iiinova — where your digital self keeps evolving

Reposted by Lina Meng, PharmD

IDSA @idsainfo.bsky.social · 22/05/2026

ID Pharmacists play an essential role in health systems. This #IDPharmacistsDay, learn five ways that pharmacists are being #AntibioticsAware via SIDP. For more sharable resources, visit sidp.org/AMSToolkit.

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Reposted by Lina Meng, PharmD

ASHE Journal @ashejournal.bsky.social · 02/02/2026

Gut check: This review highlights stewardship opportunities in intra-abdominal infections, focusing on SBP prophylaxis, antibiotic management of biliary infections and appendicitis, and optimizing amoxicillin-clavulanate and metronidazole dosing. doi.org/10.1017/ash....

doi.org

Gut check: antimicrobial stewardship opportunities in intra-abdominal infections | Antimicrobial Stewardship & Healthcare Epidemiology | Cambridge Core

Gut check: antimicrobial stewardship opportunities in intra-abdominal infections - Volume 6 Issue 1

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Reposted by Lina Meng, PharmD

ASHE Journal @ashejournal.bsky.social · 27/01/2026

Creating an advanced practice provider-led Complex Outpatient Antimicrobial Therapy program at our institute improved post-discharge follow-up, strengthened outpatient antimicrobial monitoring and supported timely outpatient interventions for patients with complex infection. doi.org/10.1017/ash....

doi.org

Can implementation of a complex outpatient antimicrobial therapy program reduce readmissions for patients with bone and joint infections? | Antimicrobial Stewardship & Healthcare Epidemiology | Cambridge Core

Can implementation of a complex outpatient antimicrobial therapy program reduce readmissions for patients with bone and joint infections? - Volume 6 Issue 1

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Reposted by Lina Meng, PharmD

Open Forum Infectious Diseases @ofidjournal.bsky.social · 26/01/2026

Feeling the Vibes: An Investigation into Resident Antibiotic Prescribing Practices ✅ Just Accepted 🔗 bit.ly/4ablBjg

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Reposted by Lina Meng, PharmD

Stanford Medicine, Infectious Diseases @stanford-med-id.bsky.social · 05/12/2025

A warm welcome to our new fellows! We are thrilled to have you on our team, here’s to an exciting journey ahead! Welcome to Stanford ID! #WelcomeFellows #InfectiousDiseases

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Reposted by Lina Meng, PharmD

Stanford Antimicrobial Safety & Sustainability Program @stanfordasp.bsky.social · 23/10/2025

🩺 Clinically, identifying a lactose fermenting GNR is particularly useful for ruling out Pseudomonas. ⚠️ Many non-lactose fermenters (especially Stenotrophomonas, Burkholderia, and Acinetobacter) can be very challenging to treat. ID consultation should be considered for invasive infections.

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Reposted by Lina Meng, PharmD

Stanford Antimicrobial Safety & Sustainability Program @stanfordasp.bsky.social · 15/10/2025

🌟 ABX Pearl of the Day: ❓ Q: When should I empirically cover for Pseudomonas aeruginosa in diabetic foot infections (DFIs)? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

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Reposted by Lina Meng, PharmD

Stanford Antimicrobial Safety & Sustainability Program @stanfordasp.bsky.social · 24/09/2025

🌟 ABX Pearl of the Day: ❓ Q: Candida only grew in 1/4 bottles. Is this a contaminant? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

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Reposted by Lina Meng, PharmD

Marisa Holubar, MD MS FIDSA @marisa-holubar.bsky.social · 24/09/2025

Yay! Tara's our awesome ASP track fellow this year - so lucky to get to work with her! @stanfordasp.bsky.social @linameng.bsky.social @dhpharmd.bsky.social @polishmd.bsky.social

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Lina Meng, PharmD @linameng.bsky.social · 18/09/2025

Risks of ABX overuse greater than benefit? 🤔

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Lina Meng, PharmD @linameng.bsky.social · 18/09/2025

The same treatment was associated with negative outcomes, including increased hospital readmissions, transfers to the ICU, and longer hospital stays. 🏥

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Lina Meng, PharmD @linameng.bsky.social · 18/09/2025

The outcome: After adjustment, empiric broad-spectrum antibiotic treatment was not associated with a lower mortality rate. 🚫

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Lina Meng, PharmD @linameng.bsky.social · 18/09/2025

