamide B/F/TAF in maintaining HIV viral load suppression #IDsky #hivsky www.nejm.org/doi/full/10....
nejm.org
Phase 3 Trial of Weekly Oral Islatravir–Lenacapavir for HIV-1 Treatment | NEJM
Once-daily, single-tablet regimens have transformed care for persons living with human immunodeficiency virus type 1 (HIV-1); however, challenges to adherence continue to limit effective treatment....
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Pharmageddon @pharmageddon.bsky.social · 29/07/2026
Yikes. Never have I treated something that probably doesn't need to be treated so aggressively. Or at least expensively.
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 28/07/2026
Update: The original link appears to be temporarily unavailable. I'll share the updated official link once it's available. #idsky
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 27/07/2026
🔥🔥Just published 🔥🔥 IDSA AMR Guidance 2026 IDSA 2026 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections 🔺ESBL , AmpC Enterobacterales 🔺CRE 🔺DTR P. aeruginosa 🔺CRAB 🔺Stenotrophomonas maltophilia #idsky www.idsociety.org/practice-gui...
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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 16/07/2026
Love seeing this data. Skip phenomenon is rare and usually occurs in the context of a clinical change. No need to repeat BCx again when already cleared....and we might be able to get away with a single set to detect clearance of SAB
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 15/07/2026
A thoughtful editorial Skipping to conclusions: Is one negative follow-up blood culture sufficient in Staphylococcus aureus bacteremia? #idsky academic.oup.com/cid/article-...
academic.oup.com
Skipping to conclusions: Is one negative follow-up blood culture sufficient in Staphylococcus aureus bacteremia?
Yonas Martin, Steven Tong; Skipping to conclusions: Is one negative follow-up blood culture sufficient in Staphylococcus aureus bacteremia?, Clinical Infec
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 15/07/2026
Staphylococcus aureus bacteremia guidelines recommend obtaining FUBCs every 2-4 days until bacteremia clearance! 🆕💥💥🟢 cohort study: Routine serial follow-up blood cultures after a negative result within 48 hours of MSSA bacteremia: low yield, high cost #idsky academic.oup.com/cid/article/...
academic.oup.com
Routine serial follow-up blood cultures after a negative result within 48 hours of methicillin-susceptible Staphylococcus aureus bacteremia: low yield, high cost
Early skip phenomenon in Staphylococcus aureus bacteremia is rare (3.1%) with a very low risk of missed persistent bacteremia (1%). A practical day-2 focus
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 20/06/2026
🆕💥🟢Among 305 episodes with suspected infective endocarditis and valve strands the majority did not represent IE. Recurrence of IE due to the same microorganism within one year was significantly more frequent among episodes with IE compared to those without #idsky academic.oup.com/cid/article/...
academic.oup.com
Validate User
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ACCP ID PRN @accpinfdprn.bsky.social · 20/06/2026
Aw🫰SNAP🫰 Cefazolin vs anti-staphylococcal PCN ⬇️⬇️⬇️
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José Molina @josemolinagb.bsky.social · 20/06/2026
If there were PK/PD issues with fosfo, the problem might arise not on early TOC, but on relapses of non-cystitis UTI. In this subanalysis of patients switched to oral in FOREST trial, more relapses were observed with fosfo for bacteremic E. coli UTI. academic.oup.com/jac/article/... #IDSky #UTIsky
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José Molina @josemolinagb.bsky.social · 20/06/2026
Caveats: - FOREST was 100% bacteremic UTI - A lower dose of oral fosfo was used (3g/48h). - Definition of relapse was more strict, requiring a new isolation of E. coli with same phenotype. - Absolute risk difference still low (11%), so definitely an option to consider if no other options! #IDSky
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Slow ID @fabian-juzek.bsky.social · 20/06/2026
star wars
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Andre Kalil, MD MPH @drandrekalil.bsky.social · 20/06/2026
Observational indeed
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Rossana Rosa @drrossanarosa.bsky.social · 20/06/2026
Sort of
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Eli Perencevich @eliowa.bsky.social · 20/06/2026
Two words
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Angela Huttner @angelahuttner.bsky.social · 19/06/2026
Retrospective study. 😊
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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 19/06/2026
Fancy stats
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Simran Gupta @simrangmd.bsky.social · 19/06/2026
faux RCT
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 19/06/2026
How would you describe target trial emulation in two words only? #idsky
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 18/06/2026
Wow! 🆕🔥🔴Multicenter OL NI RCT Oral fosfomycin (3 g once daily) was noninferior to continued intravenous therapy with carbapenems or BLBLIs when used as oral transition therapy for complicated UTIs caused by ESBL-producing Enterobacterales #IDSky #utisky academic.oup.com/cid/article-...
academic.oup.com
Fosfomycin as Oral Transition Therapy Versus Continued Intravenous β-Lactams for Complicated Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase–Producing Enterobacterales: A Multicenter,...
