JD Talbot
@dr-jd.bsky.social
Stopping antibiotics as a living
Medical microbiologist & Infectious diseases MD
Hôpital de Saint-Jérôme
Medical microbiologist & Infectious diseases MD
Hôpital de Saint-Jérôme
With the steroids making their way in SOC, I wonder if the « anti-inflammatory » effect of macrolides will still be significant.
Would love to see a RCT b-lactam/steroids as base therapy with arms with vs without macrolides.
Would love to see a RCT b-lactam/steroids as base therapy with arms with vs without macrolides.
October 18, 2025 at 1:56 PM
With the steroids making their way in SOC, I wonder if the « anti-inflammatory » effect of macrolides will still be significant.
Would love to see a RCT b-lactam/steroids as base therapy with arms with vs without macrolides.
Would love to see a RCT b-lactam/steroids as base therapy with arms with vs without macrolides.
No amoxi-clav for campylobacter?
#sparethecarba
#sparethecarba
September 29, 2025 at 9:46 AM
No amoxi-clav for campylobacter?
#sparethecarba
#sparethecarba
2- If the complication is osteomyelitis, the bone penetration of amix is 10-20%, depending on the study. Again, with MICs of 4-8, it might not be enough (I’m even unsure if MICs 1-2 are attainable).
For these specific situations, I’d welcome more clinical data.
For these specific situations, I’d welcome more clinical data.
February 25, 2025 at 1:14 PM
2- If the complication is osteomyelitis, the bone penetration of amix is 10-20%, depending on the study. Again, with MICs of 4-8, it might not be enough (I’m even unsure if MICs 1-2 are attainable).
For these specific situations, I’d welcome more clinical data.
For these specific situations, I’d welcome more clinical data.
For LZD, I wholeheartedly agree.
For amox, I have some nuances :
1- In the POET substudy, they note a good PTA using actual MICs, but the PTA using a BP of 4 was 75-85% (we usually want 90%+). This is the EUCATS BP. CLSI uses 8 as a BP. With MICs of 4 I’d be cautious, and I wouldn’t use it if 8
For amox, I have some nuances :
1- In the POET substudy, they note a good PTA using actual MICs, but the PTA using a BP of 4 was 75-85% (we usually want 90%+). This is the EUCATS BP. CLSI uses 8 as a BP. With MICs of 4 I’d be cautious, and I wouldn’t use it if 8
February 25, 2025 at 1:14 PM
For LZD, I wholeheartedly agree.
For amox, I have some nuances :
1- In the POET substudy, they note a good PTA using actual MICs, but the PTA using a BP of 4 was 75-85% (we usually want 90%+). This is the EUCATS BP. CLSI uses 8 as a BP. With MICs of 4 I’d be cautious, and I wouldn’t use it if 8
For amox, I have some nuances :
1- In the POET substudy, they note a good PTA using actual MICs, but the PTA using a BP of 4 was 75-85% (we usually want 90%+). This is the EUCATS BP. CLSI uses 8 as a BP. With MICs of 4 I’d be cautious, and I wouldn’t use it if 8
Nice!
No mention of sex in the algorithm. Do I (fore)see official IDSA endorsement of 7 days total for men with pyelonephritis?
No mention of sex in the algorithm. Do I (fore)see official IDSA endorsement of 7 days total for men with pyelonephritis?
February 19, 2025 at 10:38 PM
Nice!
No mention of sex in the algorithm. Do I (fore)see official IDSA endorsement of 7 days total for men with pyelonephritis?
No mention of sex in the algorithm. Do I (fore)see official IDSA endorsement of 7 days total for men with pyelonephritis?
We typically go for 1000/125 TID (combining amox/clav 500/125 + amox 500)
Usually well tolerated, although some GI disturbances do happen.
Usually well tolerated, although some GI disturbances do happen.
January 29, 2025 at 2:37 PM
We typically go for 1000/125 TID (combining amox/clav 500/125 + amox 500)
Usually well tolerated, although some GI disturbances do happen.
Usually well tolerated, although some GI disturbances do happen.
My first reflex would be to confirm with the lab that there really were a MSSA & MRSA in the blood culture.
If assumed true, I’d probably go for dapto+cefaz or LZD, transitioning eventually to LZD *or* tmp-smx.
Vanc MIC of 2 is of concern, esp. w/ a young adult.
