Andrew DeSio BBBBCCCCCCCIDPPPPS
andrewdesio.bsky.social
Andrew DeSio BBBBCCCCCCCIDPPPPS
@andrewdesio.bsky.social
Crit Care, ID, Cards, whatever! Still the Super Saiyan of pharmacy!
Pinned
Who is still using metronidazole q8h for most indications? There’s definitely an opportunity for less frequent dosing most of the time!

I’ve attached my proposal from last year - feel free to take a look, and hopefully it can save you some trouble and doses for you too!

1drv.ms/w/s!AurvlEJP...
Just gotta say how much I appreciate simple little studies like this that save a lot of wasted energy looking for alternatives for patients that need meds while breastfeeding. So simple yet so reassuring. pubmed.ncbi.nlm.nih.gov/39405564/
Investigating the Transfer of Lisinopril Into Human Milk: A Quantitative Analysis - PubMed
Lisinopril is commonly prescribed to manage conditions such as hypertension and heart failure. Although concerns about fetal toxicity have traditionally limited the use of lisinopril in women of repro...
pubmed.ncbi.nlm.nih.gov
April 29, 2025 at 10:50 PM
It’s true what they say about reviewer 2! Time to fix up these manuscripts and resubmit, womp womp
March 27, 2025 at 4:14 PM
Enjoying a nice comfy break from social media and capturing a couple top 3 finishes while that’s still achievable! Gotta get better about coming back here, feel like I’m just not as caught up with the latest lit these days!
March 26, 2025 at 4:01 PM
These won’t last, but I’ll take the Ws and podiums when I can!
February 26, 2025 at 4:55 PM
Is fifth third just like, the worst bank?
February 20, 2025 at 7:04 PM
Dang, first manuscript rejected from JTACS. At least lots of helpful feedback, hopefully we can rework things a bit and get it accepted somewhere.

Fingers still crossed on the prospective paper, hopefully that one makes it!
February 16, 2025 at 10:52 PM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
ONE ANTIBIOTIC PK TABLE TO RULE THEM ALL

Absorption takes drug into blood from GI,
Vd spreads drug out to where bug calls home.
And after bacteria are doomed to die,
The drug’s eliminated on the porcelain throne

In the Land of Notion where this table doth lie…

#idSky #microsky #pharmsky #medsky
January 26, 2025 at 7:48 PM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
Finally!

Antibiotics are not non-inferior to appendectomy despite a generous 20% non-inferiority margin

They are actually inferior: www.thelancet.com/journals/lan... in the @thelancet.bsky.social

#MedSky
January 17, 2025 at 3:06 AM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
Also I must have misremembered, this study found a cut-off of 284 WBCs for older women with UTI

academic.oup.com/cid/article/...
Current Pyuria Cutoffs Promote Inappropriate Urinary Tract Infection Diagnosis in Older Women
The degree of pyuria can help distinguish urinary tract infection (UTI) in older women from asymptomatic women with and without bacteriuria. We demonstrate
academic.oup.com
January 16, 2025 at 11:04 PM
Love this since every lab I’ve seen has topped out at 200+! Think my current one is 180+, with abnormal lab reported at >8 😢
Maybe! I'm glad they studied this, as its an often excluded population.

10 WBCs isn't hard to generate in the urine (e.g., in older women, the cut-off should probably be like 600+), so if someone really has a UTI, you might still get some inflammation albeit less than others?
January 16, 2025 at 10:58 PM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
Important article for #AMSSky, #TxID, #UTISky, and #IDSky in @cidjournal.bsky.social:

In neutropenic & non-neutropenic cancer patients w/ & w/o catheters, the absence of nitrite/leukocyte esterase or WBC<10 had high NPV for clinically significant bacteriuria

academic.oup.com/cid/advance-...
January 16, 2025 at 6:30 PM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
🆕💫Multicenter retrospective study @cidjournal.bsky.social
Impact of Fluconazole Resistance on the Outcomes of Patients With Candida parapsilosis Bloodstream Infections #idsky #EMIMCC
academic.oup.com/cid/advance-...
Impact of Fluconazole Resistance on the Outcomes of Patients With Candida parapsilosis Bloodstream Infections: A Retrospective Multicenter Study
Despite global concerns about fluconazole resistance in Candida parapsilosis, its impact on mortality remains unexplored. Our study found no increased mort
academic.oup.com
January 15, 2025 at 9:26 AM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
NEW PREPRINT!