Switching from intravenous antibiotics to oral fosfomycin was noninferior to continuing intravenous therapy for complicated urinary tract infections caused
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 18/06/2026
🔥Just approved 🔥 The FDA has approved Utebzi (tebipenem pivoxil) tablets as the first oral carbapenem therapy for adults with complicated urinary tract infections, including pyelonephritis #idsky #EMIMCC www.fda.gov/drugs/news-e...
fda.gov
FDA approves first oral carbapenem therapy for complicated urinary tra
FDA approves first oral carbapenem therapy for complicated urinary tract infections
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Dimitri Drekonja, MD, MS @dimitridrekonja.bsky.social · 17/06/2026
Anti-staphylococcal penicillins are now a historic curiosity. Cefazolin FTW 👏🏻👏🏻
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ID:IOTS Podcast @idiots-pod.bsky.social · 17/06/2026
Well, it only took ‘em 2 years to get past Reviewer 2, but they did it & as we say in Scotland, ‘it’s Oot’! SNAP paper 1, available now. Congrats 2 Todd Lee, Steve Tong, Josh Davis & the rest. First dram of this bottle is in your honour! Slàinte!! #IDsky #SNAP #morelikePoocloxacillin
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 17/06/2026
🔥Just published 🔥NEJM SNAP RCT In patients with MSSA bacteremia, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury. #idsky www.nejm.org/doi/full/10....
nejm.org
Cefazolin for Methicillin-Susceptible Staphylococcus aureus Bacteremia | NEJM
Staphylococcus aureus bacteremia is associated with high mortality. Whether cefazolin or an antistaphylococcal penicillin should be preferred for the treatment of methicillin-susceptible S. aureus ...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 12/06/2026
While some may view ARISE-FLUIDS as final blow to 30 mL/kg, a new cohort JAMA of 25k pts:initial administration of ≥30 mL/kg associated with lower 30d mortality among pts with hypoperfusion or intermediate lactate elevation w/o severe cardiac or kidney comorbidities. jamanetwork.com/journals/jam...
jamanetwork.com
Comorbidities, Weight-Based Initial Fluid Resuscitation, and Sepsis Mortality
This cohort study evaluates whether administration of 30 mL/kg or more of fluid within 6 hours of hospital arrival is associated with reduced 30-day mortality in adults with community-onset sepsis.
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Andy Conway Morris @andymoz78.bsky.social · 12/06/2026
Important study of real-world use of rapid respiratory diagnostics. Encouragingly, pace INHALE, no signal to harm in the intervention group (indeed signal to benefit in those with panel-detectable organisms on culture).
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 12/06/2026
🆕💥🔴Multicenter retrospective study of ICU patients with pneumonia BIOFIRE® PN Panel implementation was associated with improved early antimicrobial de-escalation and appropriate therapy #idsky academic.oup.com/cid/article-...
academic.oup.com
Clinical Impact of the BIOFIRE® FILMARRAY® Pneumonia Panel in the Veterans Affairs Healthcare System: A Difference-in-Differences Study
In this national, multicenter retrospective study of intensive care unit patients with pneumonia in Veterans Health Administration hospitals, BIOFIRE® PN P
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Andy Conway Morris @andymoz78.bsky.social · 12/06/2026
Once again, for those at the back, the effort to refute bulls*t is 10x that required to produce it. Can we please stop doing high dose Vit C trials in critical care now?
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SHORTEN-2 trial @shorten2trial.bsky.social · 11/06/2026
There’s enough evidence from observational and RCT subgroups to stop excluding systematically immunocompromised hosts from duration trials. Uncomplicated source + early response should always mean shorter. 1 in 3 patients in @shorten2trial.bsky.social is inmunocompromised bsky.app/profile/jose...
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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 11/06/2026
Excited to share an article that I've long awaited to share seeking to answer: What is the right dose of cephalexin/cefadroxil for SSTIs? We reviewed clinical studies & conducted PTA sims to elucidate this #IDSky @absteward.bsky.social accpjournals.onlinelibrary.wiley.com/doi/10.1002/...
accpjournals.onlinelibrary.wiley.com
Getting It Right the Second Time: How Can we Optimize First‐Generation Cephalosporin Dosing for Skin and Soft Tissue Infections in the 21st Century?
Optimal cephalexin and cefadroxil dosing for skin and soft tissue infections (SSTIs) is unclear. We summarize clinical and pharmacokinetic/pharmacodynamic (PK/PD) data that compare dosing strategies ...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 11/06/2026
🆕💥🟢Multicenter prospective study shows that quantitative PCR on oral wash has a better positive predictive value than PCR on bronchoalveolar lavage for the diagnosis of Pneumocystis pneumonia in HIV-negative immunocompromised patients #idsky academic.oup.com/cid/article/...