🔎 The findings: In 2,706 moderately ICH patients with pneumonia, MRSA and resistant GNB were rare, found in just 3.5% of cases. 📉

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Lina Meng, PharmD @linameng.bsky.social · 18/09/2025

Is empiric MRSA and PsA coverage needed for all moderately ICH with pneumonia? A recent study in CID offers a data-driven look. So what to do? Check out our ABX pearl on which ICH patients are best candidates for expanded empiric ABX coverage in CAP. ✅ #amssky #Idsky #medsky #pharmsky

academic.oup.com

Target Trial Emulation of Empiric Antibiotics on Clinical Outcomes in Moderately Immunocompromised Patients Hospitalized With Pneumonia

Empiric broad-spectrum antibiotic use for moderately immunocompromised patients without risk factors for multidrug-resistant organisms was associated with

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Reposted by Lina Meng, PharmD

Stanford Antimicrobial Safety & Sustainability Program @stanfordasp.bsky.social · 10/09/2025

🌟 ABX Pearl of the Day: ❓ Q: My immunocompromised patient is admitted to the ICU and starting ABX for presumed CAP. Do they need empiric MRSA and Pseudomonas coverage? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

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Reposted by Lina Meng, PharmD

Stanford Antimicrobial Safety & Sustainability Program @stanfordasp.bsky.social · 17/09/2025

🌟 ABX Pearl of the Day: ❓ Q: My patient is growing yeast in blood cultures. Is this Candida? #IDsky #medsky #meded #pharmsky #skyRX #AMSsky

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Lina Meng, PharmD @linameng.bsky.social · 25/07/2025

Check this-CLSI eliminated gentamicin as tx option for PsA. "Review of modern PK/PD) data against members of the Enterobacterales and P. aeruginosa demonstrated: • No safe aminoglycoside dosing regimen was predicted to achieve bacterial 1- or 2-log killing, regardless of the breakpoint applied."

clsi.org

2023 AST: CLSI M100 ED33 Updates | News | CLSI

Learn about updated aminoglycoside breakpoints in CLSI M100, Edition 33, for key pathogens.

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Reposted by Lina Meng, PharmD

Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 17/07/2025

🔥Finally published🔥 IDSA Guidelines on the Treatment and Management of Complicated Urinary Tract Infections (cUTI) #idsky www.idsociety.org/practice-gui...

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Lina Meng, PharmD @linameng.bsky.social · 23/05/2025

I'm hoping it's because they were super users at baseline 🤓

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Lina Meng, PharmD @linameng.bsky.social · 22/05/2025

Implementing microlearning via ABX Pearls emailed to clinicians and trainees weekly at our hospital. 81% reported an impact on their practice, across multiple stewardship domains. 👇🏻 Library here: med.stanford.edu/bugsanddrugs... #IDPharmacistsDay #medEd #AMSsky

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Lina Meng, PharmD @linameng.bsky.social · 22/05/2025

Hi! Lina here from Stanford, CA. I love working with the innovative, bright, open-minded ASP team here @stanfordasp.bsky.social and learning from amazing, dedicated pharmDs/MDs nationally that have propelled ABX stewardship forward tremendously in recent years. #IDpharmacistsday

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Reposted by Lina Meng, PharmD

Sean Ong @seanong.bsky.social · 10/04/2025

Excited to share our newest paper from my PhD: a post-hoc analysis of the BALANCE trial where we explored heterogeneity of treatment effect (HTE) in duration of antibiotic treatment for patients with bloodstream infection. A thread: doi.org/10.1016/j.ec... #IDSky @eclinicalmed.bsky.social

doi.org

Redirecting

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Reposted by Lina Meng, PharmD

Stanford Antimicrobial Safety & Sustainability Program @stanfordasp.bsky.social · 18/04/2025

🌟 ABX Pearl of the Day: Linezolid drug interactions ❓ Q: I'd like to prescribe linezolid but my patient is on serotonergic agents. What is the incidence of serotonin syndrome with this combination? #IDsky #medsky #meded #pharmsky #skyRX

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Reposted by Lina Meng, PharmD

Julie Parsonnet @julieparsonnet.bsky.social · 20/03/2025

We're looking for a new Division Chief in Adult ID at Stanford. We have a great ID/Medicine family here and the division has been growing by leaps and bounds. We also have great Pedi ID, Micro, Immunology and Transplant teams. Please share!

