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Joseph Marcus @josephmarcusid.medsky.social · 04/10/2026

These are great, but I feel applying these to other studies in a formalized setting helps trainees better apply these principles to their own research

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Joseph Marcus @josephmarcusid.medsky.social · 04/10/2026

I love this idea! We are >95% RCTs at my center, which are great studies to discuss and apply to our practice. However, there are many additional lessons to apply to observational research.

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Joseph Marcus @josephmarcusid.medsky.social · 04/10/2026

Some strategies I’ve employed: 1) Suggesting an observational study for journal club at least once or twice a year 2) Recruiting fellows (for journals that allow) to co-review with me. For these, we each review article independently, compare our thoughts and discuss how article can be improved

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Joseph Marcus @josephmarcusid.medsky.social · 04/10/2026

A #IDSky question on Journal Club. The vast majority of articles we discuss are RCTs, while trainees (due to time constraints of training) participate generally in observational research. How to you practice with trainees critically appraising this type of research to improve their own projects?

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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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Joseph Marcus @josephmarcusid.medsky.social · 01/10/2026

The @idweek.bsky.social website still says TBD. However, if it is confirmed in Boston, there should be a raw oyster pro/con debate #IDSky

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Joseph Marcus @josephmarcusid.medsky.social · 01/10/2026

There were no specific ECMO ID talks, but lots of talks on related subjects To become an @theelso.bsky.social center of excellence, a center must demonstrate a commitment to QI in ECMO and teaming up with interested ID colleagues is a simple way to do that

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Joseph Marcus @josephmarcusid.medsky.social · 01/10/2026

My second #ELSO2026 and exciting to see all of the collaborators/thought leaders moving the field forward. Talking with clinicians at different centers, with the lack of evidence, practice patterns are drastically different and there is a need for #IDSky research in these critically ill patients.

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Joseph Marcus @josephmarcusid.medsky.social · 30/09/2026

PCT is a bad prognostic sign (as BALANCE study demonstrated as well) and should be interpreted with caution in ECMO as a sign of an infection #IDSky #ELSO2026

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Joseph Marcus @josephmarcusid.medsky.social · 30/09/2026

Important factor for #IDSky clinicians taking care of ECMO patients: ECMO is extremely pro-inflammatory and inflammatory markers should be interpreted with caution. #ELSO2026

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Joseph Marcus @josephmarcusid.medsky.social · 29/09/2026

Impressive talk about setting up an ECMO team at finish line of NYC marathon and Brooklyn half marathon where cardiac arrest happens too often. Luckily no one needed to be cannulated yet. #ELSO2026

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Joseph Marcus @josephmarcusid.medsky.social · 29/09/2026

Many considerations when dosing antimicrobials during ECMO considering; -Protein binding -Hydrophilic/Lipophilic medications -The pts underlying critical illness (likely the most important) #ELSO2026

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Joseph Marcus @josephmarcusid.medsky.social · 29/09/2026

The oldest patient in 🇯🇵 placed on ECMO at time of cardiac arrest (ECPR) to survive with a favorable neurological outcome? 90. Those age >75 have lower risk of favorable outcome, but may not be complete contraindication #ELSO2026

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Joseph Marcus @josephmarcusid.medsky.social · 28/09/2026

The authors argue that some patients may be able to get away with PO only, especially with significant side effects of high dose PO Trim/Sulfa Luckily don’t see much of this terrible disease in US, but demonstrates such a difficult ⚖️ of efficacy and side effects

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Joseph Marcus @josephmarcusid.medsky.social · 28/09/2026

In 🇦🇺, the treatment of meloidosis is 2-8 weeks of IV mero/ceftaz followed by 3-6 months of high dose PO Trim/Sulfa In single center RCT, comparing IV to IV+PO: -Less relapse in IV+PO (29% vs. 6%) -81%in PO hd ADR in Trim/Sulfa group requiring 5admissions (1 ICU)‼️ doi.org/10.1093/ofid... #IDSky

doi.org

Omitting the eradication phase of treatment of adults with melioidosis: a pilot, single-center, randomized control trial

Prolonged intravenous antibiotics alone will cure many patients with melioidosis, however some still require oral eradication therapy. The potential for re

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Joseph Marcus @josephmarcusid.medsky.social · 28/09/2026

Yes! Thank you for these fantastic points. Only 20% (~120 in each group) received 7 days of study drug with median 3 days in both groups.

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Joseph Marcus @josephmarcusid.medsky.social · 27/09/2026

How are people of #IDSky counseling their colleagues with the release of this paper?

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Joseph Marcus @josephmarcusid.medsky.social · 27/09/2026

There is a lot of talk off #IDSky about the @jamanetworkopen.com article about increased mortality in Cefepime. I highly recommend the editorial: -Difference is small (<1%) -Most studies before 2010 -Dosing/Breakpoints changes since trials -ACORN shows real 🌎safety jamanetwork.com/journals/jam...

jamanetwork.com

Cefepime Dosing and Mortality

Sohani et al1 report a systematic review and bayesian meta-analysis of 110 randomized clinical trials of cefepime vs other β-lactam antibiotics in 22 598 patients. Across all trials, they found a 94.4...

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Joseph Marcus @josephmarcusid.medsky.social · 20/09/2026

For those attending #IDWeek2026, you are invited to an #IDSky Social Media Meet-Up ⏰ Oct 22 8 PM-10:30 PM Place: Marriott Marquis Lobby Bar

IDWeek Social Media Meet-Up
October 22 from 8-10 PM ad the Lobby Bar of the Marriott Marquis

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Ilan Schwartz @germhuntermd.bsky.social · 17/09/2026

Less is more, ortho-ID edition Another game changer in ortho ID from the group that brought you OVIVA Pts with ortho infections who underwent curative surgery (no DAIR) with local implantation of abx were randomized to <=7d vs >=4w ABx No Dif in 12 mo relapse www.nejm.org/doi/full/10.... #IDSky

Forest plot with primary analysis results which shows no difference in definite treatment failure, definite/probable treatment failure, or definite/probable/possible treatment failure according to treatment duration

Forest plot showing subgroup analysis which shows no difference between shorter and longer duration antibiotics in any of the subgroups including prosthetic infection, Staph aureus mono infection, and whether local gentamicin was used in mono therapy or combination therapy

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Joseph Marcus @josephmarcusid.medsky.social · 16/09/2026

I will be there and look forward to catching up! Details on #IDSky meet-up to be released soon…

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Joseph Marcus @josephmarcusid.medsky.social · 14/09/2026

Antibiotics at end of life are such a challenging topic. Thank you for sharing.

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Patrick Crowley @pcrowleydo.bsky.social · 14/09/2026

Super excited for our research to get published. 20-50% of patients enrolled in hospice will get an antibiotic, and we have little understanding of the effects of these #IDSky #MedSky

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Joseph Marcus @josephmarcusid.medsky.social · 11/09/2026

Scary 🇮🇱 study evaluating measles outbreak by sequencing showing 3️⃣ importation events: 1️⃣ from 🇷🇺 (in highly vaccinated community), two secondary cases 2️⃣ from 🇻🇳 , no secondary cases 3️⃣ from 🇧🇪 , in religious community with low vaccination rates: 3k cases, 16 deaths wwwnc.cdc.gov/eid/article/...

wwwnc.cdc.gov

Genomic and Epidemiologic Insights into Ongoing Measles Outbreak, Israel, 2025–2026

Measles Outbreak, Israel, 2025–2026

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Joseph Marcus @josephmarcusid.medsky.social · 10/09/2026

Spinal ODRIs are up there as well…

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Joseph Marcus @josephmarcusid.medsky.social · 10/09/2026

A new #ECMOID review article describing the current state of affairs in ECMO infections: 🔥 🔥 🔥 Table 1: compares 4️⃣ society definitions and demonstrate minimal overlap in: -Syndromes considered ECMO-associated infections -Definition even when infection is agreed upon doi.org/10.1177/0885... #IDSky

doi.org

Infections in ECMO: A Comprehensive Review of the Epidemiology, Diagnosis, Management and Prevention - Erika R. O'Neil, Joseph Marcus, Aditya Shah, Graeme MacLaren, Ryan P. Barbaro, 2026

Extracorporeal membrane oxygenation (ECMO) provides life support for severe respiratory and cardiac failure, including failure from severe infection such as sep...

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Joseph Marcus @josephmarcusid.medsky.social · 10/09/2026

🤔In non-ECMO, ICU pts, AU is generally 50-60% of days! Even without ECMO-specific prophylactic protocols, most of our patients are on an antimicrobial on a given day. The best 🎯 for interventions at my center appears empiric therapy beyond 72 hours when cultures are negative

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Joseph Marcus @josephmarcusid.medsky.social · 10/09/2026

The most common empiric agent: Vanc 📊 The most common targeted agent: Vanc 📊 The most common anti fungal: Mica (75% of time targeting a culture) 📊

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Joseph Marcus @josephmarcusid.medsky.social · 10/09/2026

✅52% of AU was targeting a positive culture ❌28% of AU was empiric (given before cultures identified an organism or after cultures returned negative) ✅56% of empiric AU was within 72 hours of culture collection ❌❌❌43% of empiric AU was beyond 72 hours after culture collection

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Joseph Marcus @josephmarcusid.medsky.social · 08/09/2026

Blood banks screen with a PCR in 14 states, but not Nebraska or Texas

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Joseph Marcus @josephmarcusid.medsky.social · 08/09/2026

Well done 👏 It wouldn’t be in my top 10 guesses

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Joseph Marcus @josephmarcusid.medsky.social · 07/09/2026

Some surprising #IDSky trivia: What is the most common transfusion-transmitted pathogen in the 🇺🇸?

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Joseph Marcus @josephmarcusid.medsky.social · 07/09/2026

Very timely to review with POET2 out. Excited for this episode

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Joseph Marcus @josephmarcusid.medsky.social · 06/09/2026

Such important data and so exciting that a CID was written by a med student first author 👏

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Patrick Ching @patrickching.bsky.social · 01/09/2026

Swimming 🏊 in lakes & rivers is associated with ⬆️risk of skin disease & GI illness. Swimmers compared to those who only stood on the shore had 1.8x higher risk of GI illness and 2.2x higher risk of skin ailment such as rash or itching #IDSky #GISky #DermSky www.sciencedirect.com/science/arti...

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Joseph Marcus @josephmarcusid.medsky.social · 03/09/2026

I feel like this is a conversation that happens at every institution this time of year.

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