ID Journal Club

ID Journal Club

@IDJClub

Followers5.8K
Following6

An #IDTwitter journal club, held monthly on first Mondays @ 9 pm ET. Join the discussion using #IDJClub.

Joined on May 29, 2019
Statistics

We looked inside some of the tweets by @IDJClub and here's what we found interesting.

Inside 100 Tweets

Time between tweets:
2 minutes
Average replies
6
Average retweets
1
Average likes
13
Tweets with photos
42 / 100
Tweets with videos
0 / 100
Tweets with links
0 / 100

Q8 What type of antibiotic duration study would you like to see next? Do you find this aspect settled or are more gains feasible? #IDJClub

Speaking as @TMcCarty2010 I think I would laugh at a team ordering a CRP in the setting of obvious bacteremia/sepsis and/or roll my eyes at an ID fellow making this recommendation...Q7 Who feels the same? Who will think twice? #IDJClub

Quoted @AbhirupMD

@IDJClub Is Acinetobacter so uncommon there? Here more than half of Gram-negative BSI are Acineto #IDJClub

This sounds... terrifying. 😱😱😱 https://t.co/0Y1b4TSpe4

Quoted @mangarone23

@IDJClub Like many studies in ID shorter is better #IDJClub

Increasing in volume each year. Results almost exclusively fall on the same end of the spectrum. #IDJClub https://t.co/GV1mOF2lrS

Q6 What are your overarching thoughts? Does this provide value over just stopping at 7 days? Are there certain situations you might look to employ this strategy? #IDJClub

Conclusion: Shorter antibiotic duration (with or without CRP-guidance) was non-inferior to a fixed 14-day course. Agree or disagree? #IDJClub

Q5: How much does the lower than expected event rate impact your interpretation of the results? #IDJClub https://t.co/ZtyuJa04Hw

Q5: How much does the lower than expected event rate impact your interpretation of the results? #IDJClub https://t.co/ZtyuJa04Hw

Adverse events were uncommon without differences across the three groups. The most prominent being Clostridium difficile colitis. #IDJClub

Quoted @Howzzeee

@adolfo7777 @IDJClub Agreed. I'm really glad they delineated this though because one of my big questions was going to be about resistance rates in Swis vs US. At least now I know it's mostly applicable for non-ESBLs. #IDJClub.

A few different people have made this point... but MDR doesn't generally mean increase in virulence or severity, all other factors being equal, should we treat them differently? #IDJClub https://t.co/QTodWA8Y03

Supplemental Table 3, Deviations from protocol (typically shorter or longer antibiotic courses depending on physician judgement) occurred in 34 of 164 patients (21%) in the CRP–guided group, 25 of 166 (15%) in the 7-day group, and 20 of 163 (12%) in the 14-day group. 
#IDJClub https://t.co/HUxlhfxE0o

Supplemental Table 3, Deviations from protocol (typically shorter or longer antibiotic courses depending on physician judgement) occurred in 34 of 164 patients (21%) in the CRP–guided group, 25 of 166 (15%) in the 7-day group, and 20 of 163 (12%) in the 14-day group.  #IDJClub https://t.co/HUxlhfxE0o

Risk factors for failure after multivariable analysis: foreign body material and pulmonary origin, though none of the CRP patients with those features met the primary outcome. #IDJClub

There were numerical differences in the primary outcome event rate at 30 days across groups: CRP (2.4%), 7-day (6.6%), 14-day (5.5%). A worst case sensitivity analysis with missing data did not change meeting non-inferiority criteria. #IDJClub

Median duration of treatment for CRP-guided and 7-day groups was even at 7 days compared to 14 days for that group. Still with a good bit of variety in the actual durations used for the "fixed duration" groups. #IDJClub https://t.co/4Qpq3g5HtL
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Median duration of treatment for CRP-guided and 7-day groups was even at 7 days compared to 14 days for that group. Still with a good bit of variety in the actual durations used for the "fixed duration" groups. #IDJClub https://t.co/4Qpq3g5HtL

Similar distribution of organisms across groups as well. #IDJClub https://t.co/OJ7SbguzRF

Similar distribution of organisms across groups as well. #IDJClub https://t.co/OJ7SbguzRF

Q4: Are you more hesitant to stop at 7 days for non-urinary sources of infection? What risk factors cause hesitation? #IDJClub

Much like the CID Paper published online 12/2018 (https://t.co/JKiQ9MgNp0) there was a predominance of urinary source. #IDJClub https://t.co/wyIxdoX8P3

Much like the CID Paper published online 12/2018 (https://t.co/JKiQ9MgNp0) there was a predominance of urinary source. #IDJClub https://t.co/wyIxdoX8P3

Groups look comparable (hooray randomization). #IDJClub https://t.co/RYyrBShXOm

Groups look comparable (hooray randomization). #IDJClub https://t.co/RYyrBShXOm

Q3: What are your thoughts on inclusion/exclusion? Anything you would change? Requiring a CD4 >500 for HIV+ patients feels a little extreme… #IDJClub https://t.co/i1a7j0A1mo
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Q3: What are your thoughts on inclusion/exclusion? Anything you would change? Requiring a CD4 >500 for HIV+ patients feels a little extreme… #IDJClub https://t.co/i1a7j0A1mo

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