Sophia Lee
@sophiaylee.bsky.social
#OTILT IV amikacin can be used for severe or treatment-resistant Mycobacterium avium complex (MAC) pulmonary disease. Current guidelines state that it can be used as an adjunct therapy to the standard regimen to help achieve culture conversion in severe or previously treated cases.
November 27, 2025 at 1:13 AM
#OTILT IV amikacin can be used for severe or treatment-resistant Mycobacterium avium complex (MAC) pulmonary disease. Current guidelines state that it can be used as an adjunct therapy to the standard regimen to help achieve culture conversion in severe or previously treated cases.
#OTILT Meropenem/vaborbactam is a combination of carbapenem and novel-beta lactamase inhibitor that was designed specifically to target Klebsiella pnumoniae carbapenemases (KPCs). Vaborbactam does not have antibacterial activity, but protects meropenem by inhibiting KPB enzymes from hydrolyzing it.
November 26, 2025 at 12:10 AM
#OTILT Meropenem/vaborbactam is a combination of carbapenem and novel-beta lactamase inhibitor that was designed specifically to target Klebsiella pnumoniae carbapenemases (KPCs). Vaborbactam does not have antibacterial activity, but protects meropenem by inhibiting KPB enzymes from hydrolyzing it.
#OTILT Tetracyclines are broad-spectrum antibiotics used for atypical pathogens, such as Mycoplasma pneumoniae, Anaplasmosis, Chlamydia, Brucella, and more, and also have MRSA coverage. However, it has intrinsic resistance to Pseudomonas, Proteus, and Providencia.
November 25, 2025 at 12:50 AM
#OTILT Tetracyclines are broad-spectrum antibiotics used for atypical pathogens, such as Mycoplasma pneumoniae, Anaplasmosis, Chlamydia, Brucella, and more, and also have MRSA coverage. However, it has intrinsic resistance to Pseudomonas, Proteus, and Providencia.
#OTILT Chorioamnionitis is an intra-amniotic infection, usually from bacteria ascending the lower genital tract. Typically, it is polymicrobial, commonly Ureaplasma, Gardnerella, and Mycoplasma. The ACOG guideline recommends a combination of ampicillin and gentamicin for treatment when suspected.
November 21, 2025 at 5:47 PM
#OTILT Chorioamnionitis is an intra-amniotic infection, usually from bacteria ascending the lower genital tract. Typically, it is polymicrobial, commonly Ureaplasma, Gardnerella, and Mycoplasma. The ACOG guideline recommends a combination of ampicillin and gentamicin for treatment when suspected.
#OTILT Ribavirin is an antiviral for hepatitis C treatment, and one of its major toxicities is hemolytic anemia. Ribavirin accumulates in red blood cells and induces oxidative damage, leading to accelerated RBC destruction and reduced hemoglobin levels. It is usually reversible upon discontinuation.
November 20, 2025 at 11:42 PM
#OTILT Ribavirin is an antiviral for hepatitis C treatment, and one of its major toxicities is hemolytic anemia. Ribavirin accumulates in red blood cells and induces oxidative damage, leading to accelerated RBC destruction and reduced hemoglobin levels. It is usually reversible upon discontinuation.
#OTILT Meropenem has DDI with valproic acid by decreasing serum VPA levels rapidly within 24 hours, thus increasing risk for seizure. A retrospective study has shown that after discontinuation of meropenem, the VPA concentration still remained low for 7 days and started to rise after 8-14 days.
November 19, 2025 at 6:02 PM
#OTILT Meropenem has DDI with valproic acid by decreasing serum VPA levels rapidly within 24 hours, thus increasing risk for seizure. A retrospective study has shown that after discontinuation of meropenem, the VPA concentration still remained low for 7 days and started to rise after 8-14 days.
#OTILT Azole antifungals prolong the QT interval by directly inhibiting the hERG potassium channel. By blocking it, it slows repolarization, causing a longer QT interval. The azoles also inhibit the CYP3A4 enzyme, which may increase the level of the drug that can prolong QT.
November 18, 2025 at 10:45 PM
#OTILT Azole antifungals prolong the QT interval by directly inhibiting the hERG potassium channel. By blocking it, it slows repolarization, causing a longer QT interval. The azoles also inhibit the CYP3A4 enzyme, which may increase the level of the drug that can prolong QT.
#OTILT Steroids cause demargination of neutrophils by reducing adhesion molecule expression. It releases them into circulation, increasing total WBC count without a true increase in cell production. A study has shown that WBC counts can increase by up to 4.84 within 48 hours of high-dose steroids.
November 17, 2025 at 8:18 PM
#OTILT Steroids cause demargination of neutrophils by reducing adhesion molecule expression. It releases them into circulation, increasing total WBC count without a true increase in cell production. A study has shown that WBC counts can increase by up to 4.84 within 48 hours of high-dose steroids.
#OTILT Oral fosfomycin is effective against uncomplicated UTI. However, its efficacy against non-E.coli pathogen remains uncertain. Oral fosfomycin 3g did not reliably prevent regrowth of Kleb pneumoniae in an in-vitro UTI model, especially at high bacterial inocula.
