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José Molina

@josemolinagb.bsky.social
1.7K followers 787 following 193 posts

ID doc & Antibiotic Steward • • Clinical trials and #FOAMed believer • ESCMID Guidelines Subcommittee. Now on @shorten2trial.bsky.social #AMSsky #IDSky #AMR Hospital Virgen del Rocío • Seville, Spain 🇪🇸

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Reposted by José Molina
Insolac Caja 87 Baloncesto @caja87.bsky.social · 11/10/2026
¡¡Final!! Enorme victoria del #Caja87 ante Partizán de Fuenlabrada. Con esta intensidad la temporada será muy bonita
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Angela Huttner @angelahuttner.bsky.social · 07/10/2026
Happy to confirm: attendees receive 16 European CME credits Malta, 19-21 Nov 😊 Great faculty (@gurujosh.bsky.social @steventong.bsky.social David Paterson, others) Register www.escmid.org/event-detail... Organized by @clarityinitiative.bsky.social @cmicomms.bsky.social @escmid.bsky.social #IDSky
Screenshot of the postgraduate education course flyer with the title of the course "Clinical trials: from generating the initial idea to reporting final results and everything in between" and a pretty picture of Valletta from the sea
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José Molina @josemolinagb.bsky.social · 03/10/2026
Winter is coming… #AMSsky
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Reposted by José Molina
SHORTEN-2 trial @shorten2trial.bsky.social · 03/10/2026
The OPTIMISE trial aimed to test 7 vs 14 days for treating MDR infections in ICU patients. Although underpowered due to early stop, no signal of inefficacy was observed for short treatments Pseudomonas were underrepresented in this trial 🙁 link.springer.com/article/10.1... #AMSsky #IDsky #PsWatch
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ESCMID @escmid.bsky.social · 03/10/2026
⚖️ Join this online course to discuss real-world challenges in clinical practice, research, antimicrobial stewardship, One Health and infection control. This is part of the ESCMID AMS Certificate Programme with limited spots left. 💡Register today: ow.ly/xFLN50ZCmYJ
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José Molina @josemolinagb.bsky.social · 03/10/2026
#AMSsky
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Ilan Schwartz @germhuntermd.bsky.social · 02/10/2026
Shorter is also better in ICU patients Timsit, Roberts, @angelahuttner.bsky.social, Daneman &c State-of-the-Art in AJRCCM @atsblueeditor.bsky.social For most ICU patients with (suspected) infections, abx can be 🛑 at 5-7d w clinical improvement academic.oup.com/ajrccm/advan... #IDSky #CritCareSky
Duration of antibiotic therapy in sepsis and severe infections in critically ill patients decision pathway. 

Day 1 empiric therapy: sampling (culture) before therapy, clinical exams, consider alternate diagnosis;

48-72h Tailor treatment and switch to targeted therapy where possible, PK optimization, source control

Indications for extended courses: endocarditis (4-6 weeks), brain abscess (6-12 weeks), spondylodiscitis (6-12w), prosthetic joint infection (6-12 w), incomplete removal abscess, empyema, retained prosthesis: individualized

Day 5-7: 

if Patients NOT responding or positive cultures: reassess treatment, individualize according to source control, immune status, high risk microbiology (S aureus, candida), possible suboptimal therapy (MDR), intravascular devices, ? role of serial PCT for stopping early questioned

