HIV and ID Observations

June 12th, 2025

Why the Sudden Firing of ACIP Members Should Put Every Clinician on High Alert

There are certain irrefutable verities when, like me, you’re an infectious diseases specialist married to a pediatrician. Here are our top two, which are deeply interrelated: Infectious deaths in children, or severe illnesses that lead to lifelong disability, are more devastating than similar events in adults. Each such case in a baby or child is […]

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June 6th, 2025

How ID Doctors Get Paid, Part 3: The Grab Bag Edition

If you’ve made it this far, congratulations! You’re now deep into the ID Reimbursement Rabbit Hole. Part 1 and Part 2 covered how ID doctors contribute immense value through patient care, stewardship, infection control, travel clinics — proudly fighting along the way for appropriate compensation as the “Loss Leaders” of the hospital. (Did you get your […]

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May 18th, 2025

How ID Doctors Get Paid — The Bread, Butter, and Budget Deficits of Infectious Diseases

Two decades ago, Dr. Atul Gawande wrote a memorable piece for The New Yorker about how doctors in the United States get paid. Providing a nice mix of self-reflection about his own experience and some skillful reporting, he described the challenging process of figuring out what he, a newly hired surgeon, should earn for a salary. […]

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April 11th, 2025

Looking Back at a Defunct ID Meeting — and Ahead to a Thriving One

Back in prehistoric times, many ID doctors and microbiologists would gather each fall at a meeting to review the latest antimicrobial clinical trials and promising “bug-drug” studies of novel compounds in development. The meeting was called the Interscience Conference on Antimicrobial Agents and Chemotherapy, abbreviated ICAAC. There were a bunch of problems with ICAAC. First, […]

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April 3rd, 2025

Gepotidacin — New Antibiotic or Rare Tropical Bird?

Imagine you’re birdwatching in the Costa Rican rainforest, Merlin app in hand. A flash of iridescent blue catches your eye. You scan the canopy and whisper excitedly: Look, it’s the elusive Blujepa! A rare sighting! No, not a real bird, but the brand name of gepotidacin, something rarer — and arguably more exciting — than […]

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February 14th, 2025

This Year Influenza Came Back to Remind Us It’s Not Messing Around

If it seems like pretty much everyone you know either has the flu or is recovering from it, it’s because we’re in the middle of the worst flu season in over a decade. Take a look at this figure, from our state’s surveillance data, updated yesterday: The result of all this “influenza-like illness”? Patients are deluging outpatient […]

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January 3rd, 2025

On the Inpatient ID Consult Service, Oral Antibiotics Have a Rocky Road to Acceptance

Having just completed a stint doing inpatient ID consults, I came away impressed with three things: Staph aureus remains the Ruler of Evil Invasive Pathogens in the hospital setting. You can “jinx” a holiday season by saying it’s usually quiet on Christmas. This year it sure wasn’t quiet, hoo boy. Some surgeons aren’t ready to accept […]

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December 8th, 2024

Who’s Going to Get Lenacapavir for HIV Prevention?

At the International AIDS Conference this past summer, Dr. Linda-Gail Bekker brought down the house presenting the results of the PURPOSE 1 trial of twice-yearly injectable lenacapavir for prevention of HIV in women. The results — zero infections out of over 2000 participants — demonstrated clear superiority over oral PrEP with TDF/FTC. The study simultaneously […]

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November 27th, 2024

Some ID Things to Be Grateful for This Holiday Season — 2024 Edition

The calendar says it’s nearly the fourth Thursday of November, so here in the United States, the Thanksgiving holiday is upon us. It’s a day when we gather with family and friends to express thanks, to eat plenty (usually too much), to watch a bunch of spectacular athletes bash themselves to smithereens in the name […]

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October 8th, 2024

Why We Have Antibiotic Shortages and Price Hikes — And What One Very Enterprising Doctor Did in Response

At the start of our weekly case conference, we get announcements from one of our ID pharmacists. New drug approvals, hospital policies, updated guidelines — that kind of thing. But over the last decade or so, the most common topic they’ll comment on is the latest important antibiotic shortage. For those not in medicine, you […]

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