Brad Spellberg @bradspellberg.bsky.social · 29/08/2026Congratulations @Wiki_Guidelines on publication of the latest guideline, on management of complications of persons who inject drugs! Great job team! Let's spread widely! amjmed.com/article/S0002-… @absteward.bsky.socialamjmed.com 093
Reposted by Brad SpellbergAntibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 14/05/2026“Antibiotics are among the most potent psychoactive drugs in all the pharmacopoeia. They are incredibly potent anxiolytics.They just act on the prescriber rather than the patient” -Dr. Brad Spellberg @bradspellberg.bsky.social #idquotes #idsky 0153
Reposted by Brad SpellbergAntibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 21/04/2026Proud to be part of this great team led by @bradspellberg.bsky.social 🔥Our LTE is now published “Evidence Over Eminence: Rethinking Specialty Guidelines Amid the ATS–IDSA Debate.” A timely discussion on evidence vs eminence in the guidelines development. #IDsky academic.oup.com/cid/article/...academic.oup.comEvidence Over Eminence: Rethinking Specialty Guidelines Amid the ATS-IDSA DebateBrad Spellberg, MD, Bassam Ghanem, PharmD MS BCIDP, Miguel Morante-Ruiz, MD, Émilie Bortolussi-Courval, RN PhD, Anil N Makam, MD MAS, Zeynep Ergenc, MD, Ni 1178
Reposted by Brad SpellbergAntibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 06/05/2026Static vs. cidal: it’s not complex; it’s simply incorrect @bradspellberg.bsky.social et Al Honored to be part of this amazing group who challenges dogmas and debunk ID myths #idsky #microsky journals.asm.org/doi/10.1128/... 2136
Brad Spellberg @bradspellberg.bsky.social · 26/03/2026From '23-'25 LA General Medical Center underwent a once in a generation workforce transformation, caused by fiscal & regulatory pressure. Our article describing causes & outcomes is published! Critical lessons for health systems in a time of federal uncertainty. www.dovepress.com/articles.php...dovepress.com| JHL | Dove Medical PressKey lessons learned from the LA General transformation, including approaches taken to recruitment and culture change, and outcomes achieved. 030
Brad Spellberg @bradspellberg.bsky.social · 02/03/2026Hey @infectedterran.bsky.social, my brother in Scrubs! Have you seen it yet? Man, just watched the first episode and it was like coming home after a long journey. I really missed them, and the tone was just perfect. Whaddaya think? 110
Brad Spellberg @bradspellberg.bsky.social · 01/02/2026Rock on my brother in ampho-hating! @drboulware.bsky.socialmedia.tenor.coma blue circle with a white hand making a call me gestureALT: a blue circle with a white hand making a call me gesture 050
Reposted by Brad SpellbergBrad Spellberg @bradspellberg.bsky.social · 21/01/20260 reason to think things would be difft in non HIV, children, xenomorphs, non carbon based life forms, or any other excuses stubborn deniers have. My suggestion? Do some yoga. Meditate. Light incense. Relax. And stop torturing your patients with 2 weeks of amphoterrible. Subtle as always, I know. 322
Brad Spellberg @bradspellberg.bsky.social · 21/01/2026And a congratulations to the humble @drboulware.bsky.social, who published a thoughtful editorial accompanying the study. Dr. Boulware is a true leader in ID, and it is an honor to have him evaluate our study. I encourage everyone to read his team's editorial! jamanetwork.com/journals/jam...jamanetwork.comSingle-Dose Amphotericin B for HIV-Related Cryptococcal MeningitisCryptococcal meningitis remains a life-threatening opportunistic infection among people with advanced HIV, even in high-resource settings. For decades, the standard induction regimen in the United Sta... 170
Brad Spellberg @bradspellberg.bsky.social · 21/01/2026Thank you my friend! Based on your original work!!!! US docs gotta get on board & stop pretending things that work in other countries won't work in US. AMBITION protocol is MUCH safer and MUCH more patient centered, and just as effective as 2 weeks of old, sad, amphoterrible. @absteward.bsky.social 0103
Reposted by Brad SpellbergDr. D Boulware, MD MPH @drboulware.bsky.social · 21/01/2026Patient-directed discharges (i.e. leaving against medical advice) dropped from 35% to 12%. Major congratulations to the authors: Devin Clark, Brad Spellberg @bradspellberg.bsky.social , and colleagues. 0152
Reposted by Brad SpellbergDr. D Boulware, MD MPH @drboulware.bsky.social · 21/01/2026In an excellent study of real world outcomes in LA General Medical Center, after implementing AMBITION single dose liposomal amphotericin protocol for crypto meningitis: Similar survival without recurrence Fewer severe adverse events Shorter hospitalization (lower cost) dx.doi.org/10.1001/jama... 1145