if Clinical improvement: STOP antibiotics
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José Molina @josemolinagb.bsky.social · 30/09/2026
Bad news for patients with MDR infections… Merck has announced that imipenem/relebactam supply will be discontinued in US by the end of September. Guess this will extend to Europe soon? We definitely need new payment models for antibiotics 🙁 www.cidrap.umn.edu/antimicrobia... #IDsky #AMSsky #AMR
Source: https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Imipenem%20Anhydrous%2C%20Cilastatin%2C%20and%20Relebactam%20Anhydrous%20Injection&st=d
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Clinical Microbiology and Infection @cmijournal.bsky.social · 28/09/2026
📣 In the October 2026 issue: The @escmid.bsky.social framework for reaching consensus in clinical guidelines www.clinicalmicrobiologyandinfection.org/article/S119... #IDSky #MicroSky
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José Molina @josemolinagb.bsky.social · 28/09/2026
😉 bsky.app/profile/jose...
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Angela Huttner @angelahuttner.bsky.social · 09/09/2026
Hi Gabriele! Guess what- with @germhuntermd.bsky.social & quite a few others, we are gearing up to launch an #IDjournalclub on Bsky and it looks like this paper is the one we'll start with. 😊 We will get that going soooon!! (Also, Communicable will work on a follow-up POET2 ep!) #IDSky #MedSky
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José Molina @josemolinagb.bsky.social · 20/09/2026
So, I think there still is a safe way for cefepime in clinical practice: ✅ Limited to patients with normal renal function. ✅ As empirical treatment for non-severe cases. ✅ As targeted therapy for low-MIC isolates. Extended-infusion and TDM would probably help in many cases! 🧵(5/5) #IDsky #AMSsky
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José Molina @josemolinagb.bsky.social · 20/09/2026
The role of anaerobicidal-sparing agents like cefepime could be important in sepsis or immunocompromised hosts with immunotherapy. We are learning how anaerobic microbiota may influence survival, toxicity or cancer response 🧵(4/5) 📚 www.thelancet.com/journals/lan... 📚 ascopubs.org/doi/10.1200/...
thelancet.com
Empirical antibiotic therapy for sepsis: save the anaerobic microbiota
Antibiotics are fundamental in sepsis management; however, the optimal empirical treatment remains debated. Despite anaerobes rarely being the causative pathogen of sepsis, antibiotics targeting them ...
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José Molina @josemolinagb.bsky.social · 20/09/2026
We also have the efficacy question. In my center we use EUCAST for susceptibility testing, whose MIC breakpoints are more restrictive than CLSI’s. So, we use cefepime just for strains with lower MICs than our american colleagues, probably favoring PK/PD target achievement 🧵 (3/5) #IDsky #AMSsky
Table extracted from: https://www.mdpi.com/1424-8247/19/2/283
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José Molina @josemolinagb.bsky.social · 20/09/2026
Neurotoxicity is definitely an issue for cefepime. But I find it to be very rare among patients with normal renal function and no prior seizure-predisposing conditions. This association was already established in previous metaanalyses 🧵(2/5) academic.oup.com/jac/article/... #IDsky #AMSsky
academic.oup.com
Cefepime-induced neurotoxicity: systematic review
AbstractBackground. Cefepime-induced neurotoxicity (CIN) has been well acknowledged among clinicians, although there are no clear diagnostic criteria or sp
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José Molina @josemolinagb.bsky.social · 20/09/2026
I find cefepime very useful to diversify empiric antipseudomonal treatments among immunocompromised hosts, and as a carbapenem-sparing agent against ampC producers. This recent metaanalysis made me wonder if I should stop using it… 🧵(1/5) jamanetwork.com/journals/jam... #IDSky #AMSsky #IDOnc
jamanetwork.com
Cefepime and Mortality
This systematic review with bayesian meta-analysis of randomized clinical trials examined the association of cefepime with all-cause mortality compared with other β-lactam antibiotics.
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José Molina @josemolinagb.bsky.social · 17/09/2026
So timely! 🤩
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Reposted by José Molina
ADVANcing Clinical Evidence in Infectious Diseases (ADVANCE-ID) @advance-id.bsky.social · 14/08/2026
Demystify clinical trial design & enhance your research toolkit!📊✨ Join our statistical seminars supported by @advance-id.bsky.social & @who.int Explore clinical trial theory & real-life examples with global experts. Master the numbers in the mission against disease here: ad-id.co/stats
