Samuel De l'Étoile-Morel

Medical Microbiologist & Infectious Diseases Specialist @ciusss_csmtl /
@McgillU Grad /
Espresso lover

[Samuel De l'Étoile-Morel @SamuelDM18]

@JulienPrvost5 @DiorIzzy

[Samuel De l'Étoile-Morel @SamuelDM18]

@JulienPrvost5 3 jours d'amoxicilline ? 😅

[Samuel De l'Étoile-Morel @SamuelDM18]

@JulienPrvost5 @emilie_courval C'est pas un très bon test l'antigène strep urinaire.

[Samuel De l'Étoile-Morel @SamuelDM18]

@JulienPrvost5 On a une clinique de provocation orale pour la PCN/Céphalo/TMPSMX.

[Samuel De l'Étoile-Morel @SamuelDM18]

@ABsteward "But my patients are different" 😬

[Samuel De l'Étoile-Morel @SamuelDM18]

@JulienPrvost5 Dosage correct d'amox-clav dans ce contexte, 500 TID ? 875 TID ? amox-clav 875 BID + un extra amox en PM ?

[Samuel De l'Étoile-Morel @SamuelDM18]

@DrToddLee @sebpoule @BradSpellberg @ABsteward Seems to be done at Ste-Justine. The why is here https://t.co/kJ3bnbMeq8

[Samuel De l'Étoile-Morel @SamuelDM18]

@DiorIzzy @BradSpellberg @DrToddLee @ABsteward Team 12.

[Samuel De l'Étoile-Morel @SamuelDM18]

@drtimothyli My workhorse :D

[Samuel De l'Étoile-Morel @SamuelDM18]

@venkat_id @DrNeilStone Hib is a very scary pathogen as well

[Samuel De l'Étoile-Morel @SamuelDM18]

@DrToddLee @AnilMakam @MatthewPCheng @GBL_Unit Please repost your centipede meme with bilateral cellulitis 😂

[Samuel De l'Étoile-Morel @SamuelDM18]

@DiorIzzy @BradSpellberg @lh_innovations @DrToddLee @AliSMV7 Whenever I see a colleague prescribe the right empiric drug at the right dose and appropriate PO switch.

[Samuel De l'Étoile-Morel @SamuelDM18]

@claude99fort Un dogme bien encré dans les hôpitaux du Québec !

[Samuel De l'Étoile-Morel @SamuelDM18]

Colleagues, do you currently dose metronidazole as BID or TID for anaerobic infections (excluding C.diff and brain abscess) ? #idXposts #twitterrx

[Samuel De l'Étoile-Morel @SamuelDM18]

Slowly but surely spreading the BID dosing knowledge in Québec. All my Rx are now BID.

[Samuel De l'Étoile-Morel @SamuelDM18]

Colleagues, do you currently dose metronidazole as BID or TID for anaerobic infections (excluding C.diff and brain abscess) ? #idXposts #twitterrx

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

🆕🔥🦴 Our 2025 Update to @WikiGuidelines for the Management of Pyogenic Osteomyelitis in Adults 🌟 @BradSpellberg
🧪 Diagnosis
🔹 Nuclear scans & paravertebral biopsies → high accuracy
🔹 Bone histopathology > culture
🔹 MRSA nares negative → >90% NPV for DFO
🔹 PEDD > CT-guided biopsy for spinal osteomyelitis
⚠️ ESR, procalcitonin, CRP → poor reliability
💊 Treatment
✅ Combined medical + surgical care improves outcomes
✅ Oral ≈ IV therapy; IV lead-in optional (POvIV 10th RCT confirms)
✅ Cephradine, cephalexin, cefadroxil, doxycycline, tedizolid → oral options
🧬 Rifampin adjunct → may reduce PJI/vertebral osteomyelitis failure
⚠️ Long-acting lipoglycopeptides → limited data, high cost
🔪 Surgery
⚖️ One- vs two-stage prosthetic exchange → similar outcomes
🩻 MRI pre-amputation (DFI) → lower re-amputation risk (16% vs 32%)
📌 Residual osteomyelitis on histopathology → poor predictor
💡 Takeaway: Oral therapy works; combine medical & surgical care; tailor surgery with imaging.
🔗 Full WikiGuideline: [link]
https://t.co/3RChKI8Jkm

[Samuel De l'Étoile-Morel @SamuelDM18]

@ABsteward @WikiGuidelines @BradSpellberg @DrToddLee @DrEmilyMcD Cefadroxil 🦾

[Samuel De l'Étoile-Morel @SamuelDM18]

@sebpoule Si ces cliniques ferment, ce sera le chaos dans le Centre-Sud😡

[Samuel De l'Étoile-Morel @SamuelDM18]

@ABsteward Bubonic plague 😍

[Samuel De l'Étoile-Morel @SamuelDM18]

@MRodgersRodgM @DrToddLee @MADTurnUP @LBaddour1 @jamchugh @MayoClinicINFD @LorneSchweitzer @GBL_Unit I try to stick to poet as much as possible. Sometimes, for Staph IE, I use TMPSMX/Doxycycline/Cefadroxil. I find it better tolerated compared to linezolid/rifampin.