Infectious Disease

Would you send a CMV DNA PCR in blood, and if you elect to treat with anti-CMV medication, how long would you treat and what parameters would you use,...

1 Answer available

What duration of antibiotics do you use in patients with Actinomyces osteomyelitis, i.e., do you stop after 6 weeks or do you give a longer oral antibiotic course?

1 Answer available

How do you decide between ceftolozane/tazobactam and ceftazidime/avibactam for empiric treatment of an infection due to difficult-to-treat Pseudomonas aeruginosa while awaiting additional susceptibilities?

2 Answers available

Which biomarkers or diagnostic tools do you prioritize to support the decision to start antifungal treatment in septic patients with no clear source of infection but at high risk for fungal infections?

2 Answers available

Do you routinely treat patients with neurosyphilis with IM penicillin for 1-3 weeks after completing a full treatment course of IV penicillin?

https://www.cdc.gov/std/treatment-guidelines/neurosyphilis.htm

1 Answer available

What are your top takeaways from ID Week 2024?

1 Answer available

Do you consider the use of tocilizumab in patients with COVID pneumonia who have had an improvement in supplemental O2 requirements but have significantly elevated inflammatory markers after day two of remdesivir and dexamethasone?

1 Answer available

When would you initiate exchange transfusion in babesiosis and significant hemolysis?

Is parasitemia >10% and severe hemolysis with Hb less than 7 enough to initiate this?

1 Answer available

Do you take into consideration a patient's serum albumin level in your decision to use ertapenem?

2 Answers available

Do you routinely recommend a lumbar puncture for patients with suspected ocular or otic syphilis in the absence of additional CNS symptoms?

3 Answers available

Do you routinely treat chronic sacral osteomyelitis when there is no plan for debridement or flap?

2 Answers available

What is your approach to recurrent asymptomatic bacteriuria in pregnancy for patients without personal history of recurrent UTIs or pyelonephritis?

Assuming patient already received an initial course of antibiotic treatment in response to a positive urine culture during routine screening early in ...

2 Answers available

How do you decide on the timing and number of blood cultures for suspected endocarditis given the differences in recommendations between the ESC guidelines and the Duke Criteria?

The ESC guidelines recommend obtaining at least three sets of blood cultures at 30-minute intervals before starting antibiotic therapy, each with 10 m...

3 Answers available

Do you add gentamicin when treating prosthetic valve endocarditis secondary to viridans group Streptococcus with a penicillin-intermediate isolate (MIC >0.125 - <0.5)?

2 Answers available

How often do you see bony erosions in patients with Lyme arthritis?

1 Answer available

How do you integrate next-generation sequencing with traditional culture methods to improve the identification of fungal pathogens, especially in cases where routine cultures are negative when evaluating suspected prosthetic joint infections?

1 Answer available

Do you routinely perform echocardiography in patients with Staphylococcus aureus bacteremia deemed low risk for metastatic infection, or do you selectively omit it based on specific clinical criteria?

Hendriks, et al., PMID 38576380

2 Answers available

Under what circumstances do you consider valacyclovir for the management of VZV disease of the CNS?

2 Answers available

Is there a role for suppressive antibiotic therapy when it comes to chronic femoral/tibial osteomyelitis?

1 Answer available

In patients with possible Bartonella henselae infection and elevated IgG titer, what is the best way to confirm the diagnosis: tissue biopsy with Warthin-Starry staining, tissue sent for Bartonella henselae PCR, or tissue sent for culture?

1 Answer available

What agent and for how long would you treat a patient with asymptomatic azole-resistant C auris candiduria who is planning to undergo a urological procedure?

3 Answers available

Do you routinely recommend IV systemic antibiotic therapy in additional to intravitreal antibiotic therapy for exogenous bacterial endophthalmitis?

1 Answer available

Do you preferentially avoid use of piperacillin-tazobactam for empiric anti-pseudomonal coverage in hospitalized patients due to risk of nephrotoxicity?

ACORN Randomized Clinical Trial

1 Answer available

Do you routinely check cefepime levels in patient's with suspected cefepime-induced neurotoxicity?

1 Answer available

How would you approach treatment duration for patients with persistent candida species fungemia with a history of a prosthetic heart valve but negative TEE/CT PET and no other identifiable source of infection?

2 Answers available

Do you treat prosthetic joint infections after a two-stage revision arthroplasty with oral antibiotics for the full duration of therapy, assuming a susceptible oral option is available?

1 Answer available

What is your approach to management of CIED in a patient with community-acquired Staph aureus bacteremia who clears blood cultures quickly with negative follow up blood cultures within 72 hours of antimicrobial therapy and negative TEE?

