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stanfordasp.bsky.social
Stanford Antimicrobial Safety & Sustainability Program
@stanfordasp.bsky.social
2.3K followers 800 following 270 posts
🏆 IDSA Center of Excellence in Antimicrobial Stewardship | CDPH AMS Honor Roll Gold | WHO Collaborating Centre
🩺 Stan Deresinski, Marisa Holubar, Alex Zimmet, Amy Chang, Emily Mui, Lina Meng, Will Alegria, David Ha
🔗 http://med.stanford.edu/bugsanddrugs
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stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: My male patient with dysuria is growing E. coli (>100,000 CFU/mL) on urine culture. 🚨 He has no systemic symptoms or signs of pyelonephritis or prostatitis. Does he have a complicated UTI? 🤔

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
November 12, 2025 at 5:12 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: Should I add vancomycin for severe mucositis in my patient with persistent neutropenic fever (NF) of unknown etiology? 🤔 Currently on cefepime & stable. Let’s dive in! 👇

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
November 5, 2025 at 5:38 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: Treating HAP/VAP? 🤔 Can we go shorter than 7 days?

💡A: Yes! While 7 days is the norm, evidence supports shorter courses in specific cases. Let’s break it down! 👇

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
October 29, 2025 at 7:07 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: Why does the lab mention when a GNR (gram-negative rod) is “lactose fermenting”?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
October 23, 2025 at 5:51 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: When should I empirically cover for Pseudomonas aeruginosa in diabetic foot infections (DFIs)?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
October 15, 2025 at 3:57 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: When should you consider empiric MRSA coverage for SSTI treatment?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
October 8, 2025 at 2:07 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: (Part 2)

❓Q: If my patient with pneumonia has a positive MRSA nasal PCR but respiratory cultures are NOT available, do I need to continue vancomycin for a full course of therapy?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
October 1, 2025 at 4:20 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: If my patient with pneumonia has a positive MRSA nasal PCR but respiratory cultures are negative for MRSA, do I need to continue vancomycin for a full course of therapy?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
October 1, 2025 at 4:16 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: Candida only grew in 1/4 bottles. Is this a contaminant?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
September 24, 2025 at 3:16 PM
Reposted by Stanford Antimicrobial Safety & Sustainability Program
ashejournal.bsky.social
@ritikaprasad.bsky.social @stanfordasp.bsky.social @marisa-holubar.bsky.social: The inpatient mandatory indication field outperformed the ICD-10 in inferring dc abx indications, and can be used to assess abx appropriateness without needing manual chart review.
doi.org/10.1017/ash....
Unraveling indications for discharge antibiotics: the Devil’s in the details | Antimicrobial Stewardship & Healthcare Epidemiology | Cambridge Core
Unraveling indications for discharge antibiotics: the Devil’s in the details - Volume 5 Issue 1
doi.org
September 22, 2025 at 9:28 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: My patient is growing yeast in blood cultures. Is this Candida?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
September 17, 2025 at 5:08 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: My immunocompromised patient is admitted to the ICU and starting ABX for presumed CAP. Do they need empiric MRSA and Pseudomonas coverage?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
September 10, 2025 at 5:32 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: I’m looking for oral ABX options for UTI. When might oral fosfomycin be appropriate?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
September 3, 2025 at 4:26 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: Can I use piperacillin-tazobactam to treat an Enterobacter cloacae intra-abdominal infection?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
August 20, 2025 at 1:56 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: Can I use piperacillin-tazobactam to treat an ESBL E. coli intra-abdominal infection?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
August 13, 2025 at 6:20 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day:

❓ Q: How do I tell if my gram-negative rod (GNR) is an extended-spectrum beta-lactamase (ESBL) producer?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
August 6, 2025 at 4:45 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: UTI in males

❓ Q: My male patient with dysuria is growing E. coli (>100,000 CFU/mL) on urine culture. He has no systemic symptoms or signs of pyelonephritis or prostatitis. Does he have a complicated UTI?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
July 24, 2025 at 2:52 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: penicillin allergies

❓ Q: My patient reports a reaction to penicillin (acute, self-limited rash) over 10 years ago. Can they safely receive cefazolin for their MSSA infection?
#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
July 16, 2025 at 3:23 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: sputum interpretation

❓ Q: My patient has 4+ growth of an organism on respiratory culture. Does this mean he has pneumonia?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
July 9, 2025 at 3:28 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: ertapenem hypoalbuminemia

❓ Q: My ICU patient with hypoalbuminemia has ESBL E. coli pyelonephritis, resistant to PO abx. He improved (afeb, WBC WNL, off pressors) after 3d of meropenem. Should I avoid narrowing to ertapenem?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
July 2, 2025 at 3:23 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: ABX CNS penetration

❓ Q: Which antibiotics have "good" CNS penetration for the treatment of bacterial meningitis/ventriculitis?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
June 25, 2025 at 5:21 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: Corynebacterium in resp cultures- do I treat?

❓ Q: My patient’s sputum culture is growing Corynebacterium species in addition to normal respiratory flora. Do I need to treat this?

💡 A: In most cases, no tx is necessary.

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
June 18, 2025 at 5:15 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: Coverage in septic BMT patient

❓ Q: A BMT recipient is in the ICU with septic shock. She is on IV posaconazole for antifungal prophylaxis; should we add/switch to an IV echinocandin empirically for Candida coverage?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
June 11, 2025 at 2:21 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: TMP-SMX and cytopenias

❓ Q: My immunocompromised patient is experiencing severe cytopenias while on PJP prophylaxis with trimethoprim/ sulfamethoxazole (TMP/SMX). How might I address this issue?

#IDsky #medsky #meded #pharmsky #skyRX #AMSsky
June 4, 2025 at 2:13 PM
stanfordasp.bsky.social
🌟 ABX Pearl of the Day: revisiting Vancomycin Zosyn nephrotoxicity

❓ Q: Is the combination of vancomycin and piperacillin-tazobactam safe for the kidneys?

#IDsky #medsky #meded #pharmsky #skyRX
May 28, 2025 at 2:28 PM