Enjoyed working with @tom-parks.bsky.social and @petedodd24.bsky.social on immortal time bias

In its simplest form, ITB results from misallocation of person time, i.e. pre treatment time in intervention group being counted as time on treatment

www.medrxiv.org/content/10.1...

[1/n]
January 10, 2025 at 9:29 AM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
Recent studies reinforce the benefits of oral antibiotics, as well as shorter durations of therapy in BJIs with supporting evidence
🆕💫 Review article
Bone Voyage: Navigating Updates in the Management of Bone and Joint Infections #idsky
link.springer.com/article/10.1...
Bone Voyage: Navigating Updates in the Management of Bone and Joint Infections - Current Infectious Disease Reports
Purpose of Review Advancements in the management of bone and joint infections (BJIs) aim to improve outcomes while challenging long-standing treatment practices. This review discusses key updates, inc...
link.springer.com
January 4, 2025 at 11:11 AM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
What a cool study and a powerful demonstration that Tuberculosis is largely a disease of poverty. In Brazil a large scale intervention which provided cash monthly to families living in poverty led to profound reductions in TB cases. Up to 50% among the poorest groups.
www.nature.com/articles/s41...
Effects of conditional cash transfers on tuberculosis incidence and mortality according to race, ethnicity and socioeconomic factors in the 100 Million Brazilian Cohort - Nature Medicine
Participation in Brazil’s Bolsa Familia Program, one of the largest conditional cash transfer programs in the world, was associated with large reductions in tuberculosis incidence and mortality among ...
www.nature.com
January 3, 2025 at 8:36 PM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
Though "Oral is the New IV" with antibiotics (h/t @bradspellberg.bsky.social), it's not always easy to convince reluctant inpatient clinicians -- especially (in my experience) surgeons, who want to treat "aggressively".

Interesting dynamic ...
blogs.jwatch.org/hiv-id-obser...
On the Inpatient ID Consult Service, Oral Antibiotics Have a Rocky Road to Acceptance
Having just completed a stint doing inpatient ID consults, I came away impressed with three things: Staph aureus remains the Ruler of Evil Invasive Pathogens in the hospital setting. You can “jinx” a ...
blogs.jwatch.org
January 3, 2025 at 6:53 PM
youtu.be/RRvYkrrpMKo?...

Wow these are some absolute bops! Bunch of solid SNES era soundtracks on this guy’s channel too, on top of this one!
Waterworld (SNES) - Soundtrack
YouTube video by Dean Evans
youtu.be
January 1, 2025 at 2:38 AM
Oof what a miserable Hawkeye game
December 30, 2024 at 10:57 PM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
Use of voriconazole to predict susceptibility and resistance to isavuconazole for Aspergillus fumigatus using CLSI methods and interpretive criteria

High rate of agreement suggests vori susceptibility can predict isa susceptibility in A fumigatus w/ CLSI AFST

journals.asm.org/doi/10.1128/...
December 30, 2024 at 4:14 PM
Reposted by Andrew DeSio BBBBCCCCCCCIDPPPPS
When AC is needed in acute cerebrovascular dz, heparin is usually chosen for its reversibility. Doses are often low-balled for safety, but does this come at a cost?

Fast AC is needed in CSVT, and we saw that time to therapeutic PTT/AXa can >24h with low-intensity dosing!

doi.org/10.1016/j.jo...
December 30, 2024 at 11:12 AM
Can I just bag about a former resident for a bit? So cool to see her hard work featured after all the hurdles to get this far, but couldn’t be more proud!

www.pharmacypracticenews.com/Online-First...
Empiric Antibiotic Choices for Diabetic Foot Infections Often Discordant With Risk Factors
Empiric antibiotic coverage for MRSA and Pseudomonas aeruginosa in patients with diabetic foot infections did not correlate with risk factors for these organisms.
www.pharmacypracticenews.com
December 29, 2024 at 12:23 PM
Thinking about splurging a bit in 2025, utilizing some healthcare. Something crazy like that!
December 28, 2024 at 2:25 AM
Is it just me #pharmsky, or are Entresto tablets just purposefully annoying dose sizes to force more new prescriptions for dose changes and to make pharmacies carry all 3 strengths?

I can’t think of another reason to market 24/26, 49/51, and 97/103mg tablets 🤨
December 26, 2024 at 6:57 PM
WHAT
December 26, 2024 at 12:46 AM