Would you still routinely ask for CIED removal, or would you pursue PET/CT for further evaluation and consider keeping CIED if PET/CT negative?

2 Answers available

What is your approach to monitoring of inflammatory markers during treatment of native vertebral osteomyelitis?

3 Answers available

Do you give additional pneumococcal vaccines after a dose of PCV20 in patients with asplenia?

1 Answer available

Do you find HZV titers useful in diagnosing shingles sine herpete?

1 Answer available

Do you use combination antibiotic therapy for treatment of bacterial endocarditis due to gram-negative bacilli?

1 Answer available

Do you use combination therapy for persistent MSSA bacteremia?

If yes, which combination(s)?

1 Answer available

Under what circumstances would you recommend the maternal RSV vaccine for a pregnant patient if nirsevimab will also be available for the infant after birth?

1 Answer available

Under what circumstances would you recommend early fecal microbiota transplantation over antibiotic treatment or bezlotoxumab in a patient with recurrent C. difficile infection?

1 Answer available

Have you used Karius to aid in the diagnosis of a non-resolving pneumonia, with negative bronchoscopy, biopsy, and other infectious work up in an immunocompetent patient?

1 Answer available

Do you routinely ask for removal of a indwelling central line (PICC or tunneled catheter) in a patient with pseudomonal bacteremia from known source with otherwise appropriate clinical improvement on anti-pseudomonal antibiotic therapy?

1 Answer available

How exhaustive (especially considering cost) should an immunological workup be for patients with extensive, recurrent, or deep seated Staph aureus infections without obvious immunocompromise (e.g. cancer, diabetes, steroids) or recurrent breaks in skin integrity?

1 Answer available

Do you transition to oral antibiotics to treat uncomplicated Staphylococcus aureus bacteremia after patients have improved with intravenous antibiotic therapy?

4 Answers available

Have you incorporated the use of linezolid in lieu of vancomycin plus clindamycin for empiric treatment of necrotizing fasciitis?

1 Answer available

Do you recommend lifelong antibiotic prophylaxis, or do you prefer a more selective approach based on risk factors in asplenic patients without a history of severe infections?

2 Answers available

How long would you treat an upper urinary tract infection in a patient with acute obstructive pyelonephritis due to a kidney stone status-post urinary stenting without yet removal of the stone?

4 Answers available

Do you recommend routine ophthalmologic exam for all patients with hypervirulent Klebsiella pneumoniae bacteremia?

1 Answer available

Do you choose an antibiotic with CSF penetration, such as nafcillin over cefazolin, in the setting of MSSA endocarditis with septic emboli to the brain (assuming no concomitant meningitis or brain abscess)?

3 Answers available

Is there any utility to trending Histoplasma serology titers to guide duration of therapy or treatment response for pulmonary histoplasmosis with negative urine antigen?

1 Answer available

What is your approach to duration of fidaxomicin in a patient receiving treatment for first C difficile infection while also receiving concurrent antibiotics for an infection?

Do you extend the course of fidaxomicin past initial 10 days to at least 3-7 days after completion of antibiotics?

1 Answer available

Do you adhere to the standard 5-day minimum treatment duration for community-acquired pneumonia, or have you used shorter courses for certain low-risk patients?

1 Answer available

What is your approach to treatment of patients with fulminant C difficile infection who required ileostomy creation or colectomy?

Is there a role for oral vancomycin in these patients, or is oral vancomycin redundant if other routes of administration are being used (i.e intracolo...

1 Answer available

What is your approach to antiviral treatment of HSV acute retinal necrosis?

Is there a role for oral antiviral therapy alone (as opposed to induction with IV) and for what duration? And is there a role for ongoing suppressive ...

1 Answer available

What is your approach to use of D-mannose for prevention of recurrent uncomplicated cystitis?

Especially in light of the results of the randomized clinical trial published on 8/2024 in Jama Internal Medicine by Hayward et al., PMID 38587819.

1 Answer available

Do you use oral fosfomycin as a treatment option for uncomplicated cystitis due to ESBL producing E coli?

1 Answer available

For which patients could you consider direct oral amoxicillin challenge as opposed to skin testing for penicillin allergy de-labeling?

1 Answer available

For how long would you treat Klebsiella aerogenes folliculitis of the face manifesting as a cystic lesion?

Would you combine antibiotics with isotretinoin?

2 Answers available

Do you recommend antibiotic prophylaxis for an ESKD patient with a tunneled dialysis catheter who is planned for a dental procedure?

2 Answers available

What is your approach to counseling patients regarding re-initiation of anti-TNF therapy after completion of treatment for non-disseminated pulmonary histoplasmosis?

