HIV and ID Observations

July 25th, 2024

Lenacapavir PrEP Trial Brings Down the House at the International AIDS Conference

Yesterday, at the 2024 AIDS Conference in Munich, we experienced one of those thrilling moments you always hope for when attending a scientific conference. Dr. Linda-Gail Bekker, speaking on behalf of the study investigators, presented the data on the PURPOSE-1 study of HIV prevention using twice-yearly injectable lenacapavir; results were simultaneously published in the New England […]

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July 14th, 2024

Should We Continue to Use Contact Precautions for Patients with MRSA?

Back in the early 2000s, I heard about a local hospital that eliminated contact precautions while caring for patients with methicillin-resistant Staphylococcus aureus (MRSA). No more required gowns and gloves, or warning signs on the doors, or private rooms for patients known to have MRSA. They planned to track MRSA cases carefully over the next […]

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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 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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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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January 25th, 2024

Printed Medical Textbooks — Going, Going, but Not Quite Gone

Take a look at the things behind my desk at work: cute photos of family and dog a bunch of sentimental objects, gifts from grateful patients or colleagues a smattering of miscellaneous plaques and clocks pictures of our current (awesome) first-year ID fellows and other stuff a bunch of books, several of them many inches thick […]

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