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Matt Pike

@mattpike.bsky.social
2.3K followers 2.5K following 17 posts

Hospital Pharmacist- Antimicrobial Stewardship / Infectious Disease, but enjoy dabbling in any and all therapeutic areas

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Matt Pike @mattpike.bsky.social · 10/10/2025
Wanted to get a feel for how many sites are using loading regimens of clofazimine for NTM given PK. If so, what dosing strategy? Any barriers from FDA or manufacturer as far as IND including this dosing strategy? #IDSky
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 02/05/2025
For streptococci, blood cultures virtually always cleared by day 2, so clearing quickly is not helpful. In contrast, for MSSA, MRSA, and E faecalis, clearance of blood cultures after 1 day of therapy was also very helpful at negatively adjusting the risk of IE. #IDSky
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Erin McCreary, PharmD @erinmccreary.bsky.social · 12/04/2025
@steventong.bsky.social presents the results of the PSSA domain of the SNAP 🫰 trial - the worlds largest trial of staph aureus bacteremia - at #ESCMID2025 fluclox resulted in higher mortality and more AKI compared to penicillin for PSSA
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 12/04/2025
The most important post in #ESCMIDGlobal #ESCMIDGlobal2025 #escmid2025 #IDSky
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Erin McCreary, PharmD @erinmccreary.bsky.social · 28/02/2025
Say it aint STENO! New #Breakpoints episode out today with the brilliant Amy Mathers and @juliejusto.bsky.social on behalf of @sidpharm.bsky.social We hope you love it!! 🎧 🎶 🧫 podcasts.apple.com/us/podcast/b...
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Ilan Schwartz @germhuntermd.bsky.social · 28/03/2025
From a talk on clinician job security in the AI era There may be compelling use cases driven by need & product suitability, but they are a cover for profit-driven uses Inspired by UPMC Infectious Disease Connect, Telehealth docs who undercut local clinicians for a contract at an urban NC hospital
A trojan horse, labeled "use case based on need & suitability" with warriors hidden inside labeled "profit-driven use case". Healthcare execs are greeted at the gates. the castle is labeled "healthcare"
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Lisa Jarvis @lisamjarvis.bsky.social · 01/04/2025
Noticeably silent amid the upheaval at HHS? Big pharma. Every new drug has NIH somewhere in its DNA--and NIH funding supports the training of their workforce. Now they're finding out FDA isn't safe, either. Wrote about how keeping quiet isn't working My latest @opinion.bloomberg.com (gift link):
bloomberg.com
Big Pharma Needs to Get Off the Sidelines
The industry can’t continue to sit idly by while Robert F. Kennedy Jr. guts the nation’s public health agencies.
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William F Wright @wwrighid.bsky.social · 21/03/2025
#IDSky #MedSky #PharmSky @idsainfo.bsky.social @cidjournal.bsky.social @ofidjournal.bsky.social @sidpharm.bsky.social 🔥 Ceftriaxone MIC cutoff of 8 μg/ml is an excellent predictor of ESBL production; PPV and NPV approaching 100% and 99.5%, respectively. doi.org/10.1128/JCM.00716-14
doi.org
Determining the Optimal Ceftriaxone MIC for Triggering Extended-Spectrum β-Lactamase Confirmatory Testing | Journal of Clinical Microbiology
ABSTRACT As routine testing of clinical isolates for extended-spectrum β-lactamase (ESBL) production (screen plus phenotypic confirmatory testing) is no longer required by the Clinical and Laboratory ...
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Kevin Collins @kwcollins.bsky.social · 17/03/2025
Scientists have just cured pancreatic cancer in some patients with personalized mRNA vaccines. Pancreatic cancer. And this Trump administration wants to throw it all away. They’re throwing away a cure for cancer.
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 17/03/2025
Blood culture–negative endocarditis has been associated with worse outcomes when compared with blood culture–positive endocarditis, because pathogen‐directed antimicrobial therapy and other management aspects have been difficult to achieve #idsky
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BITSCOPIC @bitscopic.bsky.social · 17/03/2025
Cefazolin may be an empiric treatment option for complicated urinary tract infections in those institutions with high susceptibilities for common UTI pathogens. #pharmsky #idsky rdcu.be/edSSG
rdcu.be
A comparison of empiric therapy with cefazolin versus ceftriaxone for patients with complicated urinary tract infections in a tertiary care veterans affairs medical center | BMC Infectious Diseases
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 19/02/2025
In patients presenting with cUTI (including acute pyelonephritis) who are improving clinically on effective therapy, we suggest treating with a shorter course of antimicrobials, using either 5-7 days of a FQ or 7d of Non FQ rather than 10-14d 14 days for cUTI is obselete! #idsky #medsky #EMIMCC
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 28/01/2025
Echinocandin Vs fluconazole step down in patients with candida glabrata candidaemia?! 🆕💫Retrospective, single-centre cohort study #JAC No significant difference in treatment duration ,incidence of persistent candidaemia or 30-day clinical failure between 2 gps #idsky academic.oup.com/jac/advance-...
