Cost? Or benefit?

I'm not sure about either 🤷🏽‍♂️

I don't routinely recommend it yet, as there is unclear benefit.

But this is a gap in our knowledge, so will be great to have some additional data. Waiting for MAGI and GoGoVax results.

However, very low risk...just hard to quantify any individual level benefit.

These are all great tips!

And always good to have a healthy respect for Staph aureus bacteremia. If people don't before their ID rotation, they usually do after it...

This is a really great piece! The part towards the end about people making choices that defy logic, but allowing space for change, really resonated with me (clinically and non-clinically).

cc: Thank you to @cidjournal.bsky.social and @idsainfo.bsky.social for publishing this supplement!

I did a little thread on the other really interesting articles from the supplement here:

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This is gold

This is great. How routine is lidocaine used for BPG in UK/Eur? I think it is harder in the US, but seems like there are good data.

I know @jncherabiemd.bsky.social is doing (has done?) a trial to study this here - clinicaltrials.gov/study/NCT063...

Agree. Might be a bit of a moot point in the US with the new agents available. But unclear how quickly settings with high AMR will have access to newer agents, so would be nice to have alternatives there (esp when ceftriaxone isn't available).

I agree with this - I've been interested in trying to study multi-doses for those reasons, esp in settings with higher resistance. I think it could work well for T> MIC. There was a nice PK study by Barbee et al - the findings from pharyngeal fluid were interesting: pubmed.ncbi.nlm.nih.gov/29624558/

It's a good question. I think it was partly a dose issue before. Single dose 800mg seems to work well in most settings, but surprising how little clinical data there are.

We reported outcomes from Vietnam - worked well for urethral/rectal sites, but some caution for throat
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