Your voice sounds wonderful and your advice is spot on! 😉

That sodium load looked intense!
1,980mg Na/6g vial x3 vials/day
=5,940 mg Na per day
(assuming dosing for normal renal fxn)

EUCAST has “Notes” for Enterobacterales and other GNs - not classic BPs. They point to their guidance docs related to fosfo:

1: www.eucast.org/fileadmin/eu...

2: www.eucast.org/fileadmin/sr...

Agree. Tolerability has been my #1 concern with this for years… but for the XDR resistant E. coli GN infxn that needs a combo option…I can see us pulling for it with close monitoring. It will be a learning curve!

Learned about OTC methenamine from community PharmD 19 years ago (yup I’m old now). It’s a godsend for women who know their triggers! 🙌🏻

Trick: Use short-term ahead of known triggers w/ LOTS of water & loose clothing to prevent rUTI. If infxn well-established, stones etc, likely isn’t enough.

We discussed it originally when Prisma Health was switching. Given all the other benefits & the shortage of clinda at the time (w/ its own ⬆️ resistance to anaerobes), we felt it had sufficient equipoise to try. If Bacteroides was isolated on cx tho, we’d typically switch to DOC like metronidazole.

I personally thanked her for all her service to date. She’s saved a lot of mommas & babies. No doubt about that. 😉

It’s always a good time with PB&J 😎

And you were amazing! Thanks again for agreeing to join the pod and lend us your brain 🧠🤗

📌

📌

For many it is! You’d be surprised how often I get asked. 😅