Gabe 🦊 @IdVilchez
ID doc for fun To Know, to Dare, to Will, to Keep Silence provider.kareo.com/gabriel-vilchez Joined October 2020-
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@BradSpellberg @Amit_Achhra @ABsteward @LordAlirezaF @VanceFowler5 My interpretation of dots is as follows: We were unable to demonstrate superiority using the prespecified DOOR outcome; however, using the traditional regulatory endpoint of TX failure/success, non inferiority would be met within a prespecified margin of 15%.
Such a pleasure to write this with @adm_stewart who did the heavy lifting! My favorite 🤩 topic, CMV. A precursor to the next international guidelines.
Such a pleasure to write this with @adm_stewart who did the heavy lifting! My favorite 🤩 topic, CMV. A precursor to the next international guidelines.
Next up at #ESCMIDGlobal2024 Andrea Kwa – post-hoc analysis of CAMERA2 trial data – does in-vitro synergy correlate with clinical outcomes? CAMERA2 was Vanco versus Vanco plus (flu)cloxacillin for MRSA bacteraemia – JAMA jamanetwork.com/journals/jama/…
#ECCMID2024 Post-hoc analysis #CAMERA2 People who received combo therapy (Vanc/Dapto PLUS Anti-Staph Beta-Lactam) if testing showed synergy then mortality improved but not amongst those without synergy.
Non inferior also on just clinical efficacy Similar AE rates. Slighly more AEs leading to discontinuation in SOC arm Great study! Provides much stronger evidence to support dalbavancin! MSSA and MRSA subgroups not reported yet. Longer term follow-up to day 180 to come.
🔥DOTS🔥 The most anticipated RCT #ESCMIDGLOBAL2024 Dalbavancin is non-inferior to SOC by clinical efficacy for complicated SAB incl Rt sided IE 2 doses Dalba 1500 mg on days 1 & 8 or 4-8 wks of SOC(cefaz or naf:MSSA;vanc or dapto:MRSA) DOOR at D70 Slides shared by @LordAlirezaF
Sneak peak of 🆕️🔥 @IDSAInfo/ @ESCMID SAB guidelines 🔆Risk stratification,high or low instead of complicated/uncomplicated 🔆Patients with high-risk features at baseline but TTE & PET/CT are negative, short course 14d Slides shared @seanongwx #ESCMIDGLOBAL2024 Oral Abx?!
Que pensais? Influye el horario en la respuesta de las vacunas? #vaccine #vacunas #Ciencia @seipweb @CAV_AEP @AEP_EnFamilia @aepediatria @ramsesevilla @pediatriaHUVR @HospitalUVRocio @Medicina_US @ibis_sevilla @SEIMC_ @SEinmunologia
Another nail in the vancomycin coffin. After accounting for laboratory testing, pharmacist management time, and costs associated with vancomycin associated AKI, daptomycin saved $166 per patient when used in place of vancomycin. academic.oup.com/ofid/advance-a…
Excellent summary of a clinical trial likely to change clinical practice. Can't wait to see the full study.
Excellent summary of a clinical trial likely to change clinical practice. Can't wait to see the full study.
While re-assessing/hunting sensi's, would you
Antibiotic Steward Ba.. @ABsteward
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2K Followers 4K Following Physician, Data Scientist "Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family." Kofi AnnanMarcus Aurelius Bot |.. @Marcus_Quote
15K Followers 45 Following Quotes by Marcus Aurelius | Roman Emperor | Stoicism | @reachmastery | “It is not death that a man should fear, but he should fear never beginning to live.”Prof. Richard Feynman @FeynmanBot
28K Followers 20 Following Quotes by Prof. Richard Feynman (not affiliated) ✍️ | Physicist | Nobel Prize Winner 🏆 | @reachmastery |Jean-Jacques Rousseau.. @RousseauQuote
14K Followers 0 Following Quotes by Jean-Jacques Rousseau | Philosopher | Writer | Composer IG 👉 https://t.co/QCB6xpH3fKMASTERY by Robert Gre.. @MasteryQuot
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1 Followers 65 Following Pharmacy nerd. Quality enthusiast. Introverted leader. Top notch teammate. All views are my own.Simran Gupta, MD @SimranGMD
364 Followers 306 Following ID fellow @mgh_ID @bwh_ID @harvardmed. former @MayoAZ_IMRES. @UConnHealth alum. Dog mom & dancer. Tweets my ownFriedrich Nietzsche |.. @QuoteNietzsche
103K Followers 8 Following Quotes by Friedrich Nietzsche | Philosopher | Writer | Poet ✍️ | Follow on IG 👉👉 https://t.co/yJ0J9yiSoxSeneca the Younger | .. @SenecaQuote
51K Followers 8 Following Quotes by Seneca The Younger | Stoic Philosopher | Letters from a Stoic | FREE Audiobook 👉 https://t.co/h8LvlLQrHwFyodor Dostoevsky | N.. @Dostoevskyquot
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3K Followers 751 Following Infectious Diseases physician-scientist @UCSF| Fascinated by protein synthesis and TB. Occasional out of the box thinker. Bahá’í , father, husband. Own views.@DrToddLee @Infected_Terran @dralicehan @ABsteward @IDiots_pod @BJegorovic @ABstewardess @maudi_ahmed @IdVilchez @Cortes_Penfield @LAGeneral_ID @IDwithNWD @docDavar @rachelpbaden I have blocked it several times here. The message was received and it’s no longer being asked for anymore. But as you said the other day, i work in a magical place.
