san.tho

Pediatrician. Advocate. Human. 🇮🇳-🇨🇦-🇺🇸. Peds Transplant/IC ID physician. Expressed views are mine alone. ❤️petrichor 🍃apricity🌤️

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

🔥Just published
A Systematic Review and Network Meta-Analysis
15 cohorts were included
Comparative Efficacy and Safety of Antibacterial Regimens for Severe Stenotrophomonas maltophilia Infections
🔺This is the most comprehensive network meta-analysis evaluating both the short-term clinical efficacy and long-term survival outcomes of targeted antimicrobial regimens for SMA infections
🔺The network meta-analysis revealed a notable discordance between primary efficacy and survival benefits
🔺A “survival paradox” exists in SMA treatment: tigecycline yields superior initial response without improving survival, whereas levofloxacin provides the most significant survival benefit
🔺Surprisingly: Levofloxacin ranked highest with a SUCRA value of 91.3% (PrBest [Probability of being best] =75.8%), establishing it as the most favorable option for patient survival.
🔺Strikingly, the traditional preferred agent, TMP-SMX, had the lowest probability of being effective, ranking definitively last with a SUCRA value of 2.4%
🔺Levofloxacin significantly improved survival versus TMP-SMX (OR=2.01, 95%CI 1.16-3.47, P=0.012)
🔺Minocycline serves as a highly reliable and effective alternative across all endpoints. Given the rising resistance and unacceptable toxicity profile
The principal findings challenge the traditional paradigm that positions TMP-SMX as the undisputed preferred therapy.
@drgabx @BradSpellberg ICYMI #idxposts
https://t.co/Jdo5Yk50WY

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

💥🔥🟢 OpTION RCT | NEJM Evidence 2026
Neither vancomycin taper-and-pulse nor fidaxomicin demonstrated superiority over standard 10-day vancomycin for recurrent CDI according to the trial's prespecified statistical criteria (P<0.0255).
Notably, vancomycin taper-and-pulse showed a numerically higher sustained clinical response (58.6% vs. 44.1%; absolute difference 14.7%, 95% CI 0.6–28.8; P=0.04), but this did not meet the more stringent prespecified significance threshold required for superiority.
Perhaps most surprising, fidaxomicin also failed to demonstrate superiority over standard vancomycin, challenging the long-held expectation that it is superior to vancomycin for rCDI.
#IDXposts
https://t.co/0ixLXCME2I

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

🔥🔥IDSA AMR Guidance 2026🔥🔥

🔺Notable Updates from the 2024 IDSA AMR Guidance Document

IDSA 2026 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections

🔺ESBL, AmpC Enterobacterales
🔺CRE
🔺DTR P. aeruginosa
🔺CRAB
🔺Stenotrophomonas maltophilia

Including updates in antimicrobial selection, dosing strategies, and management approaches.

🔺Meropenem dosing update: individualized dosing approach (1–2 g IV q8h) with higher doses considered in selected clinical scenarios.

Info inspired / credit to @RabeaAgeeli , #IDXposts
https://t.co/lfAjZU2zHQ

[IDSA @IDSAInfo]

Infectious diseases physician, Anthony Fauci, MD, FIDSA, has led with courage, scientific integrity and an unwavering commitment to improving public health.

Those qualities inspired IDSA to establish the Anthony Fauci Courage in Leadership Award.

We thank him for his extraordinary service to patients, science and the infectious diseases community.

[American Journal of Transplantation @amjtransplant]

🚨 Editor’s Choice 🚨
"Gene-edited pig cardiac xenotransplantation as a bridge to allotransplantation in infants: Progress in a pig-to-baboon model," by Cleveland et al
https://t.co/Wl8cEVd4Lu
#Xenotransplantation #HeartTransplant #PediatricCardiology

[Carlos del Rio @CarlosdelRio7]

Leptospirosis—clinical review and updates on therapeutics - The Lancet Infectious Diseases https://t.co/GXxcf0nlcJ A nice Leptospirosis review in @TheLancetInfDis

[Paul Sax @PaulSaxMD]

Post-infectious fatigue syndromes are the real deal.

Great to see this described so well by an unlikely source -- an orthopedic surgeon!

(No offense intended, Dr. Luks! It's just pretty notable, that's all.)

[The Lancet @TheLancet]

On the cover of The Lancet:
Editorial — “Robert F Kennedy Jr: 1 year of failure”

Read the latest issue: https://t.co/x0Mv0owHDx

[Juan Pablo Sánchez Navarro @melarsoprol7]

IDSA declined to endorse the 2025 ATS CAP guidelines over concerns about empiric antibiotics in viral CAP. The message is clear: most viral pneumonias lack bacterial coinfection. Precision, not reflex antibiotics, should guide care.
https://t.co/N5qDlzfxaG

[David Axelrod @davidaxelrod]

"Too often we enjoy the comfort of opinion without the discomfort of thought."
-John F. Kennedy

[Paul Offit @DrPaulOffit]

https://t.co/ZSXYKAcbwf
RFK Jr. just reversed the CDC's position on vaccines and autism

[Carlos del Rio @CarlosdelRio7]

Efficacy, Immunogenicity, and Safety of Modified mRNA Influenza Vaccine | @NEJM https://t.co/c6OtgUkrOx mRNA flu vaccine outperformed the standard flu shot in a Phase 3 clinical trial. And meanwhile HHS has stopped funding mRNA vaccine research!

[IDSA @IDSAInfo]

Decades of rigorous and scientifically sound research have proven that vaccines do not cause autism. CDC’s decision to change language on its website reversing that finding is reckless and harmful.

Our statement w/ @HIVMA, @APIC, @SHEA_Epi &amp; @SIDPharm: https://t.co/vPRXaMll6s

[Dr. Lucky Tran @luckytran]

UPDATE: Canada has announced that it has lost its measles elimination status.

This is a direct result of the increase in anti-vax disinformation, which has caused large, sustained outbreaks in the country over the last year.

[Terry Fox Foundation @TerryFoxCanada]

Thank you to those who have served, continue to serve, and made the ultimate sacrifice. We are forever grateful. #RemembranceDay #LestWeForget

[City of Toronto 🇨🇦 @cityoftoronto]

Thank you @BlueJays!

You united #Toronto and the whole country with your passion and plays. You've made us so proud. Thank you. Even without a #WorldSeries title, we #GotItAll.

#WantItAll

[Camille Nelson Kotton @KottonNelson]

Excited to be at #idweek recording for @febrilepodcast discussing refractory resistant HSV infections with @sarawinndong and @ChemalyRoy October 21 at 1:15 – 2 PM in learning lounge 1 (in back of industry exhibit area) - join us!!

[transplantid.net @TransplantIDNet]

"@TheEBMT Handbook: Hematopoietic Cell Transplantation and Cellular Therapies" from 2024 is open access!

Includes lots of ID
- neutropenic fever
- hemorrhagic cystitis
- bacterial, viral, fungal infections
and more!

@TheEBMT_CTIWP @TxID_Fellows

https://t.co/fc6iHmYC2w

[transplantid.net @TransplantIDNet]

The newest @ASTCT guidelines for #CMV in #HSCT and #CAR-T were published in @ASTCT_Journal this year. ✅ out this table of treatment options based on genotype!

@TxID_Fellows @ID_fellows

Find this and other @ASTCT guidelines at
https://t.co/oooTOwEJnV

[Jason Newland @JasonGNewland]

https://t.co/EidpE4SibL