Matt Pike
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mattpike.bsky.social
Matt Pike
@mattpike.bsky.social
Hospital Pharmacist- Antimicrobial Stewardship / Infectious Disease, but enjoy dabbling in any and all therapeutic areas
Wanted to get a feel for how many sites are using loading regimens of clofazimine for NTM given PK. If so, what dosing strategy? Any barriers from FDA or manufacturer as far as IND including this dosing strategy? #IDSky
October 10, 2025 at 11:43 AM
Reposted by Matt Pike
For streptococci, blood cultures virtually always cleared by day 2, so clearing quickly is not helpful. In contrast, for MSSA, MRSA, and E faecalis, clearance of blood cultures after 1 day of therapy was also very helpful at negatively adjusting the risk of IE. #IDSky
🆕🔥Case-control study @bradspellberg.bsky.social
Just 1/4 blood cultures positive (≥2 sets drawn) or early clearance → low IE probability. Persistent bacteremia or 4/4 bottles ↑ pretest probability
Simple bedside clues to sharpen your endocarditis game. #IDSky #EMIMCC
jamanetwork.com/journals/jam...
May 2, 2025 at 12:48 PM
Reposted by Matt Pike
@steventong.bsky.social presents the results of the PSSA domain of the SNAP 🫰 trial - the worlds largest trial of staph aureus bacteremia - at #ESCMID2025

fluclox resulted in higher mortality and more AKI compared to penicillin for PSSA
April 12, 2025 at 2:45 PM
Reposted by Matt Pike
The most anticipated RCT in ID
🔥SNAP RCT🔥The largest RCT 2 date in SA bactermia
N:1341
Cefazolin Vs ASPs ((flu)cloxacillin) for MSSA bacteremia
Cefazolin is non-inferior (90d mortality)& less AKI than ASPs
A practice-changer RCT that must change the guidelines
#ESCMIDGlobal #IDSky
April 12, 2025 at 3:14 PM
Reposted by Matt Pike
Say it aint STENO! New #Breakpoints episode out today with the brilliant Amy Mathers and @juliejusto.bsky.social on behalf of @sidpharm.bsky.social

We hope you love it!! 🎧 🎶 🧫

podcasts.apple.com/us/podcast/b...
February 28, 2025 at 12:27 PM
Reposted by Matt Pike
From a talk on clinician job security in the AI era

There may be compelling use cases driven by need & product suitability, but they are a cover for profit-driven uses

Inspired by UPMC Infectious Disease Connect, Telehealth docs who undercut local clinicians for a contract at an urban NC hospital
March 28, 2025 at 1:34 PM
Reposted by Matt Pike
Noticeably silent amid the upheaval at HHS? Big pharma. Every new drug has NIH somewhere in its DNA--and NIH funding supports the training of their workforce. Now they're finding out FDA isn't safe, either. Wrote about how keeping quiet isn't working My latest @opinion.bloomberg.com (gift link):
Big Pharma Needs to Get Off the Sidelines
The industry can’t continue to sit idly by while Robert F. Kennedy Jr. guts the nation’s public health agencies.
www.bloomberg.com
April 1, 2025 at 3:08 PM
Reposted by Matt Pike
Scientists have just cured pancreatic cancer in some patients with personalized mRNA vaccines. Pancreatic cancer. And this Trump administration wants to throw it all away.

They’re throwing away a cure for cancer.
March 17, 2025 at 1:16 AM
Reposted by Matt Pike
Blood culture–negative endocarditis has been associated with worse outcomes when compared with blood culture–positive endocarditis, because pathogen‐directed antimicrobial therapy and other management aspects have been difficult to achieve #idsky
🔥Just published 🔥
Blood Culture–Negative Endocarditis: A Scientific Statement From the American Heart Association: Endorsed by the International Society for Cardiovascular Infectious Diseases
Read the note about gentamicin/Rifampin in fig-3
www.ahajournals.org/doi/10.1161/...
March 17, 2025 at 7:17 PM
Reposted by Matt Pike
Cefazolin may be an empiric treatment option for complicated urinary tract infections in those institutions with high susceptibilities for common UTI pathogens.
#pharmsky #idsky

