HIV and ID Observations

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 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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December 8th, 2023

Clinician-to-Clinician Advice Is Great for Everyone but Still Horribly Undervalued

One of the best things about being an ID doctor is that you get to interact with all the medical and surgical specialties. This is one of the most common answers to the question, “Why did you choose to specialize in ID?” and it certainly resonates with me. As a result, we’re frequently in the position […]

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November 16th, 2023

Being a Good Doctor — Why Are the Simple Things So Hard?

The simple things that make someone not just a doctor — but a good doctor — can slip away from us when we’re too busy, or tired, or preoccupied, or hungry. That’s why it’s wise periodically to be reminded of the “soft skills” that, while individually not tricky, together make a huge difference in how […]

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October 17th, 2023

A Brilliant Strategy for Conducting Clinical Trials — The ACORN Study

The secret to doing a great clinical trial is quite simple. Here, I’ll share it with you: Come up with an important clinical question for which there’s true equipoise. Choose primary and secondary endpoints that people care about. Make the inclusion and exclusion criteria easy to understand and chosen so that they define a readily available […]

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October 8th, 2023

An October ID (and Non-ID) Link-o-Rama

For those venturing next week to IDWeek here in Boston, fall gives us our very best weather. Comfortable sunny days with brilliant blue skies, cool evenings, low humidity — great weather for exercising and sleeping. Usually you just need a light jacket. And now, after one of the rainiest Septembers on record (boo!), October has […]

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September 22nd, 2023

Long-Acting Cabotegravir-Rilpivirine for People Not Taking Oral Therapy — Time to Modify Treatment Guidelines?

HIV treatment guidelines are understandably reluctant to endorse practices that have limited data. Having served on two such panels (previously, DHHS and currently, the IAS-USA guidelines), I totally get this — you don’t want to put a stamp of approval on strategies that may ultimately do more harm than good. With the caveat that I cannot […]

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September 8th, 2023

Endless Recertification in Medicine — Some Thoughts About the Tests We Take

The tests issued by the American Board of Internal Medicine (ABIM) for credentialing physicians are much in the news again. There’s even a petition circulating to eliminate the Maintenance of Certification (MOC) process entirely, signed by nearly 20,000 physicians. I have a bunch of memories, thoughts, and feelings about ABIM and the tests they issue. They’re […]

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August 18th, 2023

My Vote for the Weirdest Antibiotic on the Planet

If you’re an ID doctor, there’s an excellent chance you’ve treated patients who have non-tuberculous mycobacteria (NTM) with clofazimine. In fact, based on a poll done with the utmost scientific rigor, it’s well more than half of you. And if you’re not an ID doctor, there’s a decent chance you’ve never even heard of it — […]

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August 9th, 2023

Really Rapid Review — Brisbane IAS 2023

You’ll find some conference highlights listed below from the 12th International AIDS Society Conference on HIV Science (or IAS 2023), which took place in lovely Brisbane — where the late July weather was delightful, the ubiquitous ibis was the local nuisance bird, and the riverside parks went on and on and on. Some might wonder if […]

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