@BradSpellberg @Infected_Terran @dralicehan @ABsteward @IDiots_pod @BJegorovic @ABstewardess @maudi_ahmed @IdVilchez @Cortes_Penfield @LAGeneral_ID @IDwithNWD @docDavar @rachelpbaden Have seen my colleagues do it here.
@ABsteward @DrToddLee @IDiots_pod @BJegorovic @dralicehan @ABstewardess @maudi_ahmed @IdVilchez @Cortes_Penfield The day that happens at LA General will be the day after I’ve been declared mentally incompetent. Which, to be fair, is likely not far off. But i got colleagues that will ensure it isn’t used for Hidradenitis even then, right team? @LAGeneral_ID @IDwithNWD @docDavar @rachelpbaden
@DrToddLee @IdVilchez @sebpoule @VanceFowler5 @Amit_Achhra @ABsteward @LordAlirezaF I am thrilled about that & always have been. One of my deepest emblazoned memories is getting into it verbally with the legendary statistical hawk Tom Fleming at an IDSA-FDA meeting years ago. He was complaining that ID doesn't do cardiology-like studies with 10,000 pts...
@IdVilchez @sebpoule @DrToddLee @VanceFowler5 @Amit_Achhra @ABsteward @LordAlirezaF It ain’t just you. I’m sorry if I’m an old fogey. But trials are loosing site of simplicity and what’s important to patients and doctors. Fancy composites may be statistically convenient, but are not readily explainable to our patients or colleagues.
@DrToddLee @IdVilchez @sebpoule @VanceFowler5 @Amit_Achhra @ABsteward @LordAlirezaF I pointed out, that would be unethical, because our drugs have very large survival benefits, so you would be randomizing far past equipoise, whereas cards folks have to do giant studies due to small absolute benefits (which they report as relative risk so they seem larger).
@DrToddLee @IdVilchez @sebpoule @VanceFowler5 @Amit_Achhra @ABsteward @LordAlirezaF First and only time I had Tom somewhat speechless. For those of you who know and love Tom, that is a really rare thing.
@IdVilchez @DrToddLee @BradSpellberg @sebpoule @Amit_Achhra @ABsteward @LordAlirezaF Shoot that’s 95% right there
@BradSpellberg @IdVilchez @sebpoule @VanceFowler5 @Amit_Achhra @ABsteward @LordAlirezaF Be happy you aren't a stroke neurologist...
@DrToddLee @VanceFowler5 @BradSpellberg @Amit_Achhra @ABsteward @LordAlirezaF Am I the only one in the room thinking it’s getting more and more difficult to understand and interpret study results ? Or I’m just becoming lazy ? - a regular/normal/average ID doc
@BradSpellberg @Amit_Achhra @ABsteward @LordAlirezaF @VanceFowler5 My interpretation of dots is as follows: We were unable to demonstrate superiority using the prespecified DOOR outcome; however, using the traditional regulatory endpoint of TX failure/success, non inferiority would be met within a prespecified margin of 15%.
Such a pleasure to write this with @adm_stewart who did the heavy lifting! My favorite 🤩 topic, CMV. A precursor to the next international guidelines.
CMV stewardship, CMV vaccines and more on the prevention of CMV with the newer drugs on the board in this review. @KottonNelson #TransplantTwitter #TransplantationJournal #NephTwitter tinyurl.com/mvbr47yf
Next up at #ESCMIDGlobal2024 Andrea Kwa – post-hoc analysis of CAMERA2 trial data – does in-vitro synergy correlate with clinical outcomes? CAMERA2 was Vanco versus Vanco plus (flu)cloxacillin for MRSA bacteraemia – JAMA jamanetwork.com/journals/jama/…
#ECCMID2024 Post-hoc analysis #CAMERA2 People who received combo therapy (Vanc/Dapto PLUS Anti-Staph Beta-Lactam) if testing showed synergy then mortality improved but not amongst those without synergy.
Non inferior also on just clinical efficacy Similar AE rates. Slighly more AEs leading to discontinuation in SOC arm Great study! Provides much stronger evidence to support dalbavancin! MSSA and MRSA subgroups not reported yet. Longer term follow-up to day 180 to come.
200 included. PWID 29 MRSA 66, MSSA 136 SSTI 30% Endovascular 20% Osteoarticular 30% Outcomes: Death SOC 4%; dalba 4% Clinical failure SOC 12%; dalba 13% Overall DOOR: 47.7% (95% CI 39.8-55.7%). Probability subject receiving dalba would have a superior door
Late breakers at #ESCMIDGlobal #4 DOTS trial. Nicholas Turner. @VanceFowler5 Dalbavancin PK - activity above MIC for at least 42 days with 2x dose weekly 1500mg Dalba vs SOC for complicated SAB and R sided IE. MSSA and MRSA Initial induction therapy for up to 10 days
#ECCMID2024 Dalbavancin vs SOC for 'Complicated' #Staph bacteraemia (although no Left. IE, no CNS infection, no retained infected prosthetic material). BIG NI-Margin allowed (20%). Dalbavancin seems ok but results consistent with being 12% worse. Really need a bigger trial.
✅ @FCBarcelona game #ECCMID2024 #escmidglobal