@conanmacdougall
Professor of Clinical Pharmacy @UCSFPharmacy, Infectious Diseases Pharmacist | Evidence-informed Instructional Design, Infectious Diseases Pharmacotherapy | Hiking, Backpacking, Boston Celtics Basketball
Study on 157 pts with P. aeruginosa bacteremia: 90-day mortality ~30% (7-day ABX) vs ~21% (14-day); no sig diff in mortality (OR 1.47) but sample size limited.๐ฆ โ๏ธ
#IDsky sharing one of the Stanford's ID fellow's meded site infectiousdiseasehub.com #idmeded #meded
We talked about PEN-FAST in class today so I sent the clip to my students!
Sounds like an exciting tool for OPAT! But I gotta say as a pharmacist seeing โIV Ensureโ just seems like an order you would see in the hospital in Julyโฆ
Pull-up bars in the airport is only the start! Next we replace the plane seats with individual pull-up bars! What better way to use otherwise wasted time flying! Plus the airlines can pack more people in! Worried about turbulence? Nah, thatโs just an opportunity to work on your core strength!
Optimal dosing strategy not clear, but pretty good success rates >90% with amoxicillin. I think in the era of PenG shortage, amox needs to 1) be expedited as an RCT compared to PenG; 2) considered an alternative with doxy
academic.oup.com/cid/article/...
(Whether 62.5mg of clavulanate per dose is going be useful against any beta lactamase producer besides some wimpy H flu is a different story, and maybe 2g amox is only tolerable because thereโs so little clav with it)
3/3: Approved dose of 4g/d of amox vs <2g/d with Augmentin 875 BID? Like it. Prolonged plasma concentrations to allow real Bid dosing? Sign me up. What do others think? Anybody an XR user? Was it well tolerated? Worth the likely price premium vs non-XR? Any chance at contemporary PKPD studies? (Ha)
2/x TID is more serious but nobody likes TID even for short course. Into this breach apparently will be coming the revival of Augmentin XR: www.cidrap.umn.edu/antimicrobia.... I admit to rarely using when it was available, but it seems like a useful tool:
1/x: Mildly spicy take is that Augmentin 875 BID for serious infections is less โmop-upโ and more like the generic brand paper towel that dissolves in the Bounty commercials. If it works itโs likely because you didnโt need it at all, because the PKPD is wishful thinking.
The Brigham and Women's PGY2 Infectious Diseases Pharmacy Residency is recruiting for the 2026-27 year! Scan the second QR code below to schedule an on-demand meeting with program leadership and current residents
Excited to see the โAdvances in Influenza Therapeuticsโ supplement out in @jidjournal.bsky.social - led by Fred Hayden and Rich Whitley, this supplement reviews what we know about antivirals and how they should be used for influenza.
academic.oup.com/jid/issue/23...
Come work as an ID pharmacist at @ucsfhealth.bsky.social! See the craziest cases, collaborate with the coolest pharmacists and physicians, teach trainees from pharmacy students to ID fellows!
sjobs.brassring.com/TGnewUI/Sear...
I first read it as โEpicpocalypseโ and thought it was a game about adopting EPIC as your EMR and thought โhey thatโs spot-on!โ
โYou say youโve โdone your researchโ but have you done your โResponsible Conduct of Researchโ?โ
In OFID, Yuki Nakano and colleagues investigate the signals and characterize the clinical features of optic nerve disorders related to oxazolidinones using the FAERS database. https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofaf520/8242009
MAHA gold-standard science.
By @glaucomflecken.bsky.social
Predict it will take at least a decade until people stop saying โpositives are it works better, negatives are itโs a lot more expensive that vancoโ. See Zolid, Line. @pharmermeg.bsky.social
feels significant that mass-market LLMs like ChatGPT are now capable of generating extensive natural-language dossiers about a given user's interests, location, preferences, identifying information, and more
simonwillison.net/2025/May/21/...
we lack good PK/PD models of what โmop-upโ looks like. It would be a lot more reassuring to have a โmop-upโ target exposure. This paper (h/t Nav Narayan) being an example (journals.asm.org/doi/10.1128/...). Important as new PO carbapenems hit the market.
Yeah that was one of my main takeaways- TID or QID is less fun than BID but is in line with the Pk and PK/PD of these drugs and with shortened overall durations is usually only like 3-5 days of completion tx. I think the main argument vs more aggressive dosing is โthis is just mop-upโ but 1/
This paper has had such a journey that I feel compelled to share it. It started when our ID PharmD resident gave an in-service to @templeid.bsky.social as a 'how-to' use oral beta-lactams for systemic Gram-negative infections, then was submitted, turned down, 1/ academic.oup.com/ofid/article...
Normally a paper that concludes โShould you do X? It depends.โ wouldnโt be at the top of my reading list but I think our (@jgpharmd.bsky.social, @emilylheil.bsky.social) new case-based paper on PO beta-lactams for GNRs highlights nuances & challenges generalizations academic.oup.com/ofid/article...
I wrote about the era of Mass Intelligence.
GPT-5 and Nano Banana are examples of how advanced AI is now making their way to many users, at scale, as both performance & efficiency keep improving. We are going to see a lot of weird things happening, all at once www.oneusefulthing.org/p/mass-intel...
Today, FDA approved seasonal covid vaccines for people 65+ and people with health conditions. I have updated my FAQ with more questions and answers from readers. www.forceofinfection.com/faq-on-fall-...
CDC list of medical conditions associated w higher risk for severe COVID-19, you need 1 to to qualify for vaccines now:
-Cancer (solid or blood cancers)
-Cerebrovascular disease (e.g., stroke)
-Chronic kidney disease (any stage)
-Chronic liver disease (fatty liver, cirrhosis, autoimmune hepatitis)
Finally a healthy reason for a second helping at Thanksgiving! Grab those Friday vaccine appointments while they last!
A figure showing the development of adaptive practice and the effects of AI
๐ก๐ฒ๐ ๐ ๐ฒ๐ฑ๐ถ๐ฐ๐ฎ๐น ๐๐ฑ๐๐ฐ๐ฎ๐๐ถ๐ผ๐ป ๐๐ฟ๐๐ถ๐ฐ๐น๐ฒ!
Many learners are more facile with the use of large language models in medicine than their supervisors are. The authors provide an approach to clinical supervision that can mitigate the perils and amplify the promise of AI. nej.md/47okmwr