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José Molina @josemolinagb.bsky.social · 14/09/2026
Thanks for the quick feedback!
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Reposted by José Molina
Catherine Berry (she/her) @catherineberry.bsky.social · 14/09/2026
This was what was developed in response to the conference presentation which coincided with our flu season. livingevidence.org.au/influenza/
livingevidence.org.au
Influenza - Australian Living Evidence Collaboration
More information coming soon
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José Molina @josemolinagb.bsky.social · 14/09/2026
Thanks so much, @catherineberry.bsky.social, this resource is so helpful! 🤩 Do you keep the recomendation for using oseltamivir in non-critical hospitalized patients for severe influenza and high-risk outpatients?
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José Molina @josemolinagb.bsky.social · 13/09/2026
Preprint of REMAP-CAP trial on oseltamivir for critical patients is now available: papers.ssrn.com/sol3/papers.... With this new trial + 2 recent metaanalyses failing to prove benefits in outpatients nor hospitalized, how is your center positioning oseltamivir for this flu season? #IDsky #PulmSky
papers.ssrn.com
Oseltamivir for Critically Ill Patients with Influenza: A Randomised Trial
​Background: The antiviral oseltamivir is widely used for the treatment of critically ill patients with influenza. Evidence from randomised trials about its eff
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José Molina @josemolinagb.bsky.social · 13/09/2026
Preprint of REMAP-CAP trial on oseltamivir for critical patients is now available: papers.ssrn.com/sol3/papers.... With this new trial + 2 recent metaanalyses failing to prove benefits in outpatients nor hospitalized, how is your center positioning oseltamivir for this flu season? #IDsky #PulmSky
papers.ssrn.com
Oseltamivir for Critically Ill Patients with Influenza: A Randomised Trial
​Background: The antiviral oseltamivir is widely used for the treatment of critically ill patients with influenza. Evidence from randomised trials about its eff
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Juan E. Losa @juanelosag.bsky.social · 11/07/2026
Sobre la importancia de programas específicos de optimización de antibioterapia (PROA) en oncología… jamanetwork.com/journals/jam...
jamanetwork.com
Antibiotic Selection for Patients With Cancer Hospitalized With Infection
This secondary analysis of the 4 Intelligent Stewardship Prompts to Improve Real-Time Empiric Antibiotic Selection (INSPRE) cluster randomized clinical trials evaluates the association of computerized...
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Reposted by José Molina
ASHE Journal @ashejournal.bsky.social · 14/07/2026
Part 1 of a two-part series on outpatient antimicrobial stewardship interventions in immunocompromised patients: what has been studied, what are barriers to implementing interventions in this group, and how ASPs might overcome these challenges. doi.org/10.1017/ash....
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José Molina @josemolinagb.bsky.social · 12/07/2026
Remdesivir and a monoclonal antibody (MBP134) will be tested against SOC. www.who.int/news/item/02... #IDsky Amazing PARTNERS initiative. Being able to run an adaptive platform trial in this situation is so needed and yet so impressive. Hats off for the team! @who.int
who.int
Patient enrolment begins in a scientific trial to identify the first effective treatments for Bundibugyo virus disease
In a major international effort to evaluate potential treatments for Ebola disease due to Bundibugyo virus (BVD), the PARTNERS clinical trial has opened enrolment today for patients in the Democratic ...
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José Molina @josemolinagb.bsky.social · 12/07/2026
A (not so) new kid on the block! Temocillin proved non-inferior to carbapenems against 3GR-Enterobacterales. Hope to see this old drug widely available in Europe soon! 🤞🏻 www.thelancet.com/journals/lan... #AMSsky #IDsky
thelancet.com
Temocillin versus carbapenems for bacteraemia due to third-generation cephalosporin-resistant Enterobacterales in Spain (ASTARTÉ): a multicentre, phase 3, open-label, non-inferiority, randomised clini...
In patients with bacteraemia caused by 3GCR-E, temocillin was non-inferior to carbapenems as targeted treatment. These findings support the use of temocillin as an effective and safe alternative to ca...
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Reposted by José Molina
Quique Carús @quiquecarus.bsky.social · 09/07/2026
