HIV and ID Observations

June 30th, 2019

Antibiotic Development Is Broken, Brothers in ID Practice, and This Year’s Winner of the ID-Related Social Media Award

I am currently rounding on the inpatient ID service, the new ID fellows arrive shortly, and Louie needs intensive doggy psychotherapy after yesterday’s strong thunderstorms here in Boston. Busy times! As a result, today’s post has no unifying theme. But what it lacks in cohesiveness it more than compensates in value, as here are three highly interesting […]

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April 14th, 2019

Here’s One “Rule” of Medical Education That Needs Fixing — Or at Least a Little Context

Like any card-carrying ID doctor, I enjoy teaching about antibiotics. Give me a whiteboard (small group), or a PowerPoint set-up (lecture hall), and I’m off and running. Not surprisingly, an important theme of these talks revolves around avoiding antibiotic overuse. Over the years, I’ve collected a few egregious examples of how marketing distorts public perception of […]

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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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June 7th, 2018

What’s Your Favorite Off-Patent Antibiotic Brand Name?

Each time the FDA approves a new drug, they also approve a new brand name. The FDA and other regulators want something safe. They critically want to avoid names that sound or look similar to existing drugs, which could trigger medication errors. And names that imply an ingredient or an action not supported by clinical data […]

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July 2nd, 2017

Delafloxacin, a New Quinolone, Is Approved for Skin Infections — But That’s Not Where It’s Really Needed

The history of the fluoroquinolone antibiotics can be divided into four eras, alternating good news and bad: Ciprofloxacin is approved — it covers everything, and is miraculous. We’re talking some tough customers here. Pseudomonas aeruginosa! Staphylococcus aureus! Neisseria gonorrhoeae! Plus, pretty much every gram negative causing urinary tract infections. There was no intravenous formulation initially, but that hardly mattered since it had […]

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June 10th, 2017

What’s Your Favorite Antibiotic? A Fantasy Draft

Over on the journal Open Forum Infectious Diseases (that’s “O-F-I-D”, not “Oh-FID”), the generous people from IDSA and Oxford University Press have allowed me to record a series of podcasts, interviewing various interesting people in the ID field. This time, however, I strayed from the usual format and asked my colleague Rebeca Plank to join me in a […]

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October 24th, 2015

Pumpkin-Flavored ID Link-o-Rama

As the leaves change colors and fall from the trees, the days grow shorter and colder, and pumpkin-colored and flavored merchandise shows up everywhere, I ask you this important question: What precisely are the infectious risks of bobbing for apples? Off we go. Receiving antibiotics in childhood is associated with weight gain. The important finding in this study is that the […]

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February 13th, 2014

Jeter is Retiring, and Certain ID Doctors Are Getting Old(er)

It’s safe to say that most of the perspectives on Derek Jeter’s retiring from baseball will not be written by ID doctors, so let me seize the opportunity. And since it’s always risky to dwell on players from a certain team while living in Boston — I have friends for whom a central component of their […]

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May 16th, 2013

ID Learning Unit — Antibiotics with Excellent Oral Absorption

Guaranteed:  Every day at a hospital near you, a patient is receiving antibiotic therapy for an infection, and the orders include the following: A slew of various oral medications, both continued from outpatient care and started anew on admission. An intravenous antibiotic. The odd thing about this combination is that there are many antibiotics with excellent […]

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January 21st, 2013

Must-Read Piece: “Fever of Too Many Origins”

Every so often a commentary gets something just right, and fortunately we have an example in this week’s New England Journal of Medicine. Entitled “Fever of Unknown Origin or Fever of Too Many Origins?”, it’s the best depiction I’ve read about doing ID consults in the intensive care unit (ICU). The author, Harold Horowitz (who has practiced […]

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