Reposted by Brad SpellbergDr. D Boulware, MD MPH @drboulware.bsky.social · 21/01/2026Is It Time to Use Single-Dose Amphotericin B for HIV-Related Cryptococcal Meningitis in the USA? The answer is yes! doi.org/10.1001/jama...doi.orgSingle-Dose Amphotericin B for HIV-Related Cryptococcal MeningitisCryptococcal meningitis remains a life-threatening opportunistic infection among people with advanced HIV, even in high-resource settings. For decades, the standard induction regimen in the United Sta... 52311
Reposted by Brad SpellbergUSC/LA General ID Fellowship Program @lageneral-id.bsky.social · 22/12/2025Behind the scenes 🔥🔥 with all the laughs on the latest Febrile Podcast @febrilepodcast.com with @lageneral-id.bsky.social and @bradspellberg.bsky.social #IDSky player.captivate.fm/episode/dd68... 063
Reposted by Brad SpellbergInfected Terran @infectedterran.bsky.social · 10/12/2025Highly recommend you check out @bradspellberg.bsky.social book "Broken, bankrupt and dying". Achieving universal coverage can be done in many different ways. The rest of the developed world has done it in all different ways (government coverage, private/public, state subsidized etc). 0101
Brad Spellberg @bradspellberg.bsky.social · 08/12/2025Hasn't been much discussion of the 40% failure rate to fill ID programs this match year. Interesting. Wonder if anyone is ever going to do anything about that? 051
Reposted by Brad SpellbergAntibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 03/12/2025🆕🎙️🔥Febrile Podcast just dropped! ✅ID Jedi @bradspellberg.bsky.social ✅Mini-cases OM,IE,Bacteremia ✅IV vs PO debates ✅Duration of therapy ✅Shmidelines Vs WikiGuideline ✅A must-listen for every antibiotic steward! #IDsky #EMIMCC febrilepodcast.com/episodes/ open.spotify.com/episode/6dkJ... 082
Reposted by Brad SpellbergFebrile @febrilepodcast.com · 01/12/2025New episode out today: Listen in to this team from LA as they walk through several mini-cases and chat IV vs PO antibiotics! Feat: Fourth year medical student Hannah Chute, Dr. Paloma Reta-Impey, and @bradspellberg.bsky.social Also check out: www.bradspellberg.com/oral-antibio... #IDsky #MedSky 2114
Reposted by Brad SpellbergAntibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 19/11/2025🆕🔥🦴 Our 2025 Update to @wiki-guidelines.bsky.social for the Management of Pyogenic Osteomyelitis in Adults 🌟 @bradspellberg.bsky.social 🔗 [link] #idsky www.amjmed.com/article/S000... 02211
Brad Spellberg @bradspellberg.bsky.social · 18/11/2025Thrilled that another regulatory innovation out of LA General is now out in @jamanetworkopen.com! The first hospital in California authorized by CDPH to administer outpt hemodialysis for up to 2 weeks for inpatients newly started on HD who lack insurance. jamanetwork.com/journals/jam...jamanetwork.comHospital Hemodialysis Unit Flexibility and Hospital Length of StayThis quality improvement study evaluates the association of hospital length of stay with a first-in-state model in which an inpatient hemodialysis unit received regulatory approval to provide temporar... 081
Reposted by Brad Spellbergwiki-guidelines.bsky.social @wiki-guidelines.bsky.social · 03/11/2025📢📢📢 We are delighted to announce that we are assembling team for our next project, Pharyngitis WikiGuideline Join us to create guidelines with the humility of uncertainty. Deadline to sign up is November 21, 2025. 152
Brad Spellberg @bradspellberg.bsky.social · 05/09/2025Thanks to @abimfoundation.bsky.social ation for posting the video of my recent lecture on the LA General Policy to Override Policies. For those of you who know my lectures, this one is among the most entertaining. And it's only 10 min. Check it out & implement the policy! youtu.be/RuKAKH8A604?...youtu.beAdministrator/Clinician Collaboration: Policies to Put Patients FirstYouTube video by ABIM Foundation 173
Reposted by Brad SpellbergJames Wilson, DO, FACP, FAWM, CTropMed @jameswilsondo.bsky.social · 22/08/2025Another plug for #wikiguidelines @bradspellberg.bsky.social When guidelines don’t keep up with medicine 062
Reposted by Brad SpellbergSébastien Poulin @sebpoule.bsky.social · 13/08/2025Me reading DOTS trial #IDsky #DOORmedia.tenor.coma man in a black shirt is standing in front of a doorALT: a man in a black shirt is standing in front of a door 2151
