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ID:IOTS Podcast @idiots-pod.bsky.social · 3d

Bit of Vitamin C’ll sort it out *

*or Vitamin A if you use Azithro as your main macrolide

ID:IOTS Podcast @idiots-pod.bsky.social · 3d

I think in theory: Mouths are wet, and I think mouth to mouth on a patient with legionella is ill advised, to say the least. Not heard of it transmitted this way but haven’t looked.

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ID:IOTS Podcast @idiots-pod.bsky.social · 3d

I guess I’d try to get more information, seeing as the patient’s not sick:
1. Nature of penicillin allergy
2. Details of the other persons illness and death.

Assuming none of that is forthcoming, I’d go empirical for severe LRTI, and do resp viral testing.

Ceftriaxone/macrolide?

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ID:IOTS Podcast @idiots-pod.bsky.social · 29d

A rare ‘Jame on an episode about fungi’ appearance this week, as we discuss Aspergillus diagnosis & treatment with Dr Iain Page & Prof Darius Armstrong-James.

podcasts.apple.com/gb/podcast/i...

#idsky #microsky #fungisky #breakingthamould

119. The Moulds: Aspergillus part 2, invasive and chronic disease

Podcast Episode · ID:IOTS - Infectious Disease Insight Of Two Specialists · 08/09/2025 · 41m

podcasts.apple.com

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ID:IOTS Podcast @idiots-pod.bsky.social · Sep 4

The #BSMM annual meeting is next week in Norwich! Details here.

Our Master of Moulds Alyssa will be there too!

Tickets still available!

#idsky #microsky #fungi

bsmm-meeting.bsky.social @bsmm-meeting.bsky.social · Aug 31

#Norwich #BSMM2025 annual meeting starts a week from today! You can still register and can also check our exciting programme here! bsmm.org/BSMM_2024/bsmm…

https://bsmm.org/BSMM_2024/bsmm…

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Reposted by ID:IOTS Podcast

Prof Cloutman-Green @girlymicro.bsky.social · Aug 31

It's finally happening

The first Girlymicrobiologist book is coming!

It Shouldn't Happen to a PhD Student: How to thrive, not just survive, during your PhD

This is the book I wish someone had given me when I started my PhD

Live to order (amazon depending) on 17/10/25

Pls share with yr networks

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 27

Ooh, that’s an interesting point. I’ve tried to move away from Broad and Narrow, but it’s so baked into our lexicon it’s difficult to avoid it completely.

Do you use other terms instead?

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 27

#idsky

I forgot to add hashtags. Oops.

ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

KASIC Putting or another brilliant post on De-escalation of ABx with some brilliant references about how de-escalation is associated with BETTER OUTCOMES for patients!

Let’s talk about this table though, as it’s been on my mind. 🪡

ID:IOTS Podcast @idiots-pod.bsky.social · Aug 27

A brilliant article on the real world impact of AMR. As time goes on I worry about this becoming a bigger part of ID clinical practice.

Saira Butt, MD @sairabt.bsky.social · Aug 27

Must read for all teams consulting infectious diseases #idsky #idmeded #meded #stewardship #voicesofID @cidjournal.bsky.social
academic.oup.com/cid/advance-...

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

@kasic.bsky.social posts are a great place to start; I pointed ppl towards them when I was working in England and got great feedback; their influence spreads far beyond Kentucky! (They K stands for Kentucky they’re from Kentucky)

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

I guess I’ll stop here. I just wanted to add my thoughts to @kasic.bsky.social’s original post, and not just shitpost around it.

BTW if anyone’s after more stewardship resources…

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

The ‘medium’ & ‘narrow’ columns I’ve got more of an issue with; I’d probably move Vanc & Clinda into ‘medium’; here I think I’m being partially influenced by the UK version of WHO’s AWaRe classification of ABx:

UKHSA AWaRe classification of antibiotics

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

Why don’t you want to use Aztreonam unless you have to? Because we need to reserve it for Rx DTR Gm negs.

The other agents in ‘broad spectrum’ are all antipseudomonal/important for Gm negs, so their use should be restricted on those grounds.

