Jonathan Youngs

Infectious Diseases / Viro doc. Interest in med ethics & fungal disease in flu and COVID. Opinions are often stolen from others.

[Jonathan Youngs @JonathanYoungs]

@ABsteward @BradSpellberg @DrToddLee @JeanThomasR Hunch is will be negative in a generalised MSSA bacteramia population. …perhaps more likely to see benefit in sub-population of slow responders? Ie persistent fever/ bacteraemia, or those with high level beta-lactamase blaZ/BORSA?

[Jonathan Youngs @JonathanYoungs]

@IDiots_pod Thanks chaps!

[Jonathan Youngs @JonathanYoungs]

@IDiots_pod And is Clinda really a TDS or a QDS drug!?

[Jonathan Youngs @JonathanYoungs]

@IDiots_pod Loved the podcast! We often consider PO stepdown for SAB at our institution but debate the best agent! Agents preferred in SABATO and SNAP quite different. Clindamycin has its haters! Did SABATO report outcome by PO agent? Do we know what Abx the two patients that died given?

[Jonathan Youngs @JonathanYoungs]

@ABsteward @BradSpellberg @DrToddLee Concerning! @ABsteward @BradSpellberg would you combine rif with oral cotrim, clinda, doxy or linezolid for staph PJI (e.g. post DAIR where cannot use a quinolone for whatever reason) - rif lowers concentrations of them all!

[Clinical Infectious Diseases @CIDJournal]

Executive Summary: State-of-the-Art Review: Evaluation and Management of Pelvic Osteomyelitis in Stage IV Pressure Injuries: A Multidisciplinary Collaborative Approach

https://t.co/DKGDTQfNJt

[Gus Hamilton @gushamilton]

We have a new comment/analysis out on a recent high profile paper in JAMA IM that aimed to compare cefepime (CPM) vs pip-taz (PTZ) for sepsis using an instrumental variable (IV)

Essentially, we think the results are biased due to a collider... 🧵 below.

https://t.co/IAh5vdEIna

[Jonathan Youngs @JonathanYoungs]

Infection doctors will appreciate this moment from #OMITB!

[Jonathan Youngs @JonathanYoungs]

@jlsalinas7 Bird fancier’s …tibia?

[Jonathan Youngs @JonathanYoungs]

@DrKaranSaraf This is so hard. Defiantly have’t cracked it yet. It is not nice to feel that your impression is being mis-represented. I think its about trying to allow differences as long as they wont negatively impact care. And make it a learning point / feedback in general terms?

[Jonathan Youngs @JonathanYoungs]

@gushamilton @ABStewardess There is some chat on this here: https://t.co/5dmozRZxrk

[Jonathan Youngs @JonathanYoungs]

@BradSpellberg @phil_c89 @ABsteward Definitely went down a bio creep rabbit hole after seeing this! Would meta-analysis not also ‘pick up’ if this was happening?

[Jonathan Youngs @JonathanYoungs]

@IDiots_pod @BradSpellberg Non inferiority shorter is better trials are great. But we have to be careful of over generalisation. Not all CAPs were created equal. Those trials will include low severity / dubious bacterial CAPs. If patient has post flu staph and CRP> 200, 5d and review, not stop regardless.

[Jonathan Youngs @JonathanYoungs]

@gushamilton @IDiots_pod @BradSpellberg @ABsteward I never liked this question - as you can tell its gunna end up being lemierre’s from page 1…

[Jonathan Youngs @JonathanYoungs]

My twitter account was hacked last night. So beware any odd messages coming from me!

[Jonathan Youngs @JonathanYoungs]

@gushamilton Cant access the paper at the mo! Why do authors conclude benefit of clari is immunomodulatory rather than providing atypical cover? Did they do testing to show low rates of legionella/mycoplasma/chlamydia vs pneumo within the cohort?

[Jonathan Youngs @JonathanYoungs]

@gushamilton @DrToddLee Confirmation bias in action! The post take should be blinded from the clerking impression!

[Jonathan Youngs @JonathanYoungs]

@IUIDfellowship As she already has 21 days of symptoms at presentation - she can continue to work I think!? Does not need to wait the 5 days if Azithro.

[MicrobesInfect @MicrobesInfect]

A case of native #dengue fever has been confirmed in the Paris region.

This is the first time that a native case has been recorded in such a northern region of France.

https://t.co/f8iLLLMKyX

[Jonathan Youngs @JonathanYoungs]

@BradSpellberg Thanks. When (as often) soft tissue closure int an option, withholding the antibiotics can feel challenging. But i understand no evidence they improve outcomes! I thought it was interesting they advocated in acute (over chronic) here https://t.co/uhjIQRyLO1

[Jonathan Youngs @JonathanYoungs]

@BradSpellberg reading your pressure sore related OM paper/ wiki guideline. I wondered - is there a distinction to be made for acute OM? E.g. is there a role for prolonged Abx (4-6wk) in a hospital onset pressure sore with radiological suggestion of OM, and MSSA surface swabs?