Why do u think u will lose the G+ argument? There’s abundant evidence on its favor. What’s to be acknowledged is that “winning” this argument is not about evidence but rather changing behaviors. Here’s @bradspellberg.bsky.social site just in case 😉 www.bradspellberg.com/oral-antibio... - ThreadSky

About ThreadSky

drrossanarosa.bsky.social • 14 days ago

Why do u think u will lose the G+ argument? There’s abundant evidence on its favor.

What’s to be acknowledged is that “winning” this argument is not about evidence but rather changing behaviors.

Here’s @bradspellberg.bsky.social site just in case 😉 https://www.bradspellberg.com/oral-antibiotics

Comments

veezaff.bsky.social•14 days ago

I guess the real question is - is there really such a thing as an uncomplicated S. aureus bacteremia? 😂

bradspellberg.bsky.social•14 days ago

That’s a phantom menace argument. Oral is proven effective for endocarditis, the most complex type of bacteremia. Including for Staph aureus IE, in RCTs. So it doesn’t matter if it’s “complicated” or not. There is no science supporting IV only. Only dogma, inertia, hubris, and stubbornness.

drrossanarosa.bsky.social•14 days ago

SABATO showed how difficult it is to find that population. It also showed its not impossible. I keep their inclusion criteria bookmarked in my laptop, and favor linezolid for “early” switches to PO.

philipbejon.bsky.social•14 days ago

Even then, the trial showing that the SABATO excluded patients needed IVs is not there. POET included Staph aureus, those patients would be excluded from SABATO, but actually did fine on orals.

drrossanarosa.bsky.social•14 days ago

Yes, SABATO is a trial of early switch to PO, not of whether one can use PO at all 😇

wesmd.bsky.social•14 days ago

Agree. If Bactrim works for the right patient, no reason to think linezolid wouldn't

juliambisome.bsky.social•14 days ago

Even for complicated, there is data supporting orals. Heldman et al. 1996 is one of my favorites, randomized to oral cipro+rifampin versus vanc+oxacillin for Staph endocarditis. No differences found. Obviously resistance rates have changed but still shows that the route of admin is not important

juliambisome.bsky.social•14 days ago

And actually, I should say no differences in efficacy specifically. There were differences; IV regimen associated with more adverse effects.

Posting Rules

Be respectful to others
No spam or self-promotion
Stay on topic
Follow Bluesky's terms of service

Comments

Posting Rules

Reply