June 10th, 2017

What’s Your Favorite Antibiotic? A Fantasy Draft

Over on the journal Open Forum Infectious Diseases (that’s “O-F-I-D”, not “Oh-FID”), the generous people from IDSA and Oxford University Press have allowed me to record a series of podcasts, interviewing various interesting people in the ID field.

This time, however, I strayed from the usual format and asked my colleague Rebeca Plank to join me in a “draft” of our 5 favorite antibiotics.

Which is emphatically not to imply that Rebeca isn’t interesting. On the contrary — she happens to have one of the most impressive pen collections in all of Eastern Massachusetts.

Still, you may wonder, why did we do this? Several reasons:

  • We sensed a burning need for this this critical educational resource, which as you will see teaches fundamental truths about these important therapeutic tools.
  • One of us wanted to honor the upcoming baseball draft (hint:  Rebeca couldn’t care less about baseball).
  • Someone gave me a USB microphone, and it was sitting around doing nothing for way too long.

In short, mostly we did it for fun.

Take a listen! And while you’re at it, two questions:

  1. What are your favorite antibiotics, and why?
  2. What should we draft next?

Meanwhile, many life lessons in this video:

(H/T to Joe Posnanski and Michael Schur for the draft idea.)

17 Responses to “What’s Your Favorite Antibiotic? A Fantasy Draft”

  1. David says:

    Chloramphenicol. OK, I now you don’t use it in the US, but we do. And it has a great coverage, both gram positive (including S. Aureus), gram negative and anaerobes.We tend to use it in critically-ill debilitated patients that you usually prefer not to intervene at all but forced to, while trying to avoid the ecological-collateral damage of cephalosporins (not to mention pip/taz or carbapenems). Aplastic anemia is the risk, which is quite rare especially if you treat IV. And it doesn’t cover pseudomonas or enterococci.

  2. Elie says:

    I love all my antibiotics the same.

  3. IMS says:

    Absolutely brilliant! I can’t believe I listened to the whole thing.

    Your opponent looks 12 years old.

  4. Chuck M says:

    Wow, such a great podcast. Perhaps my favorite moment was at the end when not only was the schoolyard bully Azithro left on the bench but the team captains couldn’t resist calling him out as the popular kid from the cool clique who just can’t play ball.

  5. Libby says:

    Doxy for sure. Good for what worries them in New England summertime

  6. Joel Gallant says:

    It may have been John Bartlett who said “doxycycline is the best antibiotic to use when you have to give an antibiotic to a patient who doesn’t need an antibiotic.”

  7. Jonesy says:

    Ceftriaxone. All the STD coverage Azithro/Doxy can’t buy, plus it’s a once-daily dose, so I get salaams from my overworked nurses.
    I blaspheme against my lovely penicillins, I know. Florey forgive me.

    But, proudest moment was in being able to treat a neutropenic fever with Ceftriaxone because it was Coag-neg Staph bacteremia (genuine, and downgraded from empirical).
    No end of Oncology staff getting sweaty because of the patient’s absent hypo-carbapenem-emia.

    • Jonesy says:

      Otherwise, Metronidazole. In part because it inexplicably makes me think of Brooklyn.
      Strange days, but also Gershwin.

  8. Michael Libman says:

    Trovafloxacin. One of the broadest spectrum antibiotics of all time. Gram negatives, gram positives, and Europeans….

  9. Arsenic. For sure. Deadly curative.

  10. Ronald says:

    Cefuroxime for sensitive staph
    Augmentin for respiratory tract infections
    Nitrofurantoin for UTI
    Fluoroquinolones for gut infections
    pipracilin tazobactum in sepsis

  11. David K says:

    Fosfomycin. Because nobody’s ever heard of it, so I look like a genius; plus the patient avoids IV antibiotics. Also I like saying “sachet.”

  12. Stephen Gerrish says:

    My “Desert Island” antibiotic? Chloramphenicol hands down. Very broad coverage, including anaerobes, penetrates everywhere, and great levels when taken orally. Having used it in my early practice, and saved many lives in Africa using it, I miss it greatly. Aplastic anemia.. yes, but you only use it when the benefits outweigh the risks. And how many other drugs that we use, if known, have similar risks.

  13. Wonderful podcast, perhaps the best that I have heard in a long time. I have shared the link with clinicians and lab colleagues.

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

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