academic.oup.com
Fluconazole step-down therapy versus echinocandins for the treatment of Candida glabrata invasive candidiasis with candidaemia
AbstractObjectives. Candida glabrata is the second most common species responsible for invasive candidiasis, including candidaemia. Echinocandins are typic
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jbaghdadi.bsky.social @jbaghdadi.bsky.social · 29/01/2025
fear of inadequate empiric coverage leads to excessive use of broad-spectrum antibiotics. to reassure you that it's OK to get it wrong (sometimes), we looked at clinical outcomes when empiric antibiotics were insufficiently broad and needed to be escalated doi.org/10.1093/cid/...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 11/12/2024
🔥🔥 NEW 🔥🔥 Year In Review: Top Infectious Diseases Articles From 2024 Our new post, a great collaboration with my friend 🌟 @idstewardship.bsky.social 1️⃣6️⃣⚡️🆔 RCTs 7️⃣Syst Reviews/Meta 3️⃣🌏Guidelines ✨️Wiki_Guidelines #idsky #EMIMCC #medsky #utisky EnJoy Share plz! www.idstewardship.com/year-review-...
idstewardship.com
Year In Review: Top Infectious Diseases Articles From 2024
In this article a selection of notable peer-reviewed publications from 2024 are provided. Article Selection by: Bassam Ghanem, Pharm.D., MS, BCPS Article Construction by: Timothy P. Gauthier, Pharm.D....
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ID:IOTS Podcast @idiots-pod.bsky.social · 30/11/2024
In their defence avibactam is a much better BLI than the 1st gen BLIs. Lower ratios required for inhibition, less likely to encounter Rx failure through Beta lactamase hyperproduction. We’ve done an episode on it, link to the show notes here for the interested: idiots.notion.site/44-Beta-Lact...
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Brad Spellberg @bradspellberg.bsky.social · 25/01/2025
And importantly, they gave NO IV LEAD IN to most patients in the oral arm. Started oral on day 1. Further busting the myth that some magical amount of IV lead in is necessary.
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Contagion® @contagionlive.bsky.social · 29/01/2025
In the latest Bench to Bedside Column @sidpharm.bsky.social Dr. Jordan Chiasson and Dr. Kristen Zeitler, discuss IV push administration including safety profiles, PK/PD characteristics, and clinical data for IV push administration prior to utilizing it in specific populations. #Idsky
contagionlive.com
Intravenous Antimicrobials: Is It Time to Push?
Intravenous (IV) push is an attractive option to administer antimicrobial therapy to patients in an efficient and effective manner in a variety of clinical settings. While many advantages to IV push a...
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Patrick Ching @patrickching.bsky.social · 17/01/2025
👇 Scripts/talking points for UTI #diagnosticstewardship #IDSky #MedSky #antimicrobialstewardship #healthcareepidemiology
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Trevor A. Crowell, MD, PhD @tcrowellmd.bsky.social · 14/01/2025
ID rule of thumb is to prophylax against PJP when high-dose steroids are used (i.e. 20mg or more of prednisone daily) for 4 or more weeks. Prophylactic regimens and other indications for prophylaxis are reviewed nicely in the linked JAMA article. www.doi.org/10.1001/jama...
doi.org
Prophylaxis Against Pneumocystis jirovecii Pneumonia in Adults
This JAMA Insights Clinical Update discusses current recommendations regarding prevention of Pneumocystis pneumonia in patients who are immunocompromised.
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Alison Smith, MD, MSc @alisongrace.bsky.social · 14/01/2025
Interested in the use of antibiotics at end of life? Join our #ESCMID webinar on the topic next Wednesday 9-11am EST! I'm honored to be speaking among the international panel. You can register here! #IDSky docs.google.com/forms/d/e/1F...
