“Antibiotics are among the most potent psychoactive drugs in all the pharmacopoeia. They are incredibly potent anxiolytics.They just act on the prescriber rather than the patient” -Dr. Brad Spellberg @bradspellberg.bsky.social #idquotes #idsky
Proud to be part of this great team led by @bradspellberg.bsky.social 🔥Our LTE is now published “Evidence Over Eminence: Rethinking Specialty Guidelines Amid the ATS–IDSA Debate.” A timely discussion on evidence vs eminence in the guidelines development. #IDsky academic.oup.com/cid/article/...
Evidence Over Eminence: Rethinking Specialty Guidelines Amid the ATS-IDSA Debate
Brad Spellberg, MD, Bassam Ghanem, PharmD MS BCIDP, Miguel Morante-Ruiz, MD, Émilie Bortolussi-Courval, RN PhD, Anil N Makam, MD MAS, Zeynep Ergenc, MD, Ni
academic.oup.com
Static vs. cidal: it’s not complex; it’s simply incorrect @bradspellberg.bsky.social et Al Honored to be part of this amazing group who challenges dogmas and debunk ID myths #idsky #microsky journals.asm.org/doi/10.1128/...
From '23-'25 LA General Medical Center underwent a once in a generation workforce transformation, caused by fiscal & regulatory pressure. Our article describing causes & outcomes is published! Critical lessons for health systems in a time of federal uncertainty. www.dovepress.com/articles.php...
| JHL | Dove Medical Press
Key lessons learned from the LA General transformation, including approaches taken to recruitment and culture change, and outcomes achieved.
dovepress.com
Hey @infectedterran.bsky.social, my brother in Scrubs! Have you seen it yet? Man, just watched the first episode and it was like coming home after a long journey. I really missed them, and the tone was just perfect. Whaddaya think?
Rock on my brother in ampho-hating! @drboulware.bsky.social
a blue circle with a white hand making a call me gesture
ALT: a blue circle with a white hand making a call me gesture
media.tenor.com
josh farkas 💊@pulmcrit.bsky.social · 6mo ago@bradspellberg.bsky.social and other ID gurus - Does this look OK to you? Any critiques and/or additional thoughts you would pass along to front-line clinicians about implementing this regimen in real life? (disclosure: my hatred of ampho-induced AKI runs deep) emcrit.org/ibcc/cryptoc...
0 reason to think things would be difft in non HIV, children, xenomorphs, non carbon based life forms, or any other excuses stubborn deniers have. My suggestion? Do some yoga. Meditate. Light incense. Relax. And stop torturing your patients with 2 weeks of amphoterrible. Subtle as always, I know.
And a congratulations to the humble @drboulware.bsky.social, who published a thoughtful editorial accompanying the study. Dr. Boulware is a true leader in ID, and it is an honor to have him evaluate our study. I encourage everyone to read his team's editorial! jamanetwork.com/journals/jam...
Single-Dose Amphotericin B for HIV-Related Cryptococcal Meningitis
Cryptococcal meningitis remains a life-threatening opportunistic infection among people with advanced HIV, even in high-resource settings. For decades, the standard induction regimen in the United Sta...
jamanetwork.com
Dr. D Boulware, MD MPH@drboulware.bsky.social · 7mo agoIn an excellent study of real world outcomes in LA General Medical Center, after implementing AMBITION single dose liposomal amphotericin protocol for crypto meningitis: Similar survival without recurrence Fewer severe adverse events Shorter hospitalization (lower cost) dx.doi.org/10.1001/jama...
Thank you my friend! Based on your original work!!!! US docs gotta get on board & stop pretending things that work in other countries won't work in US. AMBITION protocol is MUCH safer and MUCH more patient centered, and just as effective as 2 weeks of old, sad, amphoterrible. @absteward.bsky.social
Dr. D Boulware, MD MPH@drboulware.bsky.social · 7mo agoPatient-directed discharges (i.e. leaving against medical advice) dropped from 35% to 12%. Major congratulations to the authors: Devin Clark, Brad Spellberg @bradspellberg.bsky.social , and colleagues.
Patient-directed discharges (i.e. leaving against medical advice) dropped from 35% to 12%. Major congratulations to the authors: Devin Clark, Brad Spellberg @bradspellberg.bsky.social , and colleagues.
In an excellent study of real world outcomes in LA General Medical Center, after implementing AMBITION single dose liposomal amphotericin protocol for crypto meningitis: Similar survival without recurrence Fewer severe adverse events Shorter hospitalization (lower cost) dx.doi.org/10.1001/jama...
Is It Time to Use Single-Dose Amphotericin B for HIV-Related Cryptococcal Meningitis in the USA? The answer is yes! doi.org/10.1001/jama...
Single-Dose Amphotericin B for HIV-Related Cryptococcal Meningitis
Cryptococcal meningitis remains a life-threatening opportunistic infection among people with advanced HIV, even in high-resource settings. For decades, the standard induction regimen in the United Sta...
doi.org
Behind the scenes 🔥🔥 with all the laughs on the latest Febrile Podcast @febrilepodcast.com with @lageneral-id.bsky.social and @bradspellberg.bsky.social #IDSky player.captivate.fm/episode/dd68...
