N.Theerawat

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

💊 Cephalexin for severe infections: how high is high enough?

📖 OFID | 2026 | Haynes et al.

🔬 What they did
Pooled PK data from 71 patients (9 days–29 years) to model cephalexin exposure and target attainment across ages, pathogens, MICs & dosing regimens.

📌 Key findings

🦠 MSSA
• 25 mg/kg/dose (max 1,000 mg) q8h → ≥98% PTA for 35% fT>MIC at MIC 4 mg/L
• MIC 8 mg/L → q6h needed

🦠 Enterobacterales
• Standard dosing was insufficient for 60% fT>MIC
• 37.5–50 mg/kg/dose (max 1,500 mg) q6h → >90% CFR for 40–50% fT>MIC when cefazolin MIC ≤2 mg/L

👶 PK varied with age, with increasing clearance with maturation and slower absorption in neonates.

#idxposts

https://t.co/Dwcd8Z3tsA

[ASM @ASMicrobiology]

It’s time to “stirrup” a new #CaseStudySaturday! A 20-year-old female with a lower back rash & burning pain after being stepped on by a horse. Routine aerobic cultures surprisingly yielded the pathogen… Comment your guess below.

https://t.co/zW9HyQuPSw

#ASMClinMicro

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

🆕💥🟢External validation of the PACTO risk score for infective endocarditis in patients with coagulase-negative staphylococcal bacteremia: a multicenter cohort study #idxposts #IEWiki https://t.co/m9bJxnkQ6A

[IDSA @IDSAInfo]

New #IDSAGuidelines! IDSA has released an evidence-based guideline update on antiviral treatment for mild to moderate COVID-19 in infants, children, and adolescents: https://t.co/Kbodqb2xTq

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

💥Very interesting!!👀
An exiting option for CRAB!
Intravenous rifabutin (BV100) achieves pulmonary exposures substantially exceeding plasma concentrations, providing a strong pharmacological rationale for further clinical evaluation of BV100 in severe CRAB pneumonia
💥First human data on lung penetration of IV rifabutin (BV100).
•Lung exposures exceed plasma 35-fold (ELF) and 311-fold (alveolar macrophages).
•Active metabolite25-O-deacetyl-rifabutin shows similar lung accumulation #idxposts
https://t.co/Qjv7K6Kpot

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

Misdiagnosis of cellulitis is common! Approximately one-third of hospitalized patients diagnosed with cellulitis may have a non-infectious diagnosis.
🆕💥🔴Mimics of Lower Extremity Cellulitis: An Approach to the Red Leg #idxposts
https://t.co/bwNTNhwtYw

[NEJM @NEJM]

Among critically ill adults with metabolic acidosis receiving vasopressors in the ICU, sodium bicarbonate did not lead to a lower risk of major adverse kidney events within 30 days than placebo. Full SODa-BIC trial results and Research Summary: https://t.co/uTtuin6rig

[Takahiro Matsuo (Taka), MD @TakaMatsuo_ID]

【Short or Long Antibiotic Regimens in Orthopedics】@NEJM Sep 16 2026

https://t.co/Eme8mXjdYT

Important NEW RCT SOLARIO trial has been just published!

@MSISorg #EBJIS #OrthoID
#IDMedEd #IDFellow

[Open Forum Infectious Diseases @OFIDJournal]

Clinically Relevant Risk of Hepatitis B Virus Infection and Reactivation in People with HIV After Withdrawal of Anti-HBV–Active Antiretroviral Therapy in Japan

🔁 Repost
🔗 https://t.co/pJSHVznz5x

[NEJM @NEJM]

A 72-year-old man with hypertension, hyperlipidemia, and a stable ascending aortic aneurysm presented with sudden-onset, severe chest pain. CTA of the chest, abdomen, and pelvis showed a celiac-artery dissection.

Read the full case details in the Images in Clinical Medicine article “Celiac-Artery Dissection”: https://t.co/p52v1Y0vh7

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

🆕💥Just published 🆕💥
Histoplasmosis in Adults, Children, and Pregnant Individuals
Consensus Statement: Initial Antifungal Treatment of Severe Histoplasmosis #idxposts
https://t.co/WDMYw4hpWF

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

🆕💥🟢Diagnosis and Management of Patients with Suspected Left-sided Prosthetic Valve Endocarditis According to Cardiac FDG-PET CT Results
The addition of PET significantly increased the diagnosis of definite endocarditis (46% to 63%, P<0.001). #idxposts #IEWiki https://t.co/JLBYUqac3w

[NEJM @NEJM]

Case Record of the Massachusetts General Hospital (@MassGeneralNews): A 65-Year-Old Man with Fever and Rash https://t.co/T3Iwp47QWa

#Dermatology #InfectiousDisease

[NEJM Clinician @NEJMClinician]

Patients with acute myeloid leukemia who are considered “not fit” for standard cytotoxic induction chemotherapy (“7+3”) may be treated with azacitidine–venetoclax. A new study tested this less-intensive regimen for “fit” patients. @MikkaelSekeres has more: https://t.co/IBjvOOuglU

[NEJM @NEJM]

In a randomized trial involving adults who received local antibiotics during surgery for orthopedic infection, a short duration of systemic antibiotics was noninferior to a long duration regarding treatment failure at 12 months. Full SOLARIO trial results: https://t.co/4uIUCFkH1r

[Timothy Li @drtimothyli]

Among patients who had undergone orthopedic surgery and received local antibiotics, a short course (≤7 d) of systemic antibiotics was noninferior to a long course (≥4 wk) with respect to definite treatment failure by 12m.

https://t.co/jQfhAdDXzx

@ABsteward
@BradSpellberg

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

A wise friend once said
"Cellulitis is strep. We never isolate it." @BradSpellberg
🆕✨🔴Non-Purulent Cellulitis—An Updated Review #idxposts
https://t.co/1lwDtAv70l

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

🆕✨PRACTICE POINTER @bmj_latest
Diagnosis and management of lower limb cellulitis #idxposts
https://t.co/2WCFAHiEVY

[NEJM Clinician @NEJMClinician]

Download the Guideline Watch Roundup for summaries and highlights of the most important new clinical guidelines to inform your practice. 👉 https://t.co/tnoDYm0frt

[IDSA @IDSAInfo]

On IDSA’s &amp; @HIVMA’s Science Speaks blog: A study in the International Journal of Infectious Diseases explored oral fosfomycin after carbapenems as de-escalating therapy in complicated UTIs.

Read IDSA’s Journal Club review by Aldon Li, MD, FIDSA.
https://t.co/Bd6CAS0Q9t