academic.oup.com
Oral Wash PCR Improves the Diagnosis of Pneumocystis Pneumonia in Immunocompromised Patients Without HIV: A Prospective Multicenter Study
This multicenter prospective study shows that quantitative PCR on oral wash has a better positive predictive value than PCR on bronchoalveolar lavage for t
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 11/06/2026
🔥The ARISE FLUIDS RCT Among adults with septic shock, Restricted fluids + early vasopressors did not result in more days alive & out of the hospital through day 90 than liberal fluids + later vasopressors Pulmonary edema (0.6% in the vasopressor group vs. 5.0% in the fluids group; P<0.001). #idsky
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 10/06/2026
High-Dose Vitamin C in Burns Time to Stop 🆕🔥🟢VICTORY RCT High-dose intravenous vitamin C did not reduce mortality and organ dysfunction and may be associated with harm in patients with severe burn injury #EMIMCC jamanetwork.com/journals/jam...
jamanetwork.com
High-Dose Intravenous Vitamin C in Severe Burn Injury
This international randomized clinical trial evaluates the efficacy of high-dose intravenous vitamin C in reducing 28-day mortality and persistent organ dysfunction (dependence on mechanical ventilati...
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Seth Trueger @mdaware.org · 10/06/2026
I see stuff like this as less about dogma being wrong or bad but rather: we do the best we can until data beats physiology
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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 10/06/2026
New in @cmijournal.bsky.social: "Which trial do we need? Evaluating plasma microbial cell-free DNA in blood culture-negative infective endocarditis" #IDSky @absteward.bsky.social www.clinicalmicrobiologyandinfection.org/article/S119...
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Scott Fabricant MD PhD @safabric.bsky.social · 10/06/2026
No different. Bacteria are still just bacteria.
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 09/06/2026
For years, the need for longer durations in immunocompromised patients was treated as the exception to every shorter-duration bacteremia discussion. BALANCE may have finally put that belief to rest. Dogma continues to lose ground. #idsky
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 09/06/2026
🆕🔥🟢Post hoc subgroup analysis of the BALANCE RCT 7 Vs 14d duration of antibiotic therapy for bacteremia in immune compromised hosts 1037 immune compromised patients #idsky www.clinicalmicrobiologyandinfection.org/article/S119...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 09/06/2026
🆕💥🟢Retrospective observational study Anti-MRSA Cephalosporins + Daptomycin as Initial Therapy for MRSA Bacteremia: Does a “Hit Hard and Fast” Strategy Improve Outcomes? #idxposts #DOOR #idsky academic.oup.com/cid/article/...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 09/06/2026
🆕🔥🟢Excellent review article Carbapenemases: epidemiology, detection & management in a changing global landscape 🔺Carbapenemase classification. 🔺Characteristics of key carbapenemase families 🔺Geographic distribution 🔺Guideline-based treatment recommendation #idsky academic.oup.com/jacamr/artic...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 08/06/2026
🆕💥🟢HAPPEN A multicentre, stepped-wedge, cluster RCT in Australia Effectiveness of oral care for the prevention of non-ventilator hospital-acquired pneumonia #idsky www.thelancet.com/journals/lan...
thelancet.com
Effectiveness of oral care for the prevention of non-ventilator hospital-acquired pneumonia (HAPPEN): a multicentre, stepped-wedge, cluster-randomised trial in Australia
This multicentre randomised controlled trial demonstrates that improving oral care reduces NV-HAP incidence among hospitalised patients, compared with usual care. Our findings provide novel and clinic...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 08/06/2026
🆕💥🟢Systematic review and meta-analysis Discontinuation of quinolone prophylaxis during pre-engraftment neutropenia was associated with an elevated incidence of BSIs* in hematopoietic stem-cell transplant recipients #idsky academic.oup.com/ofid/article...
academic.oup.com
Effect of quinolone prophylaxis discontinuation during pre-engraftment neutropenia on incidence, mortality, and aetiology of bloodstream infections in hematopoietic stem-cell transplant recipients: a ...
Our systematic review with meta-analysis suggests that discontinuation of quinolone prophylaxis during pre-engraftment neutropenia reduces bacterial resist
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 08/06/2026
Posaconazole delayed-release tablets are labelled as ‘do not crush’ medications 🆕💥🔴Crushed posaconazole delayed-release tablets via enteric feeding tube administration: practical considerations for clinicians #idsky academic.oup.com/jac/article-...
academic.oup.com
Crushed posaconazole delayed-release tablets via enteric feeding tube administration: practical considerations for clinicians
Abstract. Posaconazole delayed-release (DR) tablets are labelled as ‘do not crush’ medications. Despite this designation, emerging research demonstrates su
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 08/06/2026
🆕💥🟢Systematic review and meta-analysis Quantifying household-level sharing of antimicrobial-resistant pathogens between pets and their owners Across 152 studies, the pooled prevalence of household-level sharing was 3.8% #idsky academic.oup.com/jac/article/...
academic.oup.com
Quantifying household-level sharing of antimicrobial-resistant pathogens between pets and their owners: a systematic review and meta-analysis
Abstract. Companion animals are increasingly recognized as potential reservoirs of antimicrobial-resistant (AMR) bacteria, yet the frequency of sharing bet
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