Reposted by Brad SpellbergSébastien Poulin @sebpoule.bsky.social · 14/08/2025I love Dalba I just don’t know why we should do a PhD in statistics to understand a trial now Or maybe am just getting old and grumpymedia.tenor.coma white monkey with a blue face is sitting on a blue blanket .ALT: a white monkey with a blue face is sitting on a blue blanket . 251
Reposted by Brad Spellberg𝐑𝐚𝐥𝐩𝐡 𝐌𝐨𝐡𝐭𝐲 𝐌𝐃 𝐌𝐏𝐇 @rmohty.bsky.social · 12/08/2025As @bradspellberg.bsky.social would say CRP is missing a letter as a test "A" (CRAP) - www.sciencedirect.com/science/arti...sciencedirect.comRevisiting diagnostics: erythrocyte sedimentation rate and C-reactive protein: it is time to stop the zombie tests 052
Reposted by Brad SpellbergAntibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 11/08/2025International guidelines recommend 5 to 7 days of antibiotic prophylaxis for patients with cirrhosis & upper GI bleeding. 🆕🔥Systematic Review ( 14 RCTs, N=1322) & Bayesian Meta-Analysis challenged this universally held dogma #idsky jamanetwork.com/journals/jam...jamanetwork.comProphylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With CirrhosisThis systematic review and meta-analysis evaluates the evidence supporting the current guidelines antibiotic prophylaxis use in patients with cirrhosis and upper gastrointestinal bleeding. 7239
Reposted by Brad SpellbergID:IOTS Podcast @idiots-pod.bsky.social · 09/08/2025#IDsky The Infectious Disease Brad Boy himself, @bradspellberg.bsky.social , has an updated Oral vs IV table, now including the Plague (Y really) and Lyme! Link here: www.bradspellberg.com/oral-antibio...bradspellberg.comOral Antibiotic RCTs | mysite 1163
Reposted by Brad Spellbergwiki-guidelines.bsky.social @wiki-guidelines.bsky.social · 03/08/2025WikiGuidelines lapel pins are available for purchase on WikiGuidelines website: www.wikiguidelines.org Support us to incorporate humility of uncertainty into guidelines! 161
Reposted by Brad SpellbergRossana Rosa @drrossanarosa.bsky.social · 10/07/2025“We’re asking the wrong question. Let’s use fundamental PK. Let’s get the drug to where the bug is, at a high enough concentration to kill the bug, and not worry about whether we label the drug static or cidal”. As said by @bradspellberg.bsky.social 🤩😇 Fabulous conversation! #IDSky #MedSky #AMSSky 1248
Brad Spellberg @bradspellberg.bsky.social · 03/07/2025Really compelling story by @corinnepurtill: "Strangers in the middle of a city: The John and Jane Does of L.A. General Medical Center". This short video tells the powerful story of the unidentified admissions to one of the busiest trauma centers in the US. www.latimes.com/00000197-c35...latimes.comLA Times Today: Strangers in the middle of a city: The John and Jane Does of L.A. General Medical CenterWatch L.A. 021
Reposted by Brad Spellbergjosh farkas 💊 @pulmcrit.bsky.social · 26/06/2025Great article on dogma in ID (with parallels to critical care) We have HUGE problems re: guidelines making recommendations & *redefining* entire diseases based on minimal data. Gov't metrics exacerbate this further. @bradspellberg.bsky.social @absteward.bsky.social @drtoddlee.bsky.social #EMIMCC 53513
Reposted by Brad SpellbergInfected Terran @infectedterran.bsky.social · 26/06/2025Oh snap! I hope this conversation happened near a hospital that has a burn unit @bradspellberg.bsky.social 371
Reposted by Brad SpellbergAntibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 24/06/2025How much evidence is needed to revise established clinical practices? and, can data alone truly catalyze such shifts? Our 🆕🔥 Article at @cidjournal.bsky.social with 🌟s @bradspellberg.bsky.social Practicing With Intent: How to Teach an Old Dogma New Tricks #IDSky academic.oup.com/cid/article/... 1228
Brad Spellberg @bradspellberg.bsky.social · 23/06/2025Thank you to @jamanetworkopen.com for publishing economic analysis of our Safer@Home virtual acute care program! Modeling shows simple reimbursement would enable a win-win-win: patients get better patient-centered care, hospitals save money/free beds, and payors save! jamanetwork.com/journals/jam...jamanetwork.comHealth Economic Analysis of an All-Virtual, At-Home Acute Care ModelThis economic evaluation estimates hospital and payer costs associated with an all-virtual, at-home acute care program. 1145
Reposted by Brad SpellbergJake Scott, MD @jakescottmd.bsky.social · 06/06/2025The work has been deeply collaborative. The idea to crowdsource controlled vaccine trials came from @bradspellberg.bsky.social, and we've had a phenomenal team - @abhaydhand.bsky.social, @alejodiaz81.bsky.social, Dr. Ali Meza Vazquez, Neal Fox, and help from many contributors from around the world. 052
