Steven Tong

@steventong.bsky.social

Infectious diseases, clinical trials, staphylococcus and streptococcus. Reader and runner. Go Hawks!

@steventong.bsky.social

The next Clarity commentary. On the SNAP trial. Neither I nor @gurujosh.bsky.social had anything to do with this commentary (deliberately).
Conclusions though are in line with my interpretation of the data. i.e., use cefazolin for MSSA bacteremia.
@angelahuttner.bsky.social @cmicomms.bsky.social

@steventong.bsky.social

Glad the conclusions ended with: 'the need for prospective studies to understand when and in whom FUBCs should be used'. The BALANCE+ trial has I think concluded enrolment to the follow-up BC domain. @seanong.bsky.social might be able to confirm.

@steventong.bsky.social

How about ESBLs where pip/taz is better than ceftriaxone? I became more supportive of pip/taz when I realised that for patients with likely GNB sepsis pip/taz had probably 95%+ activity compared to around 85% with ceftriaxone. And that's not because of Pseudomonas.

@angelahuttner.bsky.socialReposted by @steventong.bsky.social

Hi Gabriele! Guess what- with @germhuntermd.bsky.social & quite a few others, we are gearing up to launch an #IDjournalclub on Bsky and it looks like this paper is the one we'll start with. 😊 We will get that going soooon!! (Also, Communicable will work on a follow-up POET2 ep!)
#IDSky #MedSky

@steventong.bsky.social

Great post @apsmunro.bsky.social!

Doing more is such a natural reaction. But even 'benign' interventions may likely be harmful when tested properly.

I'm yet to know of a trial for sepsis where adding antibiotics has been beneficial (outside of TB where we do it to prevent emergence of resistance).

Alasdair Munro@apsmunro.bsky.social

My new post looks at two antimicrobials which have been routinely used and even recommended in guidelines despite a lack of RCT evidence In the last few weeks they’ve both been shown to have no benefit, and worse, high probability of harm - killing patients A lesson we keep failing to learn

substack.comWhen doing more harms patientsOseltamivir and adjunctive Clindamycin may have been increasing mortality
@steventong.bsky.social

We are genotyping and phenotyping as many of the isolates as we can get hold of (will be most). So the analysis of blaZ and cefazolin inoculum effect will follow once done. Can't wait to see what this shows! Altogether there were 1341 participants in SNAP, so much larger than CloCeBa.