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Reposted by ID:IOTS Podcast

Lepra UK @leprauk.bsky.social · 06/08/2026

What is lymphatic filariasis (LF)? LF is a neglected tropical disease. Usually acquired in childhood, infection occurs when filarial parasites are transmitted to humans through mosquitoes causing hidden damage to the lymphatic system. ow.ly/EWa350ZcF8G #LF #IDSky #Mosquitoes

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ID:IOTS Podcast @idiots-pod.bsky.social · 25/07/2026

Developing countries (& the UK, unlike cefoxitin!) and is well tolerated - at least locally, side effect profile is very favourable, even if it is 3 drugs. 3/3

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ID:IOTS Podcast @idiots-pod.bsky.social · 25/07/2026

…are as effective PO as IV then we have to practice what we preach. I can see the argument for Cefoxitin or 3G-ceph +/- MNZ for this situation; it’s easy, standard dosing, it’s only 1 antibiotic. I just see the advantages of A/G/M too; used right it’s safe, effective, widely available in… 2/3

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ID:IOTS Podcast @idiots-pod.bsky.social · 25/07/2026

Second gen Cephamycin: isn’t its spectrum usually approximated to 3G-ceph plus a bit of AnO cover? Re infusion number, that’s fair, though Cefox is 3/4x/d, isn’t it? But then if you give the met/amox oral you only have 1 infusion a day. If we really believe that highly bioavailable agents.. 1/3

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ID:IOTS Podcast @idiots-pod.bsky.social · 25/07/2026

Speaking specifically to C.diff rates, Amox/Gent/Met has lower rates than 3G-cephs. And we only use Gent for 3-5d before using something else, so minimising AKI. This population you could argue is young, not prone to C.diff, but I’d also argue they aren’t prone to AKI.

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ID:IOTS Podcast @idiots-pod.bsky.social · 23/07/2026

Is love to have disagreed on the multiple regimens but for gentamicin, not somewhat annoyingly, Scotland has 2… www.sapg.scot/guidance-qi-...

sapg.scot

Antimicrobial-specific guidance

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ID:IOTS Podcast @idiots-pod.bsky.social · 23/07/2026

Those first 2 points are reasonable, though not insurmountable, but that last on spectrum: I think not. Amox/Gent converts everything Ceftriaxone covers, but also ESBL/AmpC/CPE Enterobacterales, PsA*, Enterococcus too. Add Metro for the AnO and you’re set. *in urine, not relevant here I guess

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ID:IOTS Podcast @idiots-pod.bsky.social · 21/07/2026

Isn’t that an argument for just having gentamicin in the department? If ppl want to give 1 antibiotic for everything they can give meropenem and have done with it? I don’t agree that ‘1 drug faster than 2, therefore better’ is a good argument.

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ID:IOTS Podcast @idiots-pod.bsky.social · 20/07/2026

Sorry forgot to answer your question. 5mg/kg stat, then worry about their kidneys later. Amox first or second depending on if I think it’s a G+ infection or G- I only really worry about order of administration in NecFasc, and even that’s probably not doing much

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ID:IOTS Podcast @idiots-pod.bsky.social · 20/07/2026

…and has been covered extensively elsewhere 4. Worrying about the C.diff rates with Clinda and then recommending a Cephamycin as an alternative is nonsensical 5. See picture. The defence rests 2/2

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ID:IOTS Podcast @idiots-pod.bsky.social · 20/07/2026

A few things: 1. They call Cefoxitin a cephalosporin in the introduction which the cladist in me finds infuriating. 2. Antibiotics take 24-48h to work so I don’t after the initial dose needs to be on board within 1h 3. Surviving Sepsis guidance evidence based for ABx within 1h is awful… 1/2

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ID:IOTS Podcast @idiots-pod.bsky.social · 16/07/2026

I’ve done it. 1g TID. Switching from 2g QID IV, when patient stable & Sens confirmed. You?

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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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ID:IOTS Podcast @idiots-pod.bsky.social · 17/06/2026

Therapy. I don’t do this very much in my practice (MRSA isn’t a big problem here), but if I had a case failing to improve on standard Rx I’d consider it. Of only for an RCT assessing this. 2/2

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ID:IOTS Podcast @idiots-pod.bsky.social · 17/06/2026

Tempting, but I have the recent Oseltamivir trial results ringing in my ears re: extrapolating much from non-RCTs. Also these 2 groups were quite unbalanced, and the Dap+Cef group may have been treated differently in turn (they were in ICU more, for example, so maybe got more goal-directed 1/2

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ID:IOTS Podcast @idiots-pod.bsky.social · 05/06/2026

Was related to studies analysing if nephrotoxicity rates increased when we started using a lot more gentamicin (it didn’t, a bit more AKI1 but not AKI2,3 or need for dialysis). Did an episode on this ages ago with @febrilepodcast.com of you’re interested.

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ID:IOTS Podcast @idiots-pod.bsky.social · 05/06/2026

BL and FQ; so from a ‘keep ABx working’ perspective, I’d argue they’re the things to keep working. FWIW after we changed ABx policy in Scotland we saw no increase in deaths due to GNB, but our C.diff rates dropped. Not a lot was published on it at the time, though, that I can see, and most of it

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ID:IOTS Podcast @idiots-pod.bsky.social · 05/06/2026

In terms of GN resistance, despite constant AG use in Scotland we’ve seen very little increase in AG resistance. Definitely lower C.diff risk It does make the regimen more complex than just sticking them on Ceftriaxone, but most of the increase in resistance seen in ESPAUR/WHO reports pertains to

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ID:IOTS Podcast @idiots-pod.bsky.social · 26/05/2026

Addled by Ambisome? Not sure about Nystatin Never heard of Natamycin? Worry not; Jame and Alyssa are here to clear it all up Details here: podcasts.apple.com/gb/podcast/1... #idsky #microsky #infection #podcast

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139. Polyenes

Podcast Episode · ID:IOTS - Infectious Disease Insight Of Two Specialists · 26 May · 22min

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ID:IOTS Podcast @idiots-pod.bsky.social · 02/05/2026

This is worth knowing, thanks @kasic.bsky.social ! Still hate quinolones though

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ID:IOTS Podcast @idiots-pod.bsky.social · 29/04/2026

Nailed it bsky.app/profile/idio...

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ID:IOTS Podcast @idiots-pod.bsky.social · 29/04/2026

Resistance barrier is quite low Make sure the levels aren’t too high or low Just listen to this pod and you’ll then know Just where in you’re toolbox this drug goes NA NA NA NA NA #idsky #eminem #withoutme

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ID:IOTS Podcast @idiots-pod.bsky.social · 29/04/2026

Now this looks like an ep for thee About a drug that gets into your pee It’s known to treat crypto and also yeast It’s time to learn about flucytosine podcasts.apple.com/gb/podcast/i... #idsky #microsky #podcast

podcasts.apple.com

137. Flucytosine

Podcast Episode · ID:IOTS - Infectious Disease Insight Of Two Specialists · 27 April · 22min

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ID:IOTS Podcast @idiots-pod.bsky.social · 29/04/2026

Oh has #idsky been a bit quiet I hadn’t noticed Wait a minute I need to talk about my recent podcast episode drop, BRB

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ID:IOTS Podcast @idiots-pod.bsky.social · 20/03/2026

Nitro. Better track record, more commonly used, there’s the possibility you would be able to get AST on it (we don’t have the ability to test Doxy against Enterobacterales locally, and let’s face it: you can’t use Doxy for everything, can you?

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ID:IOTS Podcast @idiots-pod.bsky.social · 17/03/2026

A chat with the UK’s Prémièrë pathogen lab, now on the podcast feed!

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ID:IOTS Podcast @idiots-pod.bsky.social · 17/03/2026

Now this an episode, first of a triple About all the work of a lab called RIPL And we'd like to take minute now so sit right here And learn about all the horrible pathogens you now should fear New episode now live! #idsky #microsky podcasts.apple.com/gb/podcast/i...

podcasts.apple.com

134. The Rare and Imported Pathogens Lab (RIPL)

Podcast Episode · ID:IOTS - Infectious Disease Insight Of Two Specialists · 16 March · 46m

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ID:IOTS Podcast @idiots-pod.bsky.social · 13/03/2026

Sorry Alice, what is Roon? Am I missing out on the Next Big Thing?

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ID:IOTS Podcast @idiots-pod.bsky.social · 27/02/2026

I goes off you use Rezafungin ever you’re sort of using Anidula? YOU’LL JUST HAVE TO LISTEN SHARE THE EPISODE* TELL ALL YOUR MATES* AND DONATE SOME DOSH* TO FIND OUT *optional

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ID:IOTS Podcast @idiots-pod.bsky.social · 27/02/2026

New episode! Alyssa and Jame are joined by Tihana Bicanic, to discuss the second great antifungal drug class, Echinocandins. Part 1 of 2! (this episode we discuss the old stuff, next episode we discuss Rezafungin) #idsky #microsky #fungi podcasts.apple.com/gb/podcast/i...

podcasts.apple.com

132. Echinocandins Part 1: the old stuff

Podcast Episode · ID:IOTS - Infectious Disease Insight Of Two Specialists · 23 February · 38m

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ID:IOTS Podcast @idiots-pod.bsky.social · 09/02/2026

Consider this our post advertising the latest episode, ‘Biocide Bashing’, available now! Hold on to your Phallusocks ®️, this topic’s as scary as it gets! (That’ll make more sense after you listen) #IDsky #microsky #biocides #microbiotoxicity podcasts.apple.com/gb/podcast/i...

podcasts.apple.com

131. Biocide Bashing

Podcast Episode · ID:IOTS - Infectious Disease Insight Of Two Specialists · 09/02/2026 · 45m

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ID:IOTS Podcast @idiots-pod.bsky.social · 29/01/2026

“Always start with oral for a satisfying resolution”? “Use the mouth before things go south”? Everything I think of sounds naughty. I’ll work on it. Great poster, @drrossanarosa.bsky.social !