Would it be safe to resume and if so, when?

2 Answers available

Do you prescribe linezolid to patients who are concomitantly on an SSRI?

7 Answers available

How long would you treat a patient with recent history of TAVR presenting with E faecalis bacteremia with unclear source with TEE showing thickened valves but no obvious vegetation?

2 Answers available

How long do you treat an isolated bacterial liver abscess which has either undergone percutaneous drainage or for which an indwelling drain is placed?

3 Answers available

What is your approach to duration of systemic antibiotics for treatment of isolated bacterial endophthalmitis in the absence of bacteremia or other deep-seated metastatic foci of infection?

1 Answer available

What is your approach to a patient with undetectable MMR titers checked prior to or during immunosuppression and a history of MMR vaccination in childhood?

Is there a role for booster vaccination and if so, how do you approach the timing when a patient is already on a biologic for immunosuppression?

1 Answer available

How do you treat a patient with a gram-negative infection with resistance to imipenem but sensitivity to meropenem and negative for Carbapenem resistant organism by xpert Carba-R-assay?

1 Answer available

Have you incorporated the use of steroids for patients with severe community-acquired pneumonia?

In light of published data from the CAPE COD trial...

1 Answer available

Is there a role for repeat surveillance blood cultures in patients with prosthetic valve endocarditis without associated cardiac abscess after a 6 week course of antibiotic treatment without surgical intervention?

1 Answer available

Is there a role for chronic suppressive oral or inhaled therapy for recurrent Burkholderia cepacia pneumonia causing frequent hospitalizations in a patient with severe bronchiectasis with or without underlying cystic fibrosis?

3 Answers available

In addition to ampicillin, is there any benefit to the addition of either gentamicin or bactrim when treating a patient with listeria meningitis?

2 Answers available

Have you applied the POET trial to clinical practice?

1 Answer available

How long do you continue antibiotics after cholecystostomy tube placement for acute cholecystitis?

Since the COVID-19 pandemic, increasingly we see management of acute cholecystitis with cholecystostomy tubes as opposed to surgery, even amongst pati...

1 Answer available

What duration of therapy do you use for treatment of Legionella pneumonia in an immunocompetent host without associated empyema or extrapulmonary infection?

2 Answers available

For how long do you treat an early spinal hardware infection secondary to MSSA after operative washout and retention of hardware?

1 Answer available

Do you treat Stenotrophomonas maltophilia bacteremia with combination therapy and if so, what is your preferred combination of antibacterials?

1 Answer available

For how long do you treat uncomplicated CRE bacteremia in an immunocompetent patient?

1 Answer available

Would you consider stepping down from an echinocandin to azole therapy prior to the end of an initial six-week course for fluconazole-susceptible Candida albicans endocarditis in the absence of valve surgery?

1 Answer available

Papers discussed in this category

Circulation, 2015 Sep 15

Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.

The Annals of thoracic surgery, 2017 Feb 04

Surgical Versus Medical Therapy for Prosthetic Valve Endocarditis: A Meta-Analysis of 32 Studies.

European heart journal, 2023 Oct 14

2023 ESC Guidelines for the management of endocarditis.

The Annals of thoracic surgery, 2016-06

Rifampin for Surgically Treated Staphylococcal Infective Endocarditis: A Propensity Score-Adjusted Cohort Study.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021 May 04

Is Rifampin Use Associated With Better Outcome in Staphylococcal Prosthetic Valve Endocarditis? A Multicenter Retrospective Study.

JAMA network open, 2022 Dec 01

Association of Linezolid With Risk of Serotonin Syndrome in Patients Receiving Antidepressants.

International journal of antimicrobial agents, 2023 Jun 08

Dose optimisation of linezolid in critically ill patients based on a population pharmacokinetic model: A two-centre prospective interventional study.

Pharmacy (Basel, Switzerland), 2023 Nov 20

The Association of Serotonin Toxicity with Combination Linezolid-Serotonergic Agent Therapy: A Systematic Review and Meta-Analysis.

International journal of antimicrobial agents, 2023 May 07

Real-world evaluation of linezolid-associated serotonin toxicity with and without concurrent serotonergic agents.

JAMA network open, 2024 Jan 02

Early Switch From Intravenous to Oral Antibiotics for Patients With Uncomplicated Gram-Negative Bacteremia.

Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia, 2023 Nov 24

Treatment guidelines for multidrug-resistant Gram-negative microorganisms.

Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia, 2023 Oct 26

In vitro activity of cefiderocol and other newly approved antimicrobials against multi-drug resistant Gram-negative pathogens recovered in intensive care units in Spain and Portugal.

