Lina Meng, PharmD
@linameng.bsky.social
ID Pharmacist | Antimicrobial Stewardship Team | Stanford Health Care, CA | #MedEd #handshakestewardship
I love pugs, 🏐, and travel, but actually spend most of my free time figuring out parenting of young kids🪇
I love pugs, 🏐, and travel, but actually spend most of my free time figuring out parenting of young kids🪇
Pinned
Reposted by Lina Meng, PharmD
🩺 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.
⚠️ Many non-lactose fermenters (especially Stenotrophomonas, Burkholderia, and Acinetobacter) can be very challenging to treat. ID consultation should be considered for invasive infections.
October 23, 2025 at 5:51 PM
🩺 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.
⚠️ Many non-lactose fermenters (especially Stenotrophomonas, Burkholderia, and Acinetobacter) can be very challenging to treat. ID consultation should be considered for invasive infections.
Reposted by Lina Meng, PharmD
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
September 24, 2025 at 10:25 PM
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
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
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
September 18, 2025 at 5:42 PM
Reposted by Lina Meng, PharmD
🔥Finally published🔥
IDSA Guidelines on the Treatment and Management of Complicated Urinary Tract Infections (cUTI)
#idsky
www.idsociety.org/practice-gui...
IDSA Guidelines on the Treatment and Management of Complicated Urinary Tract Infections (cUTI)
#idsky
www.idsociety.org/practice-gui...
July 17, 2025 at 8:35 PM
🔥Finally published🔥
IDSA Guidelines on the Treatment and Management of Complicated Urinary Tract Infections (cUTI)
#idsky
www.idsociety.org/practice-gui...
IDSA Guidelines on the Treatment and Management of Complicated Urinary Tract Infections (cUTI)
#idsky
www.idsociety.org/practice-gui...
Reposted by Lina Meng, PharmD
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/10.1016/j.ec...
#IDSky @eclinicalmed.bsky.social
Redirecting
doi.org
April 10, 2025 at 9:36 AM
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/10.1016/j.ec...
#IDSky @eclinicalmed.bsky.social
Reposted by Lina Meng, PharmD
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!
March 20, 2025 at 3:40 PM
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!
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
✔️ 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
🔍 Key Points:
-Borderline urine WBC counts (6–10 cells/mL) may reflect dehydration and should be expected in patients with oliguria or anuria.
-Low urine WBC (WBC < 10) almost always excludes the diagnosis of UTI.
-Borderline urine WBC counts (6–10 cells/mL) may reflect dehydration and should be expected in patients with oliguria or anuria.
-Low urine WBC (WBC < 10) almost always excludes the diagnosis of UTI.
March 7, 2025 at 5:59 PM
#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/39181595/
January 22, 2025 at 6:22 PM
#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/39181595/
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👇
See useful tidbits on this interaction👇
January 7, 2025 at 9:51 PM
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👇
See useful tidbits on this interaction👇
For ceftriaxone-R Enterobacterales from blood, our micro report shows MIC but no interpretation. Instead, displays cautionary comment. Chance for ASP-micro lab collab! 🤝
November 25, 2024 at 8:17 PM
For ceftriaxone-R Enterobacterales from blood, our micro report shows MIC but no interpretation. Instead, displays cautionary comment. Chance for ASP-micro lab collab! 🤝
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%."
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%."
Meant to share this study by @merellambregts.bsky.social's team
@cjcrnich.bsky.social 😊 when you & I were on #Breakpoints we were asked whether there was a pyuria cutoff to help differentiate btw infection & colonization
Here may be one (in elderly ♀️ at least) #IDSky
academic.oup.com/cid/article/...
@cjcrnich.bsky.social 😊 when you & I were on #Breakpoints we were asked whether there was a pyuria cutoff to help differentiate btw infection & colonization
Here may be one (in elderly ♀️ at least) #IDSky
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
November 24, 2024 at 6:55 AM
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%."
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%."
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
November 23, 2024 at 8:25 PM
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
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
Welcome to Blue Sky! 🌟 #AMSsky #IDsky #pharmsky #skyRX #medsky
November 22, 2024 at 10:16 PM
The look I get from SICU when I tell them they can stop ABX 24 hours after early GI perf repair 👀👽 #IDsky #pharmsky #AMSsky
November 22, 2024 at 6:16 PM
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
@idsainfo.bsky.social
@sidpharm.bsky.social
#IDsky
🌟 ABX Pearl of the Day: Best practices for Tx of uncomplicated GNR bacteremia💊
📋 Q: My patient presented with septic shock from a urinary source, blood cultures positive for E. coli.
What is the duration of therapy, and must I use IV to complete the course for Enterobacterales bacteremia? 🤔
#IDsky
📋 Q: My patient presented with septic shock from a urinary source, blood cultures positive for E. coli.
What is the duration of therapy, and must I use IV to complete the course for Enterobacterales bacteremia? 🤔
#IDsky
November 20, 2024 at 8:31 PM
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
@idsainfo.bsky.social
@sidpharm.bsky.social
#IDsky
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
Me: Pick anything. You're just about done with treatment!
...1g q8h
#IDsky #medsky #pharmsky #RXsky
🔥BALANCE RCT🔥
74 hospitals in 7 countries
3,608 patients
A 7-day course of antibiotics for hospitalized patients with bloodstream infections was non inferior to 14d within a 4% prespecified margin for mortality at 90 days #idsky
www.nejm.org/doi/full/10....
74 hospitals in 7 countries
3,608 patients
A 7-day course of antibiotics for hospitalized patients with bloodstream infections was non inferior to 14d within a 4% prespecified margin for mortality at 90 days #idsky
www.nejm.org/doi/full/10....
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM
Bloodstream infections are associated with substantial morbidity and mortality. Early,
appropriate antibiotic therapy is important, but the duration of treatment is uncertain.
In a multicenter, non...
www.nejm.org
November 20, 2024 at 2:43 PM
Reposted by Lina Meng, PharmD
Congratulations to @nischalr3.bsky.social and his team for their paper being selected as the @thetxidjournal.bsky.social 2024 Bob Rubin Clinical Impact Awardee - this award selects the paper felt to have the biggest impact on clinical care in #TxID!
#IDSky
onlinelibrary.wiley.com/doi/10.1111/...
#IDSky
onlinelibrary.wiley.com/doi/10.1111/...
Evaluating antimicrobial duration for Gram‐negative bacteremia in patients with neutropenia due to hematologic malignancy or hematopoietic stem cell transplantation
In the management of immunocompromised patients with neutropenia and Gram-negative bloodstream infection, short antimicrobial courses (≤10 days) had comparable propensity score-adjusted 90-day outcom...
onlinelibrary.wiley.com
November 18, 2024 at 3:17 PM
Congratulations to @nischalr3.bsky.social and his team for their paper being selected as the @thetxidjournal.bsky.social 2024 Bob Rubin Clinical Impact Awardee - this award selects the paper felt to have the biggest impact on clinical care in #TxID!
#IDSky
onlinelibrary.wiley.com/doi/10.1111/...
#IDSky
onlinelibrary.wiley.com/doi/10.1111/...
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
November 18, 2024 at 6:49 PM
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
November 18, 2024 at 5:46 PM
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
Reposted by Lina Meng, PharmD
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
November 15, 2024 at 3:16 PM
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