HIV and ID Observations

June 20th, 2024

Early Heatwave ID Link-o-Rama

We’ll get to the links in a moment, but first, a little poll. You might have heard that there’s a new Editor-in-Chief at NEJM Journal Watch, Dr. Raja-Elie Abdulnour. We met recently, and discussed this column or blog or newsletter or whatever you want to call it. A topic came up that we’ve been wondering about […]

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June 9th, 2024

The Mysteries and Challenges of the RPR — and a Proposed Clinical Trial

Last week, we had a real treat for our weekly ID/HIV clinical conference — a review of controversies in the management of syphilis in adults by Dr. Khalil Ghanem, from Johns Hopkins. He’s a well-known expert in the field of sexually transmitted infections, syphilis in particular. A highlight of the talk was his dismantling of a […]

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May 28th, 2024

More on ID Doctors and Primary Care for People with HIV

A recently published study suggested that “non-ID doctors do better” when it comes to providing primary care to people with HIV. At least that was the attention-grabbing subject line of an email summary distributed by a local primary care doctor, Dr. Geoffrey Modest. He periodically sends around detailed descriptions of studies he finds interesting, then […]

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May 11th, 2024

Just in Time for Mother’s Day, Some Admiration and Gratitude

As I’ve written here before, I’m in awe of my mother — a smart woman who doesn’t celebrate Mother’s Day. So in place of celebrating, I’m going to use the holiday anyway as an excuse to share an event that highlights her strengths and resourcefulness. It has an ID theme eventually, so stick around to the end. […]

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April 26th, 2024

Hey, Insurance Companies and Pharmacies — Stop Messing Around with the Price of Cheap Generic Drugs

If you’re practicing medicine these days, you’ve likely experienced some version of this painfully annoying scenario. You prescribe a generic medication, one that’s inexpensive. Your patient goes to the pharmacy, and the pharmacist says that it requires a prior approval. They leave without getting their meds. Here’s a recent example from one of my patients (details […]

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April 8th, 2024

The Rise and Fall of Paxlovid

It’s been quite the ride for our “preferred” outpatient therapy for COVID-19, nirmatrelvir with ritonavir — much better known as Paxlovid, so allow me the license to use the licensed name. Let’s recap the astonishing success and now failure of this intervention (some dates approximate): December 2021, the FDA issued an Emergency Use Authorization for Paxlovid:  Action […]

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March 27th, 2024

Think Again Before Sending Your Patient Home on Intravenous Vancomycin

I took care of a patient many years ago with MRSA. The severity of the infection required a prolonged treatment course, and vancomycin was the default option. Cripes, it was the only option. He ultimately was discharged on home IV therapy, and as usual we had a plan to monitor his renal function and vancomycin […]

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March 13th, 2024

CROI 2024 Denver: Really Rapid Review

One of the most rewarding things about social media in medicine is tapping into the minds of other smart people in your field, especially people you can’t otherwise interact with on a day-to-day basis. When that person is someone like Dr. Sébastien Poulin — a funny and indefatigable ID/HIV doctor from Montreal — it’s especially worthwhile. […]

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March 2nd, 2024

Just as CROI Gets Ready to Start, an Important Change to the IAS-USA HIV Treatment Guidelines

One of the top experiences of my ID career has been working with a research group that does HIV disease modeling. The people involved are without exception smart, collaborative, generous, funny, and hard-working — an amazing combination of positive traits. They get this, I believe, from their leader and founder, Dr. Ken Freedberg, who sets a […]

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February 20th, 2024

Variability in Consult Volume Is a Major Contributor to Trainee Stress — What’s the Solution?

Back when he was program director of our ID fellowship, Dr. David Hooper would give the applicants a description of our program. One of the key parts was his estimating the workload — in particular, the number of new consults per day. “We average three to four consults a day,” he said. “But there’s a high […]

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