EClinicalMedicine, 2022 Dec 01

Duration of antibiotic treatment for Gram-negative bacteremia - Systematic review and individual participant data (IPD) meta-analysis.

Journal of clinical pharmacy and therapeutics, 2020 Sep 27

Short-course versus long-course antibiotic treatment in patients with uncomplicated gram-negative bacteremia: A systematic review and meta-analysis.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019 Sep 13

Seven Versus 14 Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia: A Noninferiority Randomized Controlled Trial.

European heart journal, 2023 Oct 25

Clinical implementation of partial oral treatment in infective endocarditis: the Danish POETry study.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2023 May 11

Choosing patients over placebos: oral transitional therapy vs. IV-only therapy for bacteraemia and infective endocarditis.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023 Jul 26

Attainment of Target Antibiotic Levels by Oral Treatment of Left-Sided Infective Endocarditis: A POET Substudy.

Infectious diseases and therapy, 2022 May 03

Legionnaires' Disease: Update on Diagnosis and Treatment.

American journal of respiratory and critical care medicine, 2019 Oct 01

Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023 Sep 18

Considerations and Concerns regarding the use of Ertapenem in Patients with Hypoalbuminemia: is it Truly Inappropriate?

The Lancet. Infectious diseases, 2024 Jan 17

Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial.

Journal of the American College of Cardiology, 2023 Jan 31

Infective Endocarditis After Transcatheter Aortic Valve Replacement: JACC State-of-the-Art Review.

JACC. Cardiovascular interventions, 2022 Jun 13

Long-Term Follow-Up of Hypoattenuated Leaflet Thickening After Transcatheter Aortic Valve Replacement.

JACC. Cardiovascular imaging, 2017 Aug 16

Diagnosis of Infective Endocarditis After TAVR: Value of a Multimodality Imaging Approach.

The New England journal of medicine, 2018 Aug 28

Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023 Sep 11

Real-World Application of Oral Therapy for Infective Endocarditis: A Multicenter, Retrospective, Cohort Study.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015-08-01

Histoplasmosis complicating tumor necrosis factor-α blocker therapy: a retrospective analysis of 98 cases.

N Engl J Med, 2023 Mar 21

Hydrocortisone in Severe Community-Acquired Pneumonia.

Ophthalmology. Retina, 2019 Mar 21

International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1.

Retina (Philadelphia, Pa.), 2021 Feb 01

VISUAL OUTCOME OF EARLY VITRECTOMY AND INTRAVITREAL ANTIBIOTICS IN ACUTE POSTSURGICAL AND POSTINTRAVITREAL INJECTION ENDOPHTHALMITIS: European Vitreo-Retinal Society Endophthalmitis Study Report Two.

Archives of ophthalmology (Chicago, Ill. : 1960), 1995 Dec

Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Endophthalmitis Vitrectomy Study Group.

The New England journal of medicine, 2024 Apr 04

Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with Covid-19.

The Journal of infectious diseases, 1980 Mar

A study of cephalothin and desacetylcephalothin in cerebrospinal fluid in therapy for experimental pneumococcal meningitis.

Antimicrobial agents and chemotherapy, 1976 Sep

Pharmacological study of cefazolin during intermittent and continuous infusion: a crossover investigation in humans.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2020 May 08

Should we reconsider cefazolin for treating staphylococcal meningitis? A retrospective analysis of cefazolin and cloxacillin cerebrospinal fluid levels in patients treated for staphylococcal meningitis.

The Lancet. Infectious diseases, 2020 Dec 14

Effectiveness of adjunctive clindamycin in β-lactam antibiotic-treated patients with invasive β-haemolytic streptococcal infections in US hospitals: a retrospective multicentre cohort study.

Open forum infectious diseases, 2023 Nov 24

Comparison of Adjuvant Clindamycin vs Linezolid for Severe Invasive Group A Skin and Soft Tissue Infections.

Circulation, 2008 Jun 09

Bacteremia associated with toothbrushing and dental extraction.

Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 1999 May-Jun

Prophylactic antibiotic therapy prior to dental treatment for patients with end-stage renal disease.

Nephrology (Carlton, Vic.), 2004 Jun

Antibiotic prophylaxis in dialysis patients undergoing invasive dental treatment.

International ophthalmology clinics, 2022 Apr 01

Challenges and Updates on the Management of Acute Retinal Necrosis.

Clinical ophthalmology (Auckland, N.Z.), 2020 Jul 08

Management Strategies of Acute Retinal Necrosis: Current Perspectives.

Retinal cases & brief reports, 2022 Nov 01

RECURRENT ACUTE RETINAL NECROSIS.

Lancet (London, England), 2021 Mar 27

Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial.

Lancet (London, England), 2021 Mar 27