HIV and ID Observations

October 15th, 2018

Outpatient Antibiotic Prescribing Boosts Patient Satisfaction Scores, Rewarding Bad Medical Practice

A recent study confirms what every busy clinician already knows. Many patients seeking care for respiratory infections expect to receive an antibiotic. When they get one, they’re happier than if they don’t. Among 8437 patients seeking care for a respiratory tract infection in a direct-to-consumer telemedicine service, 66% received an antibiotic. The rate of prescriptions prescribed by […]

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September 23rd, 2018

Picking Your Next ID Journal Club Paper? MERINO or POET Trial? Two ID Fellows Debate

Late afternoon/early evening at an academic medical center. Bright young doctors sit in a hospital workroom, putting the finishing touches on what are undoubtedly the most comprehensive and, yes, simply the best consult notes in their respective patient’s electronic medical records.  Best ever. ID Fellow #1:  Hey, pretty soon we have to do Journal Club, right? ID […]

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September 3rd, 2018

Eravacycline Approved by FDA — How Might It Be Used, Today and in the Future?

While last week the world was sunning on the beach, hiking in the woods, eating ice cream, and performing careful tick-checks, the hard workers at the Food and Drug Administration hunkered down in Silver Spring, Maryland to get three anti-infectives approved — eravacycline, doravirine, and doravirine/TDF/3TC. Maybe they saw the weather reports — hot and humid, this […]

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August 23rd, 2018

Eye Worm, MALDI-TOF, New Lyme Testing Approach, Dogs Fail as C. diff Testers, Uiyk (?), and More — A Summer Is Getting Shorter ID Link-o-Rama

A recent chilly spell here in Boston recalled a universal truth about aging — that summer seems to get shorter every year. As far as I can tell in my unscientific poll of everyone who will engage with me on this topic, there are no exceptions to this rule. Everyone thinks summer is shorter than when […]

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August 5th, 2018

Why Caring for People with HIV Is Still Great

Earlier this year, I wrote a piece about friends and colleagues of mine who have left HIV clinical practice. Something about it touched a nerve. It’s one of the most commented-on pieces in the history of this blog. Read this for a typical response. Admittedly, it was kind of a downer — but it might have been […]

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July 8th, 2018

Surgeon Who Was Denied Disability Insurance for Taking PrEP Tells His Story

Earlier this year, urology resident Dr. Philip Cheng appeared on the front page of the New York Times. Here was the headline: He Took a Drug to Prevent AIDS. Then He Couldn’t Get Disability Insurance. The piece understandably drew widespread attention, with sharp disapproval of the denial from ID specialists and public health officials. We couldn’t […]

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July 1st, 2018

Why Do Our Patients Think They Have Spider Bites?

We are currently in peak tick season here in the Northeastern United States. It might be hard for clinicians elsewhere to understand just how profoundly this changes our assessment of fevers and rashes. But consider this — ordering the trio of Lyme antibody, Anaplasma PCR, and Babesia PCR is as much a part of the routine […]

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May 20th, 2018

Why the Dolutegravir Pregnancy Warning Is Important — and What We Should Do Now

Last week, in response to newly available surveillance data, multiple agencies issued a warning about the HIV integrase inhibitor dolutegravir (DTG) and pregnancy. The warnings cite an increased risk of neural tube defects in babies born to women who became pregnant while receiving the drug. From the U.S. Department of Health and Human Services: The concern stems from […]

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May 13th, 2018

Why Experienced HIV/ID Doctors Leave Clinical Practice

Three of my good friends — they’re way more than just colleagues after all this time — in the HIV/ID world have left clinical practice recently. Abigail (Abbie) Zuger, Joel Gallant, and Chuck Hicks, each of them brilliant in different ways, won’t be caring for people with HIV anymore, something they’ve all been doing since the […]

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April 16th, 2018

Hepatitis C Positive Organ Donors — Coming Soon to a Transplant Center Near You

There’s one immutable fact in solid organ transplantation — the number of patients awaiting transplant exceeds the number of available organs. This shortage means that ethical, medically safe strategies to increase the donor pool are always a high priority. One such strategy would be to allow transplants from people who have chronic hepatitis C. If the thought of […]

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