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Zack (Snacks) Nelson, PharmD, MPH

@zacrobid.bsky.social
2.2K followers 134 following 236 posts

📍 Minneapolis 🦠 Infectious diseases specialist 🚑 Emergency med emeritus 🌈 Human

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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 24/06/2026
PAF really isn't the "end all be all." In fact, I think it decreases health equity as compared to other upstream interventions and creates a self fulfilling prophecy. Turns out empowering non-ID clinicians to do PAF creates a culture of shared responsibility + expands access to ID expertise. #IDSky
cambridge.org
Exploring unconventional antimicrobial stewardship models: options beyond traditional prospective audit and feedback | Infection Control & Hospital Epidemiology | Cambridge Core
Exploring unconventional antimicrobial stewardship models: options beyond traditional prospective audit and feedback
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 30/05/2026
This is exactly why in our UTI WikiGuideline we advocate abandoning vague adjectives to describe infections that mean different things to different people
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 06/05/2026
This dogma must stop being taught to clinicians and be put out to pasture as a relic of a bygone era in scientific literature. I love this 😍 What other dogmas should we retire? #idsky #microsky #EMIMCC
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 10/04/2026
Does anyone have formalized EMR interventions/protocols that have made it more difficult for certain care settings (ED) to order urine testing based on cloudiness/darkness of urine, altered mental status without systemic symptoms, etc. and are willing to share screenshots? #IDSky #MedSky
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 05/04/2026
Has anyone else seen this with omadacycline? I have once. #IDSky
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 16/03/2026
Perplexing that this made it through peer review without mention of an entire guideline published in the last 1.5 years directly relevant to the content… 🤔 #IDSky
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Prof Jenny Rohn @jennyrohn.bsky.social · 11/03/2026
What a study - nearly 15,000 people followed up 4-8 years after a *sole* antibiotic treatment and some *still* had disrupted gut microbiome diversity. Pretty incredible. We’ve always been taught that such disruptions are ephemeral. #IDSky #MicroSky
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 08/03/2026
Enjoyed the discussion but disappointed that WikiGuidelines, which importantly addresses many of the shortcomings highlighted, was not even mentioned 🤔 #IDSky #MedSky @erinmccreary.bsky.social @cmicomms.bsky.social @angelahuttner.bsky.social
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Dimitri Drekonja, MD, MS @dimitridrekonja.bsky.social · 26/01/2026
Wife and I in tears reading this…
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Greg Olear @gregolear.bsky.social · 25/01/2026
One of the best things I’ve read in a while:
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 24/01/2026
This is too much logic for the “law and order” crowd. They, after all, back a convicted felon who has repeatedly pardoned J6ers and sexual predators.
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Nick Pettigrew @nick-pettigrew.bsky.social · 24/01/2026
The people who'll tell you today's murder victim in Minnesota shouldn't have turned up to a protest carrying a gun are the same people who said Kyle Rittenhouse was perfectly entitled to do the same thing.
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 24/01/2026
Literal execution in broad daylight and a large segment of the population won’t even blink. www.startribune.com/ice-raids-mi...
startribune.com
Live: Man shot by federal agents in south Minneapolis this morning, witnesses say
A video appears to shows federal agents wrestling a man to the ground then shooting him.
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Conrad Lange Zbikowski @czbi.org · 23/01/2026
Demonstrators as far as the eye can see. Current status of the march in Downtown Minneapolis, Minnesota for Ice Out of Minnesota. They are turning onto 3rd Street from 5th Avenue.
Tens of thousands of demonstrators filling the streets with signs and banners
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 21/01/2026
I’m shocked. Wait. No I’m not. I’ve been seeing this in my city for weeks now.
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 10/01/2026
Can someone remind me how going through the skin twice to get 2 sets of blood cultures from two different sites is supposed to reduce contamination? Wouldn’t it increase the risk? 4 bottles from same site makes more sense and the 1st bottle serves as the “diversion”” device. #idsky
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Joseph Marcus @josephmarcusid.medsky.social · 23/12/2025
The session at @idweek.bsky.social with @bwtrautner.bsky.social and @zacrobid.bsky.social discussing the development of these and Wiki Guidelines was incredibly well done
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NEJM.org @nejm.org · 17/12/2025
Tuberculous meningitis is often fatal, and current therapies need to be improved. In the HARVEST phase 3 trial, high-dose rifampin plus standard treatment was assessed. Full trial results: nej.md/49iiDsQ #MedSky #NeuroSky #IDSky
Kaplan–Meier curves for 6-month survival according to treatment group and HIV status.
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 12/12/2025