No special concern for GNR.
If assumed true, I’d probably go for dapto+cefaz or LZD, transitioning eventually to LZD *or* tmp-smx.
Vanc MIC of 2 is of concern, esp. w/ a young adult.
No special concern for GNR.
January 14, 2025 at 2:32 AM
My first reflex would be to confirm with the lab that there really were a MSSA & MRSA in the blood culture.
If assumed true, I’d probably go for dapto+cefaz or LZD, transitioning eventually to LZD *or* tmp-smx.
Vanc MIC of 2 is of concern, esp. w/ a young adult.
No special concern for GNR.
If assumed true, I’d probably go for dapto+cefaz or LZD, transitioning eventually to LZD *or* tmp-smx.
Vanc MIC of 2 is of concern, esp. w/ a young adult.
No special concern for GNR.
I agree.
Yet I find it less troublesome since I :
- Use a weightlifting belt
- Have new shoes (UA Reign 6)
- Added hip thrusts to my routine
I feel much more stabilized and my squats are less dependent on my quads doing all the work
Yet I find it less troublesome since I :
- Use a weightlifting belt
- Have new shoes (UA Reign 6)
- Added hip thrusts to my routine
I feel much more stabilized and my squats are less dependent on my quads doing all the work
January 11, 2025 at 4:36 PM
I agree.
Yet I find it less troublesome since I :
- Use a weightlifting belt
- Have new shoes (UA Reign 6)
- Added hip thrusts to my routine
I feel much more stabilized and my squats are less dependent on my quads doing all the work
Yet I find it less troublesome since I :
- Use a weightlifting belt
- Have new shoes (UA Reign 6)
- Added hip thrusts to my routine
I feel much more stabilized and my squats are less dependent on my quads doing all the work
Enfin, si c’est différent de la norme, il faut prévoir dans le syst. informatique et en formation nursing le scénario 2 ponctions.
Bref, c’est toute une gestion de changement d’implanter la ponction unique. Ça ne se fait pas « top down » en publiant un document directeur sans crier gare…
Bref, c’est toute une gestion de changement d’implanter la ponction unique. Ça ne se fait pas « top down » en publiant un document directeur sans crier gare…
December 18, 2024 at 8:31 PM
Enfin, si c’est différent de la norme, il faut prévoir dans le syst. informatique et en formation nursing le scénario 2 ponctions.
Bref, c’est toute une gestion de changement d’implanter la ponction unique. Ça ne se fait pas « top down » en publiant un document directeur sans crier gare…
Bref, c’est toute une gestion de changement d’implanter la ponction unique. Ça ne se fait pas « top down » en publiant un document directeur sans crier gare…
Je vois un enjeu pour les infections endovasc : comment différencier une contamination répandue à toutes les bouteilles d’une vrai bactériémie CoNS quand on est consultés et que le patient est déjà traité?
Je ne peux tout de même pas faire un TEP scan à tous mes patients avec pontage/valve/etc
Je ne peux tout de même pas faire un TEP scan à tous mes patients avec pontage/valve/etc
December 18, 2024 at 8:31 PM
Je vois un enjeu pour les infections endovasc : comment différencier une contamination répandue à toutes les bouteilles d’une vrai bactériémie CoNS quand on est consultés et que le patient est déjà traité?
Je ne peux tout de même pas faire un TEP scan à tous mes patients avec pontage/valve/etc
Je ne peux tout de même pas faire un TEP scan à tous mes patients avec pontage/valve/etc
Je suis peut-être cynique, mais je crois que mes bouteilles ne seront pas plus remplies que maintenant et que le nombre restera le même. On manque d’espace dans l’incubateur, on ne fait que 3 bouteilles…
Bref, pas d’avantage côté volume sauf si on perd l’accès veineux entre les 2 ponctions.
Bref, pas d’avantage côté volume sauf si on perd l’accès veineux entre les 2 ponctions.
December 18, 2024 at 8:31 PM
Je suis peut-être cynique, mais je crois que mes bouteilles ne seront pas plus remplies que maintenant et que le nombre restera le même. On manque d’espace dans l’incubateur, on ne fait que 3 bouteilles…
Bref, pas d’avantage côté volume sauf si on perd l’accès veineux entre les 2 ponctions.
Bref, pas d’avantage côté volume sauf si on perd l’accès veineux entre les 2 ponctions.