rdcu.be/edSSG
A comparison of empiric therapy with cefazolin versus ceftriaxone for patients with complicated urinary tract infections in a tertiary care veterans affairs medical center | BMC Infectious Diseases
rdcu.be
March 17, 2025 at 1:45 PM
Reposted by Matt Pike
In patients presenting with cUTI (including acute pyelonephritis) who are improving clinically on effective therapy, we suggest treating with a shorter course of antimicrobials, using either 5-7 days of a FQ or 7d of Non FQ rather than 10-14d
14 days for cUTI is obselete! #idsky #medsky #EMIMCC
🔥A sneak peak on the upcoming IDSA guidelines for cUTI🔥
Public Comment: IDSA Guideline on Management and Treatment of Complicated Urinary Tract Infections
So it's still not published yet ! #idsky #medsky #utisky
www.idsociety.org/practice-gui...
February 19, 2025 at 10:08 PM
Reposted by Matt Pike
Echinocandin Vs fluconazole step down in patients with candida glabrata candidaemia?!
🆕💫Retrospective, single-centre cohort study #JAC
No significant difference in treatment duration ,incidence of persistent candidaemia or 30-day clinical failure between 2 gps #idsky
academic.oup.com/jac/advance-...
Fluconazole step-down therapy versus echinocandins for the treatment of Candida glabrata invasive candidiasis with candidaemia
AbstractObjectives. Candida glabrata is the second most common species responsible for invasive candidiasis, including candidaemia. Echinocandins are typic
academic.oup.com
January 28, 2025 at 12:55 PM
Reposted by Matt Pike
fear of inadequate empiric coverage leads to excessive use of broad-spectrum antibiotics. to reassure you that it's OK to get it wrong (sometimes), we looked at clinical outcomes when empiric antibiotics were insufficiently broad and needed to be escalated
doi.org/10.1093/cid/...
January 29, 2025 at 2:45 AM
Reposted by Matt Pike
🔥🔥 NEW 🔥🔥
Year In Review: Top Infectious Diseases Articles From 2024
Our new post, a great collaboration with my friend
🌟 @idstewardship.bsky.social
1️⃣6️⃣⚡️🆔 RCTs
7️⃣Syst Reviews/Meta
3️⃣🌏Guidelines ✨️Wiki_Guidelines
#idsky #EMIMCC #medsky #utisky
EnJoy
Share plz!
www.idstewardship.com/year-review-...
Year In Review: Top Infectious Diseases Articles From 2024
In this article a selection of notable peer-reviewed publications from 2024 are provided. Article Selection by: Bassam Ghanem, Pharm.D., MS, BCPS Article Construction by: Timothy P. Gauthier, Pharm.D....
www.idstewardship.com
December 11, 2024 at 11:47 PM
Reposted by Matt Pike
In their defence avibactam is a much better BLI than the 1st gen BLIs.

Lower ratios required for inhibition, less likely to encounter Rx failure through Beta lactamase hyperproduction.

We’ve done an episode on it, link to the show notes here for the interested:
idiots.notion.site/44-Beta-Lact...
November 30, 2024 at 4:38 PM
Reposted by Matt Pike
And importantly, they gave NO IV LEAD IN to most patients in the oral arm. Started oral on day 1. Further busting the myth that some magical amount of IV lead in is necessary.
January 25, 2025 at 7:07 PM
Reposted by Matt Pike
In the latest Bench to Bedside Column @sidpharm.bsky.social Dr. Jordan Chiasson and Dr. Kristen Zeitler, discuss IV push administration including safety profiles, PK/PD characteristics, and clinical data for IV push administration prior to utilizing it in specific populations. #Idsky
Intravenous Antimicrobials: Is It Time to Push?
Intravenous (IV) push is an attractive option to administer antimicrobial therapy to patients in an efficient and effective manner in a variety of clinical settings. While many advantages to IV push a...
www.contagionlive.com
January 29, 2025 at 9:24 PM
Reposted by Matt Pike
Today I fielded a call from a colleague about “recurrent UTI” in a nursing home resident. It turned into a great diagnostic stewardship opportunity where I shared this great resource from AHRQ on talking to residentes and families about UTI/ASB.

www.ahrq.gov/sites/defaul...

#IDSky #MedSky #UTISky
January 17, 2025 at 2:05 AM
Reposted by Matt Pike
ID rule of thumb is to prophylax against PJP when high-dose steroids are used (i.e. 20mg or more of prednisone daily) for 4 or more weeks. Prophylactic regimens and other indications for prophylaxis are reviewed nicely in the linked JAMA article.

www.doi.org/10.1001/jama...
Prophylaxis Against Pneumocystis jirovecii Pneumonia in Adults
This JAMA Insights Clinical Update discusses current recommendations regarding prevention of Pneumocystis pneumonia in patients who are immunocompromised.
www.doi.org
January 14, 2025 at 1:48 PM
Reposted by Matt Pike
Interested in the use of antibiotics at end of life? Join our #ESCMID webinar on the topic next Wednesday 9-11am EST!
I'm honored to be speaking among the international panel.

You can register here! #IDSky

docs.google.com/forms/d/e/1F...
January 14, 2025 at 4:23 PM
Reposted by Matt Pike
🦠 New insights from CACTUS: Ceftolozane-tazobactam shows higher clinical success rates than ceftazidime-avibactam for multidrug-resistant Pseudomonas aeruginosa pneumonia. A crucial step in optimizing treatment!

www.thelancet.com/journals/lan... #InfectiousDiseases
Effectiveness of ceftazidime–avibactam versus ceftolozane–tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study
Treatment with ceftolozane–tazobactam resulted in higher rates of clinical success compared with ceftazidime–avibactam for invasive infections due to multidrug-resistant P aeruginosa. Differences were...
www.thelancet.com
January 14, 2025 at 8:13 PM
Reposted by Matt Pike
🔗 References:
1. CLSI M100 ED34:2024, Table 2A-1, Table 2D, Appendix E, Table 2 Dosages
2. Rationale document clsi.org/standards/pr...
MRPKG | Product MRPKG
Rationale Document Package
clsi.org
January 13, 2025 at 3:30 PM
Reposted by Matt Pike
Reposted by Matt Pike
🆕💫 Narrative Review @cmicomms.bsky.social
@jeffpears0n.bsky.social
Tetracyclines, the Old and the New
🔹Tetracycline 1953
✨Doxycycline 1967
🔹Minocycline 1971
🔹Tigecycline 2005
🔹Eravacycline 2018
🔹Omadacycline 2018
#IDsky #EMIMCC
www.sciencedirect.com/science/arti...
January 13, 2025 at 11:20 AM