Good question for the next #UTI #guidelines or meanwhile for dedicated studies... Now the focus is on #ShorterIsBetter but the topic of modifying doses over the #antibiotic course in case of improvement according to primary infection site/source is still neglected.

Indeed even low doses of aminopenicillins can reach very high concentrations in the urinary tract allowing to use them for #VRE cystitis although isolates turn out to be resistant according to the antibiogram.

shea-online.org/shea-journal...

Not statistically significant differences among drugs but a slight preferable trend in favour of Meropenem_Vaborbactam, as already highlighted in previous and smaller studies.

Exactly. The key is the proper selection of the patient, focusing on the ones undergoing systemic antibiotics at higher risk. Unfortunately evidence is mainly driven by observational findings but several RCTs are underway.

pubmed.ncbi.nlm.nih.gov/35203786/

Minocycline usually shows the highest susceptibility rate but Pk/Pd features make it a suboptimal choice for BSI or pneumonia... Combination therapy and/or doubling the dose might be potential solutions. Lastly, IV administration is available in few countries.

www.sciencedirect.com/science/arti...

Interesting combinations from #POET but some are quite controversial, e.g. linezolid plus rifampicin for #MRSE

www.idstewardship.com/drug-drug-in...