Timothy Li
@drtimothyli
ID physician @CUHKMedicine • #abxstewardship • #penicillinallergy • Certificate in Travel Health®
One of the biggest reasons why we need antibiotic stewardship is to avoid creating scary monsters like this⬇️ How are you going to treat this?
Narrative review on fungal diagnostics @CMIJournal doi.org/10.1016/j.cmi.…
Static vs. cidal: it’s not complex; it’s simply incorrect @BradSpellberg @DrToddLee @ABsteward doi.org/10.1128/aac.00…
Summary: 1. Lung USG 🆗 for diagnosis 2.Empiric antibiotics suggested for CAP tested +ve for resp virus if in-pt or have comorbidities 3. <5 days antibiotics (min 3 days) if stable, except for in-pt with severe CAP 4. Systemic steroid suggested for in-pt with severe CAP
🔥🔥Just published 🔥🔥 ATS CAP guidelines 2025 Diagnosis and Management of Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline Free access pdf @atscommunity Thanks @Inox94 #IDXposts atsjournals.org/doi/10.1164/rc…
In this study from 🇳🇱 involving 400+ patients who underwent hip or knee explanation, the use of sonication fluid culture (vs tissue culture alone) detected additional microorganisms that could impact antibiotic choice in 8% to 20% of PJI cases. doi.org/10.1093/cid/ci…
"If we prescribe antibiotics unnecessarily, we may be the reason that someone develops life altering conditions years later in life or why months down the line they do not experience the response to cancer immunotherapy they desperately hoped for."
As ID physicians, when asked about the importance of ASP, many of us may share the same answers How do we know that today's carbapenem use will lead to a superbug tomorrow? Why worry about resistance decades later, when I have a patient to worry about now. academic.oup.com/cid/article/do…
Do you know where the recommendation of adjunctive therapy for E.faecalis IE came from? A case series published in 1954 (with numerous limitations) Time for a well-designed RCT of adjunctive versus monotherapy indeed
We do love a good time travel! The answers may surprise you..... A deep dive into the origins of adjunctive therapy for E. fecalis IE
If discussion on ceilings of care is applicable to resuscitation, ventilatory support, or even blood taking Why shouldn't it be applied to antimicrobial use too? Communication strategies and skills for antimicrobial treatment discussions at end of life⬇️ doi.org/10.1016/S1473-…
Structured linezolid dose reduction (600mg/d➡️300mg/d after 9-13 weeks) had comparable recurrence free cure rates as fixed linezolid 600mg/d when given along with bedaquiline and pretomanid for 26 weeks in PreXDR TB doi.org/10.1016/j.jinf…
Infections associated with marine exposure 1/9
Should secondary SBP prophylaxis (SecSBPPr) still be given in cirrhosis? In 2 🇺🇸national cohorts (>11000 SBP patients), SecSBPPr⬆️the risk of SBP recurrence in multivariable analysis by 63%–68% vs no prophylaxis. And this trend worsened over time. doi.org/10.14309/ajg.0…
Candida infective endocarditis 🍄🫀🤒 ➡️Suggested management algorithm based on valve type and surgical eligibility ➡️Follow-up recommendations doi.org/10.1016/j.cmi.…
Routine weekly surveillance for MDR-GNB in hematologic patients enables early identification of colonization, often preceding MDR-GNB BSIs. ➡️Rectal swabs positive in 27.5% of patients ➡️BSI occurred in 38.5% colonised vs 12.0% non-colonised patients doi.org/10.1016/j.cmi.…
Among 100 patients with persistent MSSA bacteraemia who were treated with ertapenem combination therapy, those with hypoalbuminemia (<2.5g/dL) had a significantly longer time to negative blood cultures. doi.org/10.1093/jac/dk…
Antimicrobial resistance, antimicrobial tolerance and heteroresistance in Pseudomonas aeruginosa doi.org/10.1038/s41579…
Pathophysiology and risk factors of ocular candidiasis Systemic treatment: 1st line = fluconazole or voriconazole (Posa: poor penetration Isavu: lack data) Lipo ampho B +/- flucytosine if resistant or refractory Echinocandins: poor penetration doi.org/10.1016/j.cmi.…
Suggested investigation of suspected immunosuppression* *Also: recurrent deep abscesses, chronic diarrhoea with weight loss, recurring infections, infection requiring prolonged antibiotic therapy, persistent rash (particularly without recent antibiotic use).…
In this study that included 42067 adults in 🇺🇸, long-acting lipoglycopeptides (laLGPs) were effective as step-down treatment of serious gram +ve bacterial infections, offering comparable outcomes (readmission/ED visit/90d inpatient☠️) vs SOC antibiotics doi.org/10.1001/jamane…
Words matter. It’s time to retire the term oral “step-down.” It implies inferiority of the oral route—and doesn’t align with stewardship principles. Terms like IV to oral switch or oral transition better promote optimal antimicrobial stewardship. What terms do you use—and why?