@NