Agree- S aureus infections 🦠 can be very complex, but a median IV duration of 24.5 days seems way too long

@aliciad3.medsky.social @buonsenso.bsky.social @alastairmca30.bsky.social

👉 Please do share your thoughts—would love to hear how others are approaching this.

journals.lww.com/pidj/abstrac...

Still, this study adds to evidence supporting daptomycin doses of 10 mg/kg/day or even higher, and worth further study.

But it also underscores the ongoing need for antimicrobial stewardship in complex pediatric infections.

Several combos raise (my) eyebrows:

🧪 teicoplanin + amox-clav + vancomycin + cefazolin
🧪 amox-clav + rifampin + amikacin

❗Even in what is most likely mono-bacterial!

This reflects a broader issue: indication creep and layering of MRSA agents without clear rationale. #AMS

🔸 All patients were on other antibiotics with daptomycin.

🔸 10/12 MSSA cases got cefazolin concurrently—so why add dapto at all?

🔸 After IV, many continued dual oral staph coverage (e.g., amox-clav + TMP/SMX).

Hard to isolate what worked.

#AntimicrobialStewardship
#AMR
#microsky

💉 High-dose daptomycin (~10 mg/kg/day) was used in >50%, with clinical success in 90%, major CRP reductions, and no serious adverse events.

Median duration: 24.5 days IV
Many transitioned to oral step-down.

Sounds promising—until you look closer.

#jongeklaren #artsinopleiding #dokterinopleiding #geneeskunde #artsleven

@medischcontact.bsky.social