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ID:IOTS Podcast @idiots-pod.bsky.social · 27/01/2026

I’ll go back to X if you don’t.

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ID:IOTS Podcast @idiots-pod.bsky.social · 27/01/2026

OI YOU … Podcast on Azole Antifungals. Would be a shame if you reposted it to AAAAAAALLL your followers, and liked it and commented on what you thought of it below PLEASE DON’T DO THAT we hate popularity!! #IDsky #microsky #fungi podcasts.apple.com/gb/podcast/i...

podcasts.apple.com

130. Azole Antifungals

Podcast Episode · ID:IOTS - Infectious Disease Insight Of Two Specialists · 26/01/2026 · 32m

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ID:IOTS Podcast @idiots-pod.bsky.social · 13/01/2026

I count that as gram negative infection (serious), would treat the same way I would for pyelo/GN BSI. Beta-lac (Ceftriaxone, Piptaz) FQ (Cipro, Levo) Cotrim Aminoglycoside (maybe, +/- amoxicillin) Depending on previous ABx exposure, micro etc. In UK it’s Amox/Gent or CRO, depending on location

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ID:IOTS Podcast @idiots-pod.bsky.social · 12/01/2026

Incidentally: only oral 3rd gen we have in the UK is cefixime: it’s got low bioavailability, so I wouldn’t consider it equivalent to Ceftriaxone. I’ve never used it, actually… the UK has a weird attitude to oral cephalosporin in general…

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ID:IOTS Podcast @idiots-pod.bsky.social · 12/01/2026

Is this going to be a podcast series? It should be. At the back of my mind I’ve had an idea for a “Microbe Maestros” mini series where we’d explore famous figures in micro/ID: Pasteur, Koch, Lancefield, Spellberg, etc. Starting with the GOAT, Fleming, obviously…

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ID:IOTS Podcast @idiots-pod.bsky.social · 12/01/2026

First 10 days: leave it the fuck alone. IV Ceftriaxone 2g BD, with IV Amox. D11 onwards: I forget about all that synergistic Ceftriaxone/gentamicin crap and go with what POET showed worked (maybe even better than IV Rx): one of the oral regimens.

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ID:IOTS Podcast @idiots-pod.bsky.social · 12/01/2026

I wonder if @bradspellberg.bsky.social would recommend any mono-Rx regimens from the #wikiguidelines #endocarditis guidance? (Honoured to be @‘d in the same tweet, naturally. Unless he comes and poopoos my argument in which case I never liked him)

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ID:IOTS Podcast @idiots-pod.bsky.social · 12/01/2026

…They’d be on high dose IV Amox/Cef, so wouldn’t switch to PO Amox before as I can’t get to 12g/d with oral admin. Does that make a difference? Who knows; but with 12g/d you’ll be getting T>MIC of almost 100%, even if they’ve got 6 kidneys and a dialysis machine up their backside. 2/3

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ID:IOTS Podcast @idiots-pod.bsky.social · 12/01/2026

I advocate for it whenever I can. POET regimens that made it into ESC 2023 guidance: -Linez + 1 of Amox, Moxi, Rif -Amox + 1 of Moxi, Rif So once I get to D10 I try to switch to 1 of those (the Moxi regimens only if the others can’t be done), and sometimes I’m successful. Before D10… 1/3

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ID:IOTS Podcast @idiots-pod.bsky.social · 12/01/2026

Yeah yeah we all know what to do with Penicillin Allergy BUT: what about cephalosporin allergy? Bet you don’t know what to do about that! Well this week’s episode can help! Listen below, or on your podcast app… #IDsky #Microsky #infection #allergy podcasts.apple.com/gb/podcast/i...

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129. Penicillin allergy 3: CEPH FAST

Podcast Episode · ID:IOTS - Infectious Disease Insight Of Two Specialists · 12/01/2026 · 56m

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ID:IOTS Podcast @idiots-pod.bsky.social · 31/12/2025

From a UK PoV, we’d use Fluclox as a default: Cefazolin is becoming more widespread post-SNAP and the recent papers re: Cefazolin CNS Penetration, but we’ve the most experience with ASP.

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ID:IOTS Podcast @idiots-pod.bsky.social · 28/12/2025

I tried to get Cotrim in S but Callum tier-blocked me.

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ID:IOTS Podcast @idiots-pod.bsky.social · 28/12/2025

Can’t disagree with that. It’s probably the next drug episode we’re doing. Thinking of titling it “why vancomycin isn’t crap even though everyone thinks it is”. Also wonder when Dalba’s off patent if we’ll all start ‘stat Dalba’-ing everyone we need to cover for MRSA and forget about the rest of it

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ID:IOTS Podcast @idiots-pod.bsky.social · 28/12/2025

I SAID IF YOU WERE AMERICAN TO SUB AZITHRO FOR CLARI GOD JONATHAN WHAT DID YOUR LAST PODCAST SLAVE DIE OF??!!

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