iiinova — where your digital self keeps evolving

Jonathan Ryder, MD @jonathanrydermd.bsky.social · 13/09/2026

PDF is available! Its not formatted and its hard to find, but if you scroll down there are several links to the individual sections and each has a PDF link (e.g., where it says "Executive Summary" below) www.idsociety.org/globalassets...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 12/09/2026

I had a hard time believing the conclusions from the graphical abstract, but then I realized that it looks like all the outcomes are switched from what is actually reported in the paper

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 07/09/2026

This is demonstrated by the fact that they didn't find the tailored therapy arm to have demonstrably less adverse events. Perhaps if this was quite a bit less, then there might be something to weigh in the balance of relapse

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 31/08/2026

I agree, always a concern. However, the outcomes were at 6 months with only about 2 weeks difference in therapy, so that may wash that out a bit. The other thing is the K-M curves showed a lot of early relapses in the shorter therapy arm, which is not seen in standard arm. This concerned me

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 29/08/2026

POET II RCT is out now in @nejm.org, assessing antibiotic duration in endocarditis! "Response-tailored" vs standard durations in Staph, Strep & Enterococci n=502 Response tailored with 13d less antibiotics, similar composite safety but higher relapse #IDSky www.nejm.org/doi/abs/10.1...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 28/08/2026

This was a new one for me at today’s NE ID Conference: Emerging fungal infection in turtles/tortoises called Emydomyces testavorans One treatment option is terbinafine baths The more you know… @germhuntermd.bsky.social @fungaldoc.bsky.social

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 28/08/2026

So excited to be at the 2026 Nebraska ID Conference today. Have already heard from IDSA President-Elect Wendy Armstrong and NE DHHS HAI Director Salman Ashraf. Now NE State Epidemiologist Sydney Stein discussing measles lessons learned. #IDSky

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 04/08/2026

New RCT from @nejm.org Evidence: PO Vanc x10 d VS PO Vanc Taper/Pulse VS Fidaxomicin for 1st or 2nd Recurrence of CDiff (n=308) Day 59 sustained clinical response: Vanc TP: 58.6% vs Vanc x10: 44.1% vs Fidaxo: 44.1% (p>0.0255 = not significant) #IDSky #CDiff evidence.nejm.org/doi/full/10....

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 04/08/2026

New in @jamanetworkopen.com from BrighT STAR Collaborative: Diagnostic stewardship via clinical decision support in pediatric endotracheal aspirate Cx's associated with 16% reduction in cultures, but no change in antibiotics. No safety concerns identified pubmed.ncbi.nlm.nih.gov/42536370/

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 23/07/2026

Come join us at the 2026 Nebraska ID Conference! Have an amazing speaker panel, 3 different tracks (stewardship, long term care, and NIDS), and posters from trainees! www.eventbrite.com/e/2026-nebra...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 21/07/2026

Evidence from Mexico that Ceftriaxone is an effective alternative to IV penicillin for neurosyphilis in PLWH Prospective data would be so helpful for this, as we need better alternatives (ideally something PO) #IDSky academic.oup.com/ofid/article...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 19/07/2026

Registry of 38 patients with autoantibodies against interferon-gamma in Hong Kong Primarily had disseminated mycobacterial infections, but also Salmonella and Talaromyces Patients who received rituximab had better outcomes

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 21/06/2026

Not all apples to apples. Editorial for this piece with a nice summary of available evidence for fosfomycin academic.oup.com/cid/advance-...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 21/06/2026

Happy Father's Day!! I finally found some Honduran coffee in Omaha to help celebrate @josephmarcusid.medsky.social @drrossanarosa.bsky.social

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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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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 29/05/2026

For the non-Spanish readers, I put the images in Google translate (expected caveats)

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 18/05/2026

Usual care with no virus detected was 45% whereas intervention with no virus detected was 61%

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 13/05/2026

At least 5 years. I don't think its wrong to save a lot of money by any means, just make sure you upgrade your membership soon thereafter!

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 28/04/2026

There is a whole culture of tailgaiting. My favorite team (KC Chiefs) is particularly notorious/famous for their tailgates. Lots of food and beverages, even very early in the morning lol. Representative pics attached :)

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 13/04/2026

This is pretty cool handiwork in EPIC for discharge stewardship!