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Christine Rabinak, PhD, MBA @brainsbeesbikes.bsky.social · 14/01/2025
🦠 New insights from CACTUS: Ceftolozane-tazobactam shows higher clinical success rates than ceftazidime-avibactam for multidrug-resistant Pseudomonas aeruginosa pneumonia. A crucial step in optimizing treatment! www.thelancet.com/journals/lan... #InfectiousDiseases
thelancet.com
Effectiveness of ceftazidime–avibactam versus ceftolozane–tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study
Treatment with ceftolozane–tazobactam resulted in higher rates of clinical success compared with ceftazidime–avibactam for invasive infections due to multidrug-resistant P aeruginosa. Differences were...
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Stanford Antimicrobial Safety & Sustainability Program @stanfordasp.bsky.social · 13/01/2025
🔗 References: 1. CLSI M100 ED34:2024, Table 2A-1, Table 2D, Appendix E, Table 2 Dosages 2. Rationale document clsi.org/standards/pr...
clsi.org
MRPKG | Product MRPKG
Rationale Document Package
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William F Wright @wwrighid.bsky.social · 13/01/2025
#IDSky #MedSky #PharmSky @idsainfo.bsky.social @cidjournal.bsky.social @ofidjournal.bsky.social @sidpharm.bsky.social 🚨 According to this publication beta-lactams with the highest seizure potential include: 1) Cefazolin, 2) Cefepime, and 3) PCN-G (Table 1). doi.org/10.3390/microorganisms9071505
doi.org
Beta-Lactams Toxicity in the Intensive Care Unit: An Underestimated Collateral Damage?
Beta-lactams are the most commonly prescribed antimicrobials in intensive care unit (ICU) settings and remain one of the safest antimicrobials prescribed. However, the misdiagnosis of beta-lactam-rela...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 13/01/2025
🆕💫 Narrative Review @cmicomms.bsky.social @jeffpears0n.bsky.social Tetracyclines, the Old and the New 🔹Tetracycline 1953 ✨Doxycycline 1967 🔹Minocycline 1971 🔹Tigecycline 2005 🔹Eravacycline 2018 🔹Omadacycline 2018 #IDsky #EMIMCC www.sciencedirect.com/science/arti...
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Jarod Fox MD @jdfoxmd.bsky.social · 01/01/2025
www.nejm.org/doi/full/10....
nejm.org
Trial of Early, Goal-Directed Resuscitation for Septic Shock | NEJM
Early, goal-directed therapy (EGDT) is recommended in international guidelines for the resuscitation of patients presenting with early septic shock. However, adoption has been limited, and uncertai...
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Clinical Infectious Diseases @cidjournal.bsky.social · 24/12/2024
Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of Infective Endocarditis: A Retrospective Cohort Study ✅ Just Accepted #IDSky
buff.ly
Time to Staphylococcus aureus Blood Culture Positivity as a risk marker of Infective Endocarditis: A Retrospective Cohort Study
Endocarditis occurs in approximately 10-15% of patients with Staphylococcus aureus bacteremia. Short time to positivity (TTP) in blood culture flasks has been linked to endocarditis in smaller studies. This study evaluated the association between TTP and endocarditis in S. aureus bacteremia in a large cohort.
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Timothy Li @drtimothyli.bsky.social · 26/12/2024
Strategy for penicillin allergy delabeling by non-allergists For very low risk non-allergic index reactions, direct delabeling w/o testing is reasonable whereas a single step challenge may be considered for patients who are anxious or desire additional reassurance. doi.org/10.1016/j.ja... #IDSky
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Nate D @natedefelice.bsky.social · 17/12/2024
#MedSky #EMIMCC #IDsky #cardiosky @pulmcrit.bsky.social What is the culture at your hospital for potassium replacement? At most hospitals I'm at it seems to be a culture of replace to K 4.0 and the individual doctor makes the call. This paper confirms my bias... jamanetwork.com/journals/jam...
jamanetwork.com
Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery
This randomized clinical trial examines whether a lower serum potassium concentration trigger for supplementation is noninferior to a high-normal trigger for the prevention of atrial fibrillation afte...
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Bug Pharmacist // Tim Gauthier @idstewardship.bsky.social · 14/12/2024
📋👀 Did you miss any of these articles from 2024? 📲 www.idstewardship.com/year-review-... #IDsky with @absteward.bsky.social
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Anthony Lau, PharmD BCPS @alaurx.bsky.social · 15/12/2024
10/ IV push antibiotics free up nurses’ time, reduce healthcare costs (~$40,000 USD/year), and improve adherence to sepsis bundles (also supports planetary health mission!) Nurses overwhelmingly prefer IV push for its efficiency and reduced workload.
