LA General is seeking a Director of Inflammatory Bowel Disease and Director of GI Ambulatory Care in the Division of Gastroenterology and Hepatology. See job description attached!

Thanks to @absteward.bsky.social for finding the most recent Shorter is Better: TB Is Complex Study. Shows 8 week regimens are inferior to 24 week for cure. Sets a lower boundary for TB. Slides and website updated.
www.bradspellberg.com/shorter-is-b...

Thanks to @josemolinagb.bsky.social from Seville, Spain, for finding a great Shorter Is Better study from 2021 for bronchiectasis exacerbations! Updated tables attached, with link to website with citations. Had to shrink the font to fit so many RCTs in table!
www.bradspellberg.com/shorter-is-b...

@lageneral.bsky.social
Congratulations to LA General for 3 straight Leapfrog A grades! 1.5 years of sustained excellence and counting!

Oh no! The pipeline is still not dying!

We're not even half way through the current 5 year period in the graph...
Also, the Table is getting awfully full!

Thanks to @absteward.bsky.social for finding 2 RCTs of shorter (1 IM dose) vs. longer (3 weekly IM doses) of PCN for "Early Syphilis"! Added to the Shorter Is Better Table. 23 distinct conditions now reported in the table!
References at
www.bradspellberg.com/shorter-is-b...

Attention Med Blue Sky! LA General has nearly completed its once-in-a-generation transformation! Only a few positions left. We need:

OB Gyn (hospitalists)
Maternal Fetal Medicine
Rheum
Nephrology

County employment, excellent benefits, loan repayment.
Contact me! bspellberg@dhs.lacounty.gov

Thanks to @absteward.bsky.social who always finds new studies first! TB is indeed complex. For rif-resistance, we had a 6 mo novel regimen vs. 9-20 mo standard therapy RCT. Now we add an RCT comparing 5 novel regimens, 4 were NI to 18-24 std therapy. Tables updated! bradspellberg.com/shorter-is-b...

It's a good question. For time>MIC killer, TID might make more sense PK/PD wise. On other hand, adherence might be worse. There's only one way to know if 1 is better. Someone gotta do the trial. The below slide is from my Shorter Is Better talk. When I have data, Im a different clinician...

Thx to
@absteward.bsky.social for finding a new oral vs. IV osteo RCT! Primary endpoint was re surgery. But, 2nd endpoints = treatment failure, recurrence, and non-union. Similar oral vs. IV outcomes for all outcomes. So this is the 10th RCT now, added to table. bradspellberg.com/oral-antibio...

Medscape's annual physician specialty salary report is out. IDSA still fiddling while Rome burns.
The yellow highlighted statement in the report is sad...but true. Change is needed. Who will champion it? We know IDSA won't.

This is discussed in wikiguidelines. It is reasonable to not reset if the valve culture from the explant is negative, and it is reasonable to start over if the culture is positive. But there are no data really either way. See WikiGuidelines answer below.

LA General is nearing the finish line of our hiring transformation. We have hired an unprecedented 250 physicians/APPs in 16 months. We are the largest US public hospital, & busiest trauma center, West of Texas. We're on a journey to become the best public hospital in the US.