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 11/04/2026

Hard to leave Chicago without some deep dish!

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 11/04/2026

That’s a wrap on #SHEASpring2026! Was so nice to catch up with so many fellow stewies & epis this week! Chicago was chilly but I was pleasantly surprised overall Was a great opportunity to share a poster on BCx stewardship and give a talk on QI for BCx stewardship! @sheaepi.bsky.social

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 10/04/2026

Yes this has our order set we use! Not sure it totally addresses your question though

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 10/04/2026

So excited for this paper to be released during #SHEASpring2026! Was so great working with Dr. Sarah Turbett on this piece. “Mindful Diagnostics: A CNS Infection Case Study” We dive into MEP, Karius, and CSF metagenomics diagnostic stewardship! #IDSky www.cambridge.org/core/journal...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 09/04/2026

More foodie adventures in Chicago, this time at Russian Tea Time

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 08/04/2026

Maybe we should just get rid of sinks entirely…water-free patient care

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 08/04/2026

Sinks, ice machines, and toilets all serve as likely reservoirs

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 08/04/2026

De-implementation for blood cultures

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 05/04/2026

Starting off with a classic Penicillin cocktail…seems fitting. The Purple Pig is 5 min from the SHEA Spring hotel, highly recommend!

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 18/03/2026

New target trial emulation study in @cmijournal.bsky.social comparing monotherapy (mostly amp) to combo (mostly amp with CRO or gent) for Enterococcus faecalis BSI (not endocarditis). Composite outcome similar between mono & combo #IDSky www.clinicalmicrobiologyandinfection.org/article/S119...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 15/03/2026

Comparison of differing pathogens using the Wilson-Jungner Criteria for asymptomatic carriage

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 12/03/2026

Excited to share a SoMe ID community that I'm helping build as one of their Founding Physicians: Roon The ID community is launching today. The fragmentation between X and BlueSky has hurt ID social media. I hope this medically focused SoMe will improve this connection and collaboration Join below!

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 23/02/2026

Is one dose of PenG or 28-days doxycycline adequate for late/unknown syphilis? This study is encouraging! @drmichaelmarks.bsky.social

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 22/02/2026

New from @cidjournal.bsky.social and Mayo Clinic, a modern cohort of Legionella PNA: 344 adults with Legionella (85% L pneumophila) 1/3rd ICU, 1/8 died at 30 days Urine Ag only + test in 42.4%, but among those with +PCR/Cx, UAg+ in only 25.6% #IDSky #Legionella academic.oup.com/cid/advance-...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 14/02/2026

Nice study from Mayo group on FUBCs in Strep BSI Higher positivity with S. anginosus & VGS than with BHS/SPN as well as deep-seated infxns, but not immunocompromised #IDSky #BCxStewardship academic.oup.com/ofid/advance...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 01/01/2026

Happy New Year! Don't forget to check your belly button for ticks this next summer! #IDSky www.nejm.org/doi/full/10....

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 16/12/2025

smh That said, I've found many FDA black box warnings to be not very helpful. For example, this one on metronidazole (good thing we aren't prescribing it to mice/rats):

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 11/12/2025

94-98%. Depends on the stage of syphilis. The real question I have is do we need probenecid? Can we just do amox 1g TID (or QID)? Seems like 1g TID for early syphilis is probably reasonable. A bit less promising for late syphilis, although only 7 patients per arm academic.oup.com/cid/article/...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 12/11/2025

Oral watermelon and RIF with rectal INH, ethambutol and/or enrofloxacin for 12-18 months? Very interesting article. Apparently costs $20K per elephant per year and the elephants didn't like it much pmc.ncbi.nlm.nih.gov/articles/PMC...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 11/11/2025

Is this a weight loss drug mediated via an ungulate virus? #IDSky #IYKYK #Orf

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 27/10/2025

This study was very nice to illustrate differences in rates of Pseudomonas DFI in differing parts of the US. Here in Nebraska, it must be the right mixture of cold and dry, very very low rates of PsA in DFI. And this study matches our local data almost exactly academic.oup.com/ofid/article...

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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 25/10/2025

Just watched the session on sepsis today and its a great preview of a future replacement for SEP-1 that's been submitted to CMS as well as a guidance document for best practices in sepsis that is coming out from an IDSA committee

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