November 15, 2025 at 1:44 AM
#OTILT Oral fosfomycin is effective against uncomplicated UTI. However, its efficacy against non-E.coli pathogen remains uncertain. Oral fosfomycin 3g did not reliably prevent regrowth of Kleb pneumoniae in an in-vitro UTI model, especially at high bacterial inocula.
#OTILT Prophylactic ABX should be given before surgery, and if continued, it should be stopped ≤24 hours post-op. Current guidelines do not support post-operative prophylactic ABX d/t no clear benefits. A retrospective study showed prolonged ABX prophylaxis increased AE (AKI, CDI) w/o reducing SSI.
November 13, 2025 at 7:48 PM
#OTILT Prophylactic ABX should be given before surgery, and if continued, it should be stopped ≤24 hours post-op. Current guidelines do not support post-operative prophylactic ABX d/t no clear benefits. A retrospective study showed prolonged ABX prophylaxis increased AE (AKI, CDI) w/o reducing SSI.
#OTILT Pip/tazo may be used in ESBL E.coli UTI. However, it's not recommended for other ESBL infections. In an RCT comparing pip/tazo with meropenem for bloodstream infections caused by E. coli or K. pneumoniae with CTX resistance, pip/tazo failed to meet non-inferiority for 30-day mortality.
November 12, 2025 at 10:06 PM
#OTILT Pip/tazo may be used in ESBL E.coli UTI. However, it's not recommended for other ESBL infections. In an RCT comparing pip/tazo with meropenem for bloodstream infections caused by E. coli or K. pneumoniae with CTX resistance, pip/tazo failed to meet non-inferiority for 30-day mortality.
#OTILT Beta-lactams are first-line therapy for MSSA bacteremia. In a retrospective cohort study, pip-tazo was found to have higher mortality in 30 days after culture compared to nafcillin, oxacillin, or cefazolin when used as monotherapy.
November 10, 2025 at 7:20 PM
#OTILT Beta-lactams are first-line therapy for MSSA bacteremia. In a retrospective cohort study, pip-tazo was found to have higher mortality in 30 days after culture compared to nafcillin, oxacillin, or cefazolin when used as monotherapy.
#OTILT Clindamycin can suppress toxin production by inhibiting bacterial protein synthesis, reducing the effects of group A strep toxins. However, in the case of clindamycin resistance, a study showed linezolid was non-inferior to clindamycin in terms of risk of in-hospital mortality.
November 7, 2025 at 8:40 PM
#OTILT Clindamycin can suppress toxin production by inhibiting bacterial protein synthesis, reducing the effects of group A strep toxins. However, in the case of clindamycin resistance, a study showed linezolid was non-inferior to clindamycin in terms of risk of in-hospital mortality.
#OTILT Febrile neutropenic pts often receive broad-spectrum beta-lactams alone or in combination. In patients w/ febrile neutropenia d/t MSSA BSI, use of combo beta-lactam therapy was associated with higher odds of 60-day all-cause mortality compared to monotherapy of broad-spectrum beta-lactam.
November 7, 2025 at 2:31 AM
#OTILT Febrile neutropenic pts often receive broad-spectrum beta-lactams alone or in combination. In patients w/ febrile neutropenia d/t MSSA BSI, use of combo beta-lactam therapy was associated with higher odds of 60-day all-cause mortality compared to monotherapy of broad-spectrum beta-lactam.
#OTILT When concerned for bacterial meningitis, patients are given ceftriaxone to cover Haemophilus influenzae, Neisseria meningitidis, and Strep pneumoniae, vancomycin for ceftriaxone-resistant S. pneumoniae, and ampicillin for Listeria empirically. Then, based on culture, ABX would be narrowed.
November 5, 2025 at 8:36 PM
#OTILT When concerned for bacterial meningitis, patients are given ceftriaxone to cover Haemophilus influenzae, Neisseria meningitidis, and Strep pneumoniae, vancomycin for ceftriaxone-resistant S. pneumoniae, and ampicillin for Listeria empirically. Then, based on culture, ABX would be narrowed.
#OTILT TEM-1 is most common beta-lactamase enzyme in H. influenzae, which provides resistance by hydrolyzing the beta-lactam ring in ABX. This prevents drug from binding to PBPs, failing to inhibit cell-wall synthesis. It can be treated w/ extended-spectrum cephalosporins such as CTX or cefepime.
November 4, 2025 at 7:45 PM
#OTILT TEM-1 is most common beta-lactamase enzyme in H. influenzae, which provides resistance by hydrolyzing the beta-lactam ring in ABX. This prevents drug from binding to PBPs, failing to inhibit cell-wall synthesis. It can be treated w/ extended-spectrum cephalosporins such as CTX or cefepime.
#OTILT CMV is a common infection after allogeneic hematopoietic-cell transplantation. Letermovir is used for CMV PPX in CMV-seropositive transplant recipients. Compared to placebo, it was associated with significantly lower CMV risk by week 24 (37.5% vs 60.6%; p<0.001) with mostly mild SE.
