HIV and ID Observations

March 18th, 2018

Why with Extremely Resistant Infections, It’s Extremely Important to Consult ID

Since the only procedures most of us Infectious Diseases doctors do with any regularity are biopsies of patient medical records, we have to justify our existence in other ways — such as collecting data on how our expertise improves patient outcomes. There are a bunch of these papers published, with this one being the most widely […]

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February 25th, 2018

Is Self-Administered Postexposure Prophylaxis Another Viable Option for HIV Prevention?

Most of the pivotal trials of pre-exposure prophylaxis (PrEP) have used daily therapy. The lone exception is the IPERGAY study. Men at high risk for acquiring HIV took two tablets of tenofovir DF/emtricitabine (TDF/FTC, Truvada) before sex, and one tablet the next 2 days. The strategy was highly effective in preventing HIV acquisition, and intermittent PrEP is endorsed […]

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February 19th, 2018

Can We Solve the Morass of Outpatient Intravenous Antibiotic Therapy?

If you want to get an ID doctor riled up, here are a few reliable strategies: Get an ID consult on a complex patient just to summarize the chart for your discharge summary. Endorse the view that procedural doctors deserve their vastly higher salaries than MDs in cognitive specialties. Prescribe azithromycin for patients with bad colds. […]

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February 12th, 2018

Shingles Vaccine Video, New Name for C. diff, Flu B Rising, and More — A Pre-Valentine’s Day ID Link-o-Rama

With Valentine’s Day and early spring training baseball both on the horizon this week, it’s obviously time for an extra special ID Link-o-Rama. On to the links, with a bonus non-ID section and a highly recommended video at the end: The ACIP issued its official recommendations for herpes zoster (shingles) immunization. Preferred: the new recombinant zoster vaccine, […]

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February 5th, 2018

The Four States of Clinical Medicine, and a Movie Review (Sort Of)

I finally saw The Big Sick. And hooray, it’s excellent. 9/10. Based loosely on the real-life courtship between comedian Kumail Nanjiani and writer Emily V. Gordon, the movie has great word of mouth, is making gobs of money for an independent comedy, and was nominated for Best Original Screenplay. Deserves both the the accolades and the cash. In […]

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January 28th, 2018

Apple Wants to Build an Electronic Medical Record — Here’s Where They Should Start

If you want to get a bunch of clinicians riled up — make them really mad — ask them to describe the problems with their current electronic medical record. So when a company like Apple announces it plans to introduce an electronic medical record of sorts, we should rejoice, right? This is the company, after all, that leveraged […]

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December 24th, 2017

On-Service Digest, December 2017 — Plus a Holiday Song

You youngsters out there might not believe this, but there was a time when passing out copies of published papers — actual hard-copies — was a major part of the teaching hospital experience. Now that this tree-destroying practice is over, many still regularly cite published studies on rounds. The goal is to provide some guidance and reason […]

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December 10th, 2017

Injection Drug Use-Related HIV Cases Increase in Massachusetts — Is This the Start of a Trend?

Recently the Massachusetts Department of Public Health sent out this concerning notice: The Massachusetts Department of Public Health (MDPH) has noted an increase in newly diagnosed and acute HIV infections among persons who inject drugs (PWID). To date in calendar year 2017 (through November 21), there have been 64 HIV infections reported among individuals who inject […]

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December 3rd, 2017

Why, Even with Depressing Predictions About Flu Vaccine Effectiveness, We Should Still Recommend and Get It

Each year, the print and broadcast media round up a bunch of experts on influenza and ask them to predict the severity of the upcoming flu season. Most of the time their responses are noncommittal — predicting how bad the flu season will be year to year is tricky business, akin to picking stocks, making 12-month […]

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July 19th, 2017

Mystifying Cochrane Library Review on HCV Therapy Elicits Strong Response from IDSA

Last month, the Cochrane Review published a controversial paper on HCV therapy that left many ID doctors and hepatologists perplexed. After reviewing 138 randomized clinical trials using directly acting, non-interferon based therapies, they came to the following conclusions: The use of sustained virologic response (“SVR”) — or “cure”, if you want to use plain English — as a […]

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