(FQ also have a poor side effect profile if course)

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

The issue I think is that spectrum isn’t the only determinant for de-escalation, which isn’t explicitly stated in this table; it’s stewardly use of ABx.

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

If you look at the spectrum for these drugs, you’ll see it’s all over the place.
AGs are arguably wider spectrum than Aztreonam;
So too Cotrim & Ceftriaxone
Doxy, HUGE spectrum, is in the middle
And in terms of C.diff risk, the highest risk agent (Clinda) is in the ‘narrow’ column.

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

KASIC Putting or another brilliant post on De-escalation of ABx with some brilliant references about how de-escalation is associated with BETTER OUTCOMES for patients!

Let’s talk about this table though, as it’s been on my mind. 🪡

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

Oh I forgot about that, did you or @absteward.bsky.social post that previously, in another place?

V interesting. I’m putting that in my ID:IOTS Guide to Co-trimoxazole when I get round to writing it!

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

I hadn’t even heard of Cystoisospora!

Fine I’ll give you dimorphic fungi, but there’s a lot of crossover in your bacteria section (eg Melioid)

Like a parent of 2 children, though… I love them both equally

But also like a parent of 2 children, not 50:50 all the time

(I’m a parent of 2 children)

B.ps

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

WHAT??!!

I love Cotrim but it’s got no atypical cover, no worms and malaria cover, doesn’t do STIs, can’t use it for H.pylori

Doxy’s winning that fight (unless the fight’s happening in plasma)

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

Mero: AZTREONAM, what are you doing up here in Broad Spectrum?
Aztreo: I treat Pseudomonas!
Piptaz: yeah, *tobramycin* treats Pseudomonas
Tobra: hey…
Aztreo: I’m important for DTR Gram Negatives!
Mero: yeah when your little friend Avibactam is with you
Ceftazidime: that guy’s not so bad TBF

bugsandwalks.bsky.social @bugsandwalks.bsky.social · Aug 24

Aztreonam, broad spectrum…cough…really…awkward silence…

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

Ceftriaxone: I’m a big broad spectrum boy. I cover Staph aureus, Strep, & Enterobacterales!
Cotrimoxazole: MRSA?
Cef: No
Cotrim: ESBL?
Cef: No
Cotrim: CPE?
Cef: No
Cotrim: PCP?
Cef: No. That’s not even a bacteria, no drug could cover all that
Cotrim: okay. What do I know. I’m only MEDIUM SPECTRUM

ID:IOTS Podcast @idiots-pod.bsky.social · Aug 23

Ah yes, the famously medium-spectrum doxycycline.

It only covers
Staphylococci
Pneumococci
Beta haemolytic Streptococci
Actinomyces
Mycoplasma
Chlamydophila
Legionella
H.influenzae
Moraxella catarrhalis
ESBL E.coli UTI
Pseudomonas UTI(maybe!)
Burkholderia pseudomallei
Vibrio
H.pylori

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

C.acnes: you got a reference? Id like to include it in my “ID:IOTS Guide to Tetracyclines” page:

idiots.notion.site/87-Tetracycl...

87. Tetracyclines | Notion

Listen here: Buzzsprout 87. ID:IOTS guide to Tetracyclines - ID:IOTS - Infectious Di…

idiots.notion.site

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 24

I AM SUCH A SILLY SAUSAGE I FORGOT ALL THE NONBACTERIAL SPECTRA!

Here you are

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ID:IOTS Podcast @idiots-pod.bsky.social · Aug 23

I’ll give you Paeudomonas but NO MORE

ID:IOTS Podcast @idiots-pod.bsky.social · Aug 23

Also
• Syphilis
• Chlamydia
• Gonorrhoea
• Brucella
• Bartonella
• Coxiella burnetii
• Franciscella
• Leptospira
• Streptobacillus
• Yersinia pestis
• Borrelioses (Lyme, Relapsing fever)
• Rickettsiales (RMSF, Typhus, Scrub typhus, Anaplasma, Erlichia)
• Whipple’s
• Anthrax (Rx & PEP)
POOR DOXY
2/2

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