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Stanford Antimicrobial Safety & Sustainability Program @stanfordasp.bsky.social · 13/12/2024
🌟 ABX Pearl of the Day: empiric yeast coverage in intra-abdominal infections (IAI) 💡 Q: My patient has an IAI. Should I add an antifungal agent? #IDsky #Medsky #MedEd #PharmSky #SkyRX
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KASIC @kasic.bsky.social · 14/12/2024
Locked in Against Line Infections. Check out this week’s KASIC pearl to learn that The Devil is in the Details: Antibiotic Lock Therapy ➡️ kymdro.org/kasic/?p=8081 #IDSky #AntimicrobialResistance #antimicrobialstewardship #rxtwitter #pharmacy #FOAMed #NPs #PAs
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Clinical Infectious Diseases @cidjournal.bsky.social · 14/12/2024
The impact of lower respiratory tract sample cultures on outcomes in community-acquired pneumonia: a propensity score matched cohort study ✅ Just Accepted #IDSky
buff.ly
The impact of lower respiratory tract sample cultures on outcomes in community-acquired pneumonia: a propensity score matched cohort study
This study aimed to determine whether collecting a lower respiratory tract sample (LRTS) for bacterial microscopy, culture, and resistance (MCR) testing affects outcomes in patients with CAP.
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 13/12/2024
SC administration of antibiotics offers an attractive alternative to other parenteral routes of administration, particularly in situations where IV administration is challenging. This study established that delivery of SC cefazolin appears to be safe and well tolerated #idsky
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Andrea Prinzi Ph.D., MPH, SM(ASCP) @andreaprinzi.bsky.social · 13/12/2024
Today’s #SciComm is right in line with this post on the ESBL confirmation dilemma: asm.org/Articles/202... #ClinMicro #IDSky
asm.org
Extended-Spectrum Beta-Lactamases: To Confirm or Not Confirm? | ASM.org
Methods to detect extended-spectrum beta-lactamase (ESBL) expression are limited, yet correct identification of bacterial resistance mechanisms is imperative as it directly impacts patient care.
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Gabriele Pollara @gpollara.bsky.social · 13/12/2024
More evidence that the evidence behind clinical benefit of conventional sputum cultures is a bit 🤷‍♂️ #IDSky #ClinMicro #AMR @cidjournal.bsky.social academic.oup.com/cid/advance-...
academic.oup.com
The impact of lower respiratory tract sample cultures on outcomes in community-acquired pneumonia: a propensity score matched cohort study
AbstractObjectives. This study aimed to determine whether collecting a lower respiratory tract sample (LRTS) for bacterial microscopy, culture, and resista
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 13/12/2024
Despite established antiviral therapy for HSV, VZV & CMV encephalitis,outcome remains poor Excellent 🆕️✨️ Review by Dr.Bodilsen Optimization of antiviral dosing in Herpesviridae encephalitis:a promising approach to improve outcome #idsky #EMIMCC www.clinicalmicrobiologyandinfection.com/article/S119...
clinicalmicrobiologyandinfection.com
DEFINE_ME
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Alice Han @dralicehan.bsky.social · 12/12/2024
Need more details. Is it carbapenem resistant? Would consider azithro and adjunctive agent that it is susceptible to. This is a nice review #Idsky journals.asm.org/doi/10.1128/...
journals.asm.org
Achromobacter Infections and Treatment Options | Antimicrobial Agents and Chemotherapy
Achromobacter is a genus of nonfermenting Gram-negative bacteria under order Burkholderiales. Although primarily isolated from respiratory tract of people with cystic fibrosis, Achromobacter spp. can ...