c.org/NjjyxpJb68
c.org
Firma la petición
Creación especialidad enfermedades infecciosas como en el resto de la Unión Europea ¡YA!
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Gabriele Pollara @gpollara.bsky.social · 09/07/2026
Disappointing data on meningitis vaccine preventing Neisseria gonorrhoea infections Then again negative trial data is as useful as positive findings, so that we focus resources most effectively #IDSky www.nejm.org/doi/full/10....
nejm.org
Meningococcal B Vaccine to Prevent Neisseria gonorrhoeae Infection | NEJM
No vaccines are currently licensed for the prevention of Neisseria gonorrhoeae infection. Observational studies suggest that the four-component meningococcal serogroup B vaccine (4CMenB) may reduce...
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José Molina @josemolinagb.bsky.social · 07/07/2026
Nurses boost AMS! #UTIsky #AMSsky
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José Molina @josemolinagb.bsky.social · 07/07/2026
Immunocompromised hosts should not be excluded from duration trials. The question is how we can safely incorporate them into these studies to generate the evidence we need. Our editorial in @cmijournal.bsky.social is freely available here: 🔓 authors.elsevier.com/a/1nOm-,RGPg... #IDsky #TxID #IDOnc
authors.elsevier.com
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id-journal.bsky.social @id-journal.bsky.social · 07/07/2026
EcoRxChoice 🌍💊 lets users compare plastic waste from antimicrobial regimens, promoting eco-friendly prescribing. Supported by SIDP to boost sustainable antimicrobial stewardship.
cambridge.org
EcoRxChoice.com— an SIDP-funded calculator integrating environmental metrics with antimicrobial stewardship
View abstract Healthcare sustainability is a multidisciplinary field that seeks to mitigate healthcare’s environmental consequences. Antimicrobial stewardship and healthcare sustainability both aim to reduce wasteful resource use while maximizing patient safety. However, a strong partnership between antimicrobial stewardship and healthcare sustainability has yet to develop. To facilitate environmentally sustainable decision-making in antimicrobial prescribing, we developed a web-based calculator (EcoRxChoice (www.ecorxchoice.com)) where users can enter different antimicrobial regimens and compare how much plastic waste each regimen creates. This work was supported in part by the Society of Infectious Diseases Pharmacists (SIDP), reflecting SIDP’s commitment to strengthening sustainability as a practical extension of antimicrobial stewardship and empowering infectious disease pharmacists to make measurable environmental impact through evidence-based care.
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Clinical Microbiology and Infection @cmijournal.bsky.social · 06/07/2026
🌟 The 2025 JCR Impact Factor for CMI has risen to 8.7! We thank our editors, reviewers, authors and readers for their dedication and extraordinary work. Read about how CMI did in 2025 here: clinicalmicrobiologyandinfection.org/article/S119... #IDSky #MicroSky #JIF #JCR2025
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NEJM.org @nejm.org · 01/07/2026
𝐍𝐞𝐰 𝐢𝐧 𝑵𝑬𝑱𝑴 𝑪𝒂𝒕𝒂𝒍𝒚𝒔𝒕 𝑰𝒏𝒏𝒐𝒗𝒂𝒕𝒊𝒐𝒏𝒔 𝒊𝒏 𝑪𝒂𝒓𝒆 𝑫𝒆𝒍𝒊𝒗𝒆𝒓𝒚! HealthPartners’ Antimicrobial Stewardship Program demonstrates the potential of centralized complex outpatient antibiotic therapy programs to optimize patient care. Learn more: nej.md/4uEs79k Explore the July issue: nej.md/3QMDUo2
The image depicts an illustration related to an article published in NEJM Catalyst Innovations in Care Delivery. It shows three figures walking along winding paths that connect platforms labeled with the medical hospital symbol. The figures navigate a complex network, symbolizing the coordination of outpatient antibiotic therapy programs.
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Steven Tong @steventong.bsky.social · 27/06/2026
We are genotyping and phenotyping the SNAP MSSA isolates for cefazolin inoculum effect. So we can look at cefazolin vs ASPs (randomized) treatment effect in CIE+, and compare to that in CIE-. I estimate several hundred (prob >400) in each CIE group.
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ACCP ID PRN @accpinfdprn.bsky.social · 26/06/2026
Looking for a new antimicrobial stewardship metric? 👀 Authors from the VA have proposed a new "S3" option, which assesses the initiation, spectrum, and duration of therapy. 📖 Read more here academic.oup.com/cid/advance-... #AntimicrobialStewardship
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Andy Conway Morris @andymoz78.bsky.social · 23/06/2026