Remind me again why we don't use oral cefixime (availability not withstanding) or cefpodoxime for gonorrhea? We preferentially rx chlamydia for 7 days now with doxy, so save me the single dose argument. MIC creep ("reduced susceptibility" from 1.5 decades ago) is not a good answer! #IDSky #MedSky
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 10/12/2025
Can someone remind me why we don't use amoxicillin to treat primary, secondary, early latent syphilis? (Other than that the GODlines don't mention it) #IDSky #MedSky
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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 22/10/2025
#idweek2025 new in #UTI IDSA vs wikiguidelines #idsky #Idfellows #idfellowship #teachID
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Saira Butt, MD @sairabt.bsky.social · 22/10/2025
#idweek2025 new in #UTI IDSA vs wikiguidelines 2/ #idsky
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Saira Butt, MD @sairabt.bsky.social · 22/10/2025
#idweek2025 new in #UTI IDSA (GRADE methodology: clinical cure critical based on pt feedback) vs wikiguidelines (clear recommendation vs clinical review) 1/
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 17/10/2025
Don’t miss @bwtrautner.bsky.social and I talk about what’s new in UTI (the UTI WikiGuideline and IDSA cUTI guideline) on Wednesday AM at 08:00 EST! #idweek2025 #idsky
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 17/10/2025
Don’t miss @bwtrautner.bsky.social and I talk about what’s new in UTI (the UTI WikiGuideline and IDSA cUTI guideline) on Wednesday AM at 08:00 EST! #idweek2025 #idsky
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CIDRAP @cidrap.bsky.social · 28/04/2025
#COVID patients who don't receive remdesivir not more likely to die, data suggest Models found no difference in all-cause death rates, 30-day hospital readmissions, or length of stay before and after restrictions were put into place. www.cidrap.umn.edu/c...
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 26/04/2025
In CID: Our real world study is the 1st (to our knowledge) to detail widespread restriction of remdesivir with patients that represent present-day epidemiology in the era of near universal SARS-CoV-2 seropositivity. #IDSky #MedSky @ebhirsch.bsky.social academic.oup.com/cid/advance-...
academic.oup.com
Into the Unknown: Practical Remdesivir Restriction in the Era of Widespread SARS-CoV-2 Seropositivity
AbstractBackground. There is limited data to support routine remdesivir use in the contemporary era of SARS-CoV-2 with widespread seropositivity.Methods. A
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 26/04/2025
In CID: Our real world study is the 1st (to our knowledge) to detail widespread restriction of remdesivir with patients that represent present-day epidemiology in the era of near universal SARS-CoV-2 seropositivity. #IDSky #MedSky @ebhirsch.bsky.social academic.oup.com/cid/advance-...
academic.oup.com
Into the Unknown: Practical Remdesivir Restriction in the Era of Widespread SARS-CoV-2 Seropositivity
AbstractBackground. There is limited data to support routine remdesivir use in the contemporary era of SARS-CoV-2 with widespread seropositivity.Methods. A
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wiki-guidelines.bsky.social @wiki-guidelines.bsky.social · 26/03/2025
We are incredibly proud of our entire UTI WikiGuideline drafting team!
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 10/12/2024
#IDSky: the iDIAPASON trial was stopped early due to low enrollment, results still published, sheds doubt on whether the 3 RCTs demonstrating non-inferiority of 8 days to 15 days for VAP is applicable to PA-VAP -- pulmonologists are quoting this study still! How long do you typically treat PA-VAP?
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Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 07/12/2024
WOW 🔥 Our article is still on the most viewed list in the last 7 days from #JAMANetworkOpen @zacrobid.bsky.social @dremilymcd.bsky.social @drtoddlee.bsky.social @bradspellberg.bsky.social #idsky #medsky #utisky #EMIMCC
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 04/12/2024
45 year old generally healthy female on infliximab for Crohn's disease develops non-typhoidal Salmonella bacteremia and UC+ for same organism. She rapidly improves on IV ceftriaxone. Q: What duration are you treating for? A: -- 7 days? -- 10 days? -- 14 days? -- 4-6 weeks? And... why, #IDSky?!
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 04/12/2024
45 year old generally healthy female on infliximab for Crohn's disease develops non-typhoidal Salmonella bacteremia and UC+ for same organism. She rapidly improves on IV ceftriaxone. Q: What duration are you treating for? A: -- 7 days? -- 10 days? -- 14 days? -- 4-6 weeks? And... why, #IDSky?!
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 21/11/2024
What did I do this morning? Fill out quick surveys about CDI! They’re quick and support very important research! #IDSky redcap.link/guubtkxs @connorprosty.bsky.social @drtoddlee.bsky.social @dremilymcd.bsky.social
redcap.mchi.mcgill.ca
Prophylaxis, Diagnosis, and Management of Clostridioides difficile Infections: An International Cross-Sectional Survey of Clinicians
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Zack (Snacks) Nelson, PharmD, MPH @zacrobid.bsky.social · 08/11/2024
My first #IDSky post will be a shameless promotion of our new UTI WikiGuideline! jamanetwork.com/journals/jam... Of 37 questions, only 6 had enough data to fully meet criteria for a clear recommendation!
jamanetwork.com
Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections
This consensus statement creates a clinical guideline for the diagnosis and management of urinary tract infections that addresses the gap between the evidence and recommendation strength.
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