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Bug Pharmacist // Tim Gauthier @idstewardship.bsky.social · 12/12/2024
👀 New in @AJHPOfficial! academic.oup.com/ajhp/advance... “You do not currently have access to this article.” as usual. 🤑 #IDsky
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Bug Pharmacist // Tim Gauthier @idstewardship.bsky.social · 12/12/2024
🔥New in @ASHE_Journal 👉 www.cambridge.org/core/journal... #IDsky
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 11/12/2024
🆕️🌟The first study to compare diagnostic performances of (1→3)-β-D-Glucan (BDG) and Aspergillus galactomannan (GM) for the diagnosis of HIV-associated histoplasmosis #idsky #medsky #mycosky www.ijidonline.com/article/S120...
ijidonline.com
Fungal biomarkers in HIV-associated disseminated histoplasmosis: a multicenter diagnostic accuracy study on the Guiana shield
Invasive fungal infections are neglected but common diseases, mainly affecting immunocompromised hosts (1,2). These diseases affect more than 150 million people worldwide, and have high mortality rates, often above 20-30% (3). Their overall burden is therefore significant, and may become even more concerning due to i) a growing number of immunocompromised individuals, ii) persistent diagnostic and therapeutic difficulties in many countries, and iii) the relative dearth of research on invasive fungal infections (4).
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Erin McCreary, PharmD @erinmccreary.bsky.social · 11/12/2024
we updated our metronidazole dosing across UPMC system over a year ago based on Sunish's prelim work and now the final evaluation is published! so proud of him!! #idsky #amssky #pharmsky #medsky www.sciencedirect.com/science/arti...
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Timothy Li @drtimothyli.bsky.social · 10/12/2024
Characteristics of selected urine dipstick tests for diagnosis of UTI It has been used to rule out a UTI with a combination of negative results for both the nitrite and leukocyte esterase tests, but a positive result from either test alone cannot diagnose a UTI doi.org/10.1128/cmr.... #IDSky
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Anthony Lau, PharmD BCPS @alaurx.bsky.social · 10/12/2024
14/ TLDR: In presence of active severe infection (eg. sepsis or bacteremia), it’s best to hold IV iron therapy. This precaution helps minimize the possible risk of worsening infection & ensures patient safety. Also, usually no urgency to give IV iron when septic (at least not from my POV/priority).
media.tenor.com
a man is walking down a hallway with a suitcase and the words iron deficiency written on the bottom .
ALT: a man is walking down a hallway with a suitcase and the words iron deficiency written on the bottom .
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IDMD @idmdtdi.bsky.social · 10/12/2024
Tpoxx safe but didn't improve mpox resolution or pain #idsky end of STOMPP
niaid.nih.gov
NIH Study Finds Tecovirimat Was Safe but Did Not Improve Mpox Resolution or Pain
Tecovirimat was safe but did not reduce the time to lesion resolution or reduce pain among adults with mild to moderate clade II mpox and a low risk of severe disease in an international study.
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 10/12/2024
Pharmacodynamic studies indicate that anaerobic killing is optimized when the plasma AUC) to MIC ratio is ≥70:1; the probability of achieving this target with 1000mg/d of metronidazole is > 99% against B. fragilis that exhibit MICs < 2mg/L #idsky #medsky #EMIMCC
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 09/12/2024
🆕✨Systematic Review of the Literature Evaluation of the Efficacy of Piperacillin/Tazobactam in Extended-Spectrum Beta- Lactamase-Producing(ESBL) Enterobacteriaceae Urinary Tract Infections #idsky #medsky #EMIMCC #AMSsky #utisky journals.sagepub.com/doi/abs/10.1...
journals.sagepub.com
Evaluation of the Efficacy of Piperacillin/Tazobactam in Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Urinary Tract Infections: A Systematic Review of the Literature - Samantha P. Sut...
Objective: To evaluate the efficacy of piperacillin/tazobactam (PTZ) for the treatment of extended-spectrum beta-lactamase-producing enterobacteriaceae (ESBL-PE...
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 04/12/2024
Cefepime represents an excellent alternative to carbapenems for BSI due to AmpC-producing strains, whereas piperacillin/tazobactam is associated with a higher rate of clinical and microbiological failure Do we need an RCT? #idsky #medsky #AMSsky
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Jonathan Ryder, MD @jonathanrydermd.bsky.social · 06/12/2024
For evidence, two RCTs show that addition of TMP-SMX to cephalexin has no benefit, so dual therapy not indicated: pubmed.ncbi.nlm.nih.gov/23457080/ pubmed.ncbi.nlm.nih.gov/28535235/ Nice systematic review from @steventong.bsky.social on TMP-SMX for SSTI: pubmed.ncbi.nlm.nih.gov/29255730/
pubmed.ncbi.nlm.nih.gov
Clinical trial: comparative effectiveness of cephalexin plus trimethoprim-sulfamethoxazole versus cephalexin alone for treatment of uncomplicated cellulitis: a randomized controlled trial - PubMed
NCT00676130.
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