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Lina Meng, PharmD @linameng.bsky.social · 07/03/2025

Ongoing UCx stewardship efforts at Stanford 🤝 in partnership with infection control, CAUTI taskforce, micro lab, RNs ✔️ 2017: switch to UA with reflex only of wbc>10 ✔️2024: a creation of UCx order panel. 🚧 remove UA/UCx orders from surgery pre-op ordersets? #IDsky #AMSsky

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Lina Meng, PharmD @linameng.bsky.social · 22/01/2025

#idsky #amssky Anyone using Tamiflu after IV peramivir in ICU patients that gain enteral access? Do people trust IV peramivir efficacy in severe/hospitalized flu? pubmed.ncbi.nlm.nih.gov/39181595/

pubmed.ncbi.nlm.nih.gov

Antivirals for treatment of severe influenza: a systematic review and network meta-analysis of randomised controlled trials - PubMed

World Health Organization.

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Lina Meng, PharmD @linameng.bsky.social · 07/01/2025

I learned about this meropenem/VPA drug interaction the hard way as a new practitioner after unsuccessfully dose titrating VPA for days (and wasting 💰). Fortunately VPA indication was for alcohol withdrawal (non benzo ICU protocol at Stanford), not seizures! See useful tidbits on this interaction👇

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Lina Meng, PharmD @linameng.bsky.social · 26/11/2024

Yes Epic+beaker. Agh that's tough when you have lab limitations

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Lina Meng, PharmD @linameng.bsky.social · 25/11/2024

For ceftriaxone-R Enterobacterales from blood, our micro report shows MIC but no interpretation. Instead, displays cautionary comment. Chance for ASP-micro lab collab! 🤝

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Lina Meng, PharmD @linameng.bsky.social · 24/11/2024

Study shared by esteemed👇 on pyuria cutoff (in elderly♀️)"At a cutoff of 264 leuk/µL, sensitivity and specificity of microscopy were 88% (positive and negative likelihood ratio: 7.2 and 0.1, respectively). The commonly used cutoff of 10 leuk/µL had a poor specificity (36%) and a sensitivity of 100%."

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Lina Meng, PharmD @linameng.bsky.social · 23/11/2024

Thrilled to see @conanmacdougall.bsky.social join! 🌟 Your insights are always spot-on. This graph on new ABX approval is spot on. 😂 So true about the emotional rollercoaster—though here, prescribers don't pay attention to drug cost unless formulary restricted. #IDsky #AMSsky #pharmsky #skyrx

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Lina Meng, PharmD @linameng.bsky.social · 22/11/2024

Love our peds ASP colleagues and their amazing tools! ♥️ One of our ED's go-to favorites is their pediatric Amox-Clav Dosing Guide—because seriously, who can keep track of all those doses and formulations/ratios? Welcome to Blue Sky! 🌟 #AMSsky #IDsky #pharmsky #skyRX #medsky

stanfordchildrens.org

Guidelines & Protocols

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Lina Meng, PharmD @linameng.bsky.social · 22/11/2024

The look I get from SICU when I tell them they can stop ABX 24 hours after early GI perf repair 👀👽 #IDsky #pharmsky #AMSsky

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Lina Meng, PharmD @linameng.bsky.social · 20/11/2024

I miss having you around here! Especially miss your sense of humor. 🥰

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Lina Meng, PharmD @linameng.bsky.social · 20/11/2024

True. Would be great to get away from FQ in terms of C.diff etc. I think urinary source is where the data's strongest for PO BL leniency. Even if we can get prescribers to remember to use higher than usual doses, nobody wants to (or can remember to) take a med 3-4x/day!

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Lina Meng, PharmD @linameng.bsky.social · 20/11/2024

I sense a debate or update brewing for ID Week 2025/SIDP: team FQ vs b-lactam for uncomplicated GNR bacteremia? 🎙️👥 @idsainfo.bsky.social @sidpharm.bsky.social #IDsky

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Lina Meng, PharmD @linameng.bsky.social · 20/11/2024

Right this should be prospective studied. With standard doses used, "Recurrent BSI at 90 days was the main driver for the composite outcome occurring in 64 (5.4%) and 107 (9.4%) patients of the highly and less-bioavailable groups, respectively (p < 0.001) (aOR, 0.56; 95% CI, 0.40–0.78)"

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Lina Meng, PharmD @linameng.bsky.social · 20/11/2024