November 3, 2025 at 9:20 PM
#OTILT CMV is a common infection after allogeneic hematopoietic-cell transplantation. Letermovir is used for CMV PPX in CMV-seropositive transplant recipients. Compared to placebo, it was associated with significantly lower CMV risk by week 24 (37.5% vs 60.6%; p<0.001) with mostly mild SE.
#OTILT CD4 is a surface protein on helper T-cells that helps recognize foreign invaders and signal other immune cells to respond. In HIV patients, CD4 counts can become low as HIV binds to and enters CD4 T-cells, destroying them over time. However, it can also be influenced by overall WBC counts.
October 31, 2025 at 9:31 PM
#OTILT CD4 is a surface protein on helper T-cells that helps recognize foreign invaders and signal other immune cells to respond. In HIV patients, CD4 counts can become low as HIV binds to and enters CD4 T-cells, destroying them over time. However, it can also be influenced by overall WBC counts.
#OTILT Nitrofurantoin is DOC in uncomplicated cystitis. However, it can rarely cause pulmonary toxicity, likely due to oxidative stress from its liver metabolism. This stress can damage cells and trigger inflammation, leading to immune activation and fluid filled inflammatory cells in the lungs.
October 30, 2025 at 10:04 PM
#OTILT Nitrofurantoin is DOC in uncomplicated cystitis. However, it can rarely cause pulmonary toxicity, likely due to oxidative stress from its liver metabolism. This stress can damage cells and trigger inflammation, leading to immune activation and fluid filled inflammatory cells in the lungs.
#OTILT IgM and IgG antibodies to Mycoplasma pneumoniae can be used to help diagnose. A (+) IgM result indicates a recent or current infection, as it is the first antibody that body produces in response to infection. However, (+) IgG shows a past infection as it develops later in course of illness.
October 29, 2025 at 9:40 PM
#OTILT IgM and IgG antibodies to Mycoplasma pneumoniae can be used to help diagnose. A (+) IgM result indicates a recent or current infection, as it is the first antibody that body produces in response to infection. However, (+) IgG shows a past infection as it develops later in course of illness.
#OTILT Methenamine is used for the prevention of recurrent UTIs. It is a prodrug that requires a urine pH below 6 to be hydrolyzed into formaldehyde and ammonia, producing its antibacterial effect. To maintain an acidic urine environment, it is often given with 2-4 g of ascorbic acid daily.
October 28, 2025 at 6:13 PM
#OTILT Methenamine is used for the prevention of recurrent UTIs. It is a prodrug that requires a urine pH below 6 to be hydrolyzed into formaldehyde and ammonia, producing its antibacterial effect. To maintain an acidic urine environment, it is often given with 2-4 g of ascorbic acid daily.
#OTILT Cefazolin has been observed to exhibit an inoculum effect, characterized by an increased MIC when bacterial concentrations are elevated in vitro, in MSSA isolates. However, clinical relevance of this phenomenon remains unclear, and cefazolin is recommended for native-valve MSSA endocarditis.
October 27, 2025 at 6:19 PM
#OTILT Cefazolin has been observed to exhibit an inoculum effect, characterized by an increased MIC when bacterial concentrations are elevated in vitro, in MSSA isolates. However, clinical relevance of this phenomenon remains unclear, and cefazolin is recommended for native-valve MSSA endocarditis.
#OTILT Pip/tazo may rarely cause drug-induced transaminitis. Mild ALT and bilirubin elevations can occur 1-3 weeks after starting or within days to weeks after stopping therapy. Usually, it's self-limited and resolved upon discontinuation. However, acute liver injury is suspected if ALT ≥5× ULN.
October 24, 2025 at 9:24 PM
#OTILT Pip/tazo may rarely cause drug-induced transaminitis. Mild ALT and bilirubin elevations can occur 1-3 weeks after starting or within days to weeks after stopping therapy. Usually, it's self-limited and resolved upon discontinuation. However, acute liver injury is suspected if ALT ≥5× ULN.
#OTILT Mechanisms of methicillin resistance in Staph. aureus occurs by drug target modification. MRSA acquires the MecA gene that encodes for PBP2a, which has very low affinity for beta-lactam antibiotics. This allows the bacterium to continue synthesizing cell wall, limiting access of beta-lactam.
October 23, 2025 at 9:38 PM
#OTILT Mechanisms of methicillin resistance in Staph. aureus occurs by drug target modification. MRSA acquires the MecA gene that encodes for PBP2a, which has very low affinity for beta-lactam antibiotics. This allows the bacterium to continue synthesizing cell wall, limiting access of beta-lactam.
#OTILT β-lactams exhibit time-dependent killing. The efficacy is determined by duration that drug concentration remains above MIC of pathogen, rather than by peak level. To optimize, prolonged infusions may be used to maintain drug concentrations above MIC for a greater portion of dosing interval.
October 22, 2025 at 6:12 PM
#OTILT β-lactams exhibit time-dependent killing. The efficacy is determined by duration that drug concentration remains above MIC of pathogen, rather than by peak level. To optimize, prolonged infusions may be used to maintain drug concentrations above MIC for a greater portion of dosing interval.