The implications of this work is that we need look into body compartments to understand the inflammatory responses and can't simply rely on blood. Further, we need to tailor our treatments to the mechanisms identified- a simple "pneumonia=treatment X" is not going to work.
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Andy Conway Morris @andymoz78.bsky.social · 23/06/2026
Great to see our new paper out in Nature Communications. In it we describe three novel phenotypes in lungs of patients with pneumonia. Pn1 -a non-neutrophil driven lung injury phenotype, Pn2-a balanced immune response with best recovery and Pn3-persistent inflammation driven by immature neutrophils
rdcu.be
Pulmonary inflammation in severe pneumonia is characterised by compartmentalised and mechanistically distinct sub-phenotypes
Nature Communications - Analysis of cell samples from pneumonia patients may indicate specific phenotypes associated with disease. Here the authors use a multi-omics approach to analyse...
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John Ross @johnrossmd.bsky.social · 23/06/2026
Good news: C difficile diarrhea cases are decreasing in hospitals due to decreased antibiotic use Bad news: C difficile is increasing in the community, possibly due to widespread use of antibiotics in agriculture #IDSky
academic.oup.com
Validate User
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José Molina @josemolinagb.bsky.social · 23/06/2026
The OASIS RCT comparing olorofim vs amphotericin B for azole-resistant aspergillosis met its primary endpoint of non-inferiority for mortality (23% vs 24%), with fewer AEs (36% vs 64%), according to company report: www.shionogi.com/global/en/ne... Looking forward to the publication! #IDsky #IDOnc
shionogi.com
F2G and Shionogi Announce Positive Topline Results from Global Phase 3 OASIS Study Evaluating Oral Olorofim Versus AmBisome® Followed by Standard of Care in Patients with Invasive Aspergillosis
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José Molina @josemolinagb.bsky.social · 23/06/2026
Bringing #AMR into the outcome assessment of duration trials with the new DOOR-FRAME is very welcome! Larger samples and systematic AMR assessment among participants will be likely required to prove benefit academic.oup.com/ofid/article... #IDSky #AMSsky Awesome work by @seanong.bsky.social et al
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Nature Portfolio @natureportfolio.nature.com · 23/06/2026
Plastic pollution is pervasive across ecosystems. A Review in Nature Reviews Biodiversity summarizes current evidence on plastic exposure pathways, organismal responses and potential effects at higher levels of biological organization. go.nature.com/3QsA6rS 🌎🧪
This is figure 1, which shows the interactions of plastic with biodiversity.
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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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José Molina @josemolinagb.bsky.social · 21/06/2026
Antimicrobial Stewardship [vol.2] already running! Did we miss someone? 😉 #AMSsky #IDsky #MicroSky #PharmSky go.bsky.app/2qsEveQ
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José Molina @josemolinagb.bsky.social · 20/06/2026
In my view, fosfomycin may be that antibiotic slightly less effective but so more convenient in so many ways (oral route, unbeatable dosing, broad spectrum with low ecological impact...) Now we have data from many RCTs to better inform and engage patients in shared decission-making! #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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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 · 19/06/2026
How could we define the best treatment duration for immunocompromised hosts? Happy to share our perspective in this editorial in @cmijournal.bsky.social, building on the recent BALANCE subanalysis for this vulnerable population www.sciencedirect.com/science/arti... #AMSsky #TxID #IDOnc #IDsky
sciencedirect.com
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Contagion® @contagionlive.bsky.social · 18/06/2026
The #FDA has approved #tebipenem pivoxil the first oral carbapenem antibiotic in the US for adults with complicated urinary tract infections. #IDsky #Medsky www.contagionlive.com/view/fda-app...
contagionlive.com
FDA Approves Tebipenem Pivoxil as First Oral Carbapenem For Complicated Urinary Tract Infections | Contagion Live
The FDA has approved tebipenem pivoxil (Utebzi), the first oral carbapenem antibiotic in the US for adults with complicated urinary tract infections (cUTIs), including pyelonephritis, providing an eff...
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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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