Highly recommend you check out @bradspellberg.bsky.social book "Broken, bankrupt and dying". Achieving universal coverage can be done in many different ways. The rest of the developed world has done it in all different ways (government coverage, private/public, state subsidized etc).
Hasn't been much discussion of the 40% failure rate to fill ID programs this match year. Interesting. Wonder if anyone is ever going to do anything about that?
🆕🎙️🔥Febrile Podcast just dropped! ✅ID Jedi @bradspellberg.bsky.social ✅Mini-cases OM,IE,Bacteremia ✅IV vs PO debates ✅Duration of therapy ✅Shmidelines Vs WikiGuideline ✅A must-listen for every antibiotic steward! #IDsky #EMIMCC febrilepodcast.com/episodes/ open.spotify.com/episode/6dkJ...
New episode out today: Listen in to this team from LA as they walk through several mini-cases and chat IV vs PO antibiotics! Feat: Fourth year medical student Hannah Chute, Dr. Paloma Reta-Impey, and @bradspellberg.bsky.social Also check out: www.bradspellberg.com/oral-antibio... #IDsky #MedSky
🆕🔥🦴 Our 2025 Update to @wiki-guidelines.bsky.social for the Management of Pyogenic Osteomyelitis in Adults 🌟 @bradspellberg.bsky.social 🔗 [link] #idsky www.amjmed.com/article/S000...
Thrilled that another regulatory innovation out of LA General is now out in @jamanetworkopen.com! The first hospital in California authorized by CDPH to administer outpt hemodialysis for up to 2 weeks for inpatients newly started on HD who lack insurance. jamanetwork.com/journals/jam...
Hospital Hemodialysis Unit Flexibility and Hospital Length of Stay
This quality improvement study evaluates the association of hospital length of stay with a first-in-state model in which an inpatient hemodialysis unit received regulatory approval to provide temporar...
jamanetwork.com
📢📢📢 We are delighted to announce that we are assembling team for our next project, Pharyngitis WikiGuideline Join us to create guidelines with the humility of uncertainty. Deadline to sign up is November 21, 2025.
Thanks to @abimfoundation.bsky.social ation for posting the video of my recent lecture on the LA General Policy to Override Policies. For those of you who know my lectures, this one is among the most entertaining. And it's only 10 min. Check it out & implement the policy! youtu.be/RuKAKH8A604?...
Administrator/Clinician Collaboration: Policies to Put Patients First
YouTube video by ABIM Foundation
youtu.be
Another plug for #wikiguidelines @bradspellberg.bsky.social When guidelines don’t keep up with medicine
UNMC Infectious Diseases Division @unmc-id.bsky.social · 12mo agoUNMC ID faculty Dr. Jenn Davis and 🌟 resident Dr. Gigi Green joined up to publish an interesting case in @cidjournal.bsky.social as part of the Clinical Delimmas in ID series: "A Blurry Line: Navigating Treatment Decisions When the Guidelines Don't Fit" #IDSky academic.oup.com/cid/advance-...
I love Dalba I just don’t know why we should do a PhD in statistics to understand a trial now Or maybe am just getting old and grumpy
a white monkey with a blue face is sitting on a blue blanket .
ALT: a white monkey with a blue face is sitting on a blue blanket .
media.tenor.com
As @bradspellberg.bsky.social would say CRP is missing a letter as a test "A" (CRAP) - www.sciencedirect.com/science/arti...
Revisiting diagnostics: erythrocyte sedimentation rate and C-reactive protein: it is time to stop the zombie tests
sciencedirect.com
International guidelines recommend 5 to 7 days of antibiotic prophylaxis for patients with cirrhosis & upper GI bleeding. 🆕🔥Systematic Review ( 14 RCTs, N=1322) & Bayesian Meta-Analysis challenged this universally held dogma #idsky jamanetwork.com/journals/jam...
Prophylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis
This systematic review and meta-analysis evaluates the evidence supporting the current guidelines antibiotic prophylaxis use in patients with cirrhosis and upper gastrointestinal bleeding.
jamanetwork.com
#IDsky The Infectious Disease Brad Boy himself, @bradspellberg.bsky.social , has an updated Oral vs IV table, now including the Plague (Y really) and Lyme! Link here: www.bradspellberg.com/oral-antibio...
Oral Antibiotic RCTs | mysite
bradspellberg.com
WikiGuidelines lapel pins are available for purchase on WikiGuidelines website: www.wikiguidelines.org Support us to incorporate humility of uncertainty into guidelines!
“We’re asking the wrong question. Let’s use fundamental PK. Let’s get the drug to where the bug is, at a high enough concentration to kill the bug, and not worry about whether we label the drug static or cidal”. As said by @bradspellberg.bsky.social 🤩😇 Fabulous conversation! #IDSky #MedSky #AMSSky
ASM@asm.org · last yr.Bactericidal vs Bacteriostatic Antibiotics. This controversial topic has important conceptual ramifications to treat severe infections. youtu.be/3z4BItBrzbk
Really compelling story by @corinnepurtill: "Strangers in the middle of a city: The John and Jane Does of L.A. General Medical Center". This short video tells the powerful story of the unidentified admissions to one of the busiest trauma centers in the US. www.latimes.com/00000197-c35...
LA Times Today: Strangers in the middle of a city: The John and Jane Does of L.A. General Medical Center
Watch L.A.
latimes.com