Reposted by Brad Spellbergwiki-guidelines.bsky.social @wiki-guidelines.bsky.social · 05/06/2025#JoinTheMovement #MedicalScience #ClinicalResearch #RCTmatters #HealthcareInnovation #MedEd #WikiGuidelines 021
Reposted by Brad Spellbergwiki-guidelines.bsky.social @wiki-guidelines.bsky.social · 05/06/2025Your Role: Review existing guidelines across all specialties to evaluate whether or not recommendations are based on high-quality, adequately powered, peer-reviewed, and publicly accessible prospective studies, including at least one randomized controlled trial 143
Reposted by Brad Spellbergwiki-guidelines.bsky.social @wiki-guidelines.bsky.social · 05/06/2025📢📢📢Join our team appraising the level of evidence used to make consensus guideline recommendations across all specialties Deadline to sign up: 6/20/25 New to WikiGuidelines? Use the link below to complete WikiGuidelines New Participant application. forms.office.com/r/Tyb8R0iM8X 163
Brad Spellberg @bradspellberg.bsky.social · 29/05/2025Amazing job, summarizing 260 RCTs of vaccines with nearly 2.5 million patients randomized! We will turn this into a peer reviewed manuscript, but the table summarizing the trials can be seen on the web: www.bradspellberg.com/vaccine-rctsbradspellberg.comVaccine RCTs | mysite 13614
Reposted by Brad SpellbergJake Scott, MD @jakescottmd.bsky.social · 29/05/2025Just wrapped data extraction for our global vaccine RCT review: 260 trials (1951 to 2025) 2,468,751 trial participants Possibly the most comprehensive dataset of its kind. Huge thanks to the team that powered through to this milestone. @bradspellberg.bsky.social docs.google.com/spreadsheets/d…docs.google.com 8208
Brad Spellberg @bradspellberg.bsky.social · 27/05/2025LA General is seeking a Director of Inflammatory Bowel Disease and Director of GI Ambulatory Care in the Division of Gastroenterology and Hepatology. See job description attached! 000
Brad Spellberg @bradspellberg.bsky.social · 25/05/2025Thanks to @absteward.bsky.social for finding the most recent Shorter is Better: TB Is Complex Study. Shows 8 week regimens are inferior to 24 week for cure. Sets a lower boundary for TB. Slides and website updated. www.bradspellberg.com/shorter-is-b... 0126
Reposted by Brad SpellbergJake Scott, MD @jakescottmd.bsky.social · 25/05/2025Our 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… @bradspellberg.bsky.social @apnews.com @statnews.com @nytimes.comdocs.google.com 083
Reposted by Brad SpellbergAntibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 23/05/2025The results of this study call into question the accuracy of susceptibility testing for organisms containing MBLs when conducted in nutrient-rich media and reiterate the need for clinical validation of in vitro susceptibility testing results #idsky 1101
Reposted by Brad SpellbergJoanna Schaenman, MD, PhD @jschaenmanmd.bsky.social · 16/05/2025This is a great way to characterize these tests as 'zombies' 😨 Hard to get folks to stop ordering these tests despite the lack of data , especially in immunocompromised patients! @idsensei.bsky.social @bradspellberg.bsky.social @ast-idcop.bsky.social 022
Reposted by Brad SpellbergJake Scott, MD @jakescottmd.bsky.social · 12/05/2025Grateful to @cidrap.bsky.social & @mtosterholm.bsky.social highlighting our vaccine RCT table in this viewpoint. This kind of recognition reinforces the value of collective, evidence-based efforts to bring clarity to vaccine research. @bradspellberg.bsky.social www.cidrap.umn.edu/anti-science...cidrap.umn.eduViewpoint: Proposed system for vaccine approval, safety monitoring begs crucial questions 142
Brad Spellberg @bradspellberg.bsky.social · 12/05/2025This may be of interest @mtosterholm.bsky.social @cidrap.bsky.social 030
Reposted by Brad SpellbergJake Scott, MD @jakescottmd.bsky.social · 12/05/2025Fresh #s from our crowd-sourced, verifiable vaccine trial dataset: bit.ly/4mbdl6U - 123 controlled trials (polio to chikungunya) - 1.9 million participants - ~80% placebo, 15% active control (used only when placebo would be unethical) Every entry links to primary source @bradspellberg.bsky.socialbit.lyPlacebo-Controlled Vaccine RCTs (Living List) 142
Reposted by Brad SpellbergJake Scott, MD @jakescottmd.bsky.social · 12/05/2025Folks from around the world came together (off the clock, with no funding) not to argue, but to illuminate. Grateful to @bradspellberg.bsky.social, @abhaydhand.bsky.social, @adamlauring.bsky.social, Neal Fox, @jkeelan57.bsky.social, @alejodiaz81.bsky.social, & many other contributors bit.ly/44zoJDmbit.lyVaccine RCTs | mysite 043