Couple of our providers anecdotally have preferentially used BL over FQ. No diff in 30-d mortality with FQ vs BL in urinary source BSI (Sutton, Saad). But systematic review (Punjabi) found higher recurrence rate 5.5%BL vs 1.9% FQ, OR 2.05 from all sources; Similar signal in Mack; variable BL use 🤷‍♀️🤔

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Lina Meng, PharmD @linameng.bsky.social · 20/11/2024

ID team Q: recs on amoxicillin PO dose for stepdown for uncomplicated strep bacteremia on day 5? Me: Pick anything. You're just about done with treatment! ...1g q8h #IDsky #medsky #pharmsky #RXsky

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Lina Meng, PharmD @linameng.bsky.social · 18/11/2024

Back to ASP work on Monday, and it feels like everyone has aspirated over the weekend and is on ABX. 🫠 Perfect timing for this ABX pearl on distinguishing aspiration pneumonitis from pneumonia. 🔑 Hyperacute resolution? Skip the ABX. Check it out! 👇 #USAAW24 #AMSsky #IDsky #pharmsky #MedEd

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Lina Meng, PharmD @linameng.bsky.social · 18/11/2024

Shout out to our amazing ASP team members @dhpharmd.bsky.social and @marisa-holubar.bsky.social for this fun idea! 🦠💜 Loving the micro nerd energy at Stanford for #USAAW24. 🙌 What’s everyone else doing this week? #IDsky #Medsky #pharmsky #amssky

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Reposted by Lina Meng, PharmD

Lina Meng, PharmD @linameng.bsky.social · 15/11/2024

Need help! 🙏 #IDsky #Medsky #AMSsky @joshparkpharmd.bsky.social—looking for ideas/must-haves to build a simple ED dashboard 📊 for tracking ABX use & outcomes. We’re on Epic and keeping it basic for the first go. CC: @dhpharmd.bsky.social

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Reposted by Lina Meng, PharmD

Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 16/11/2024

Multiple RCTs comprised patients with gram negative bacteremia from predominantly urinary sources demonstrate noninferiority of 7 days compared with 14 total days of treatment for a variety of patient-oriented outcomes, such as clinical cure, clinical failure,relapse, and all-cause mortality. #idsky

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Lina Meng, PharmD @linameng.bsky.social · 16/11/2024

Hi #IDsky & #PharmSky! 👋 I'm an ABX stewie (formerly critical care) at Stanford: ✨ Passionate about learning from others in ID, ASP, & RX. 🛠️ Love creating tools & education for frontline clinicians. 📚 Started Stanford ABX pearls series and Obesity ABX Guidance Excited to connect and share ideas!

med.stanford.edu

ABX Pearls

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Lina Meng, PharmD @linameng.bsky.social · 15/11/2024

🔄 Just got this consult question this week from our ICU pharmD—a great reminder during our blood culture and IV fluid shortages! 💡💊 Love it when I can reply back ✂️🗒️ with our team's ABX Pearl #IDsky #MedEd #pharmSky #RXsky 🔗ABX pearl library here: med.stanford.edu/bugsanddrugs...

med.stanford.edu

ABX Pearls

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Lina Meng, PharmD @linameng.bsky.social · 15/11/2024

Just in time before the BCx bottle shortage—this team’s work in diagnostic stewardship was vital! 💪 Proud to have such amazing colleagues leading these efforts with Epic hard stops driving real impact. Congrats on the Award! 🏆👏 #IDsky #medsky #amssky @grod11.blsky.social @jlsalinas.blsky.social

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Lina Meng, PharmD @linameng.bsky.social · 15/11/2024

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Lina Meng, PharmD @linameng.bsky.social · 15/11/2024

We also send weekly ABX pearls to most providers including ED- really popular so far.👏 Our ED pharmDs give regular ABX talks at EM resident didactics. 🩺 Check it out: med.stanford.edu/bugsanddrugs... #medEd #AMSsky #IDsky

med.stanford.edu

ABX Pearls

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Lina Meng, PharmD @linameng.bsky.social · 15/11/2024

Fortunately we have a 24/7 team of ED pharmDs that field nearly every ABX Q (and are curbsides on call backs which is run by RNs). Our ID and IPC partners have tackled diagnostic stewardship of UCx and BCx orders. We still have lots of work though. #IDsky #Pharmsky #Medsky

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