David A. Forero-Peña MD.

I’m leaning toward the POINT perspective: hospital antibiograms may soon become obsolete! Link:journals.asm.org/doi/10.1128…

OMG, imipenem-relebactam 👀 may not be the anti-Pseudomonas drug many thought it was for CRPA. Only 27% of CRPA isolates were susceptible to all 3 novel βL/βLIs, while 22% were not susceptible to any. Most strikingly: • I/R susceptibility: ~33% • C/T susceptibility: ~69% • CZA susceptibility: ~67%

🆕💥🟢🧬 US Enterobacterales (2020–2024): key resistance snapshot MBL on the rise Aztreonam-avibactam ++ 📊 Prevalence in 82 US centers: - MDR: 20.4% - CRE: 1.1% 😯 - XDR: 0.5% ⚠️ Carbapenemase landscape in CRE: - KPC: ~51% - NDM (MBL): ~23%🔺🔺 - OXA-48-like: ~4% - CAZ-AVI & MEM-VAB: excellent vs non-MBL CRE - Only aztreonam-avibactam + cefiderocol* reliably cover MBL producers. #idxposts sciencedirect.com/science/ar…

"Flu"cloxacillin is out, cefazolin is in. SNAP RCT + CloCeBa RCT Cefazolin is non-inferior to Anti Staphylococcal Penicillins (ASPs) for treatment of MSSA bactremia and causes less AKI and should be 1st line therapy #idxposts #ESCMIDGlobal2026

Super interesting! 🆕⚡🔴Meropenem and fosfomycin against K. pneumoniae: towards a combination breakpoint using a pharmacometric approach Meropenem-fosfomycin combination therapy produces robust synergy against MDR Klebsiella pneumoniae strains, and expands attainable clinical breakpoints compared to monotherapy In vitro data from 12 clinical Klebsiella pneumoniae strains (carrying genes such as KPC, NDM, OXA-48, VIM, CTX-M, SHV, etc.), generated in dynamic in vitro infection model experiments mimicking human pharmacokinetics of meropenem and fosfomycin, were analysed using pharmacodynamic modelling Meropenem and fosfomycin monotherapies achieved PTA ≥90% only for low MICs (≤4 mg/L for meropenem, ≤4 mg/L for fosfomycin). In contrast, combination therapy enabled PTA ≥90% for bacteriostasis at MICs up to 32 mg/L (meropenem) and 512 mg/L (fosfomycin), and for 1-log killing at 32 mg/L | 256 mg/L, using low-dose regimens (meropenem 2 g + fosfomycin 2 g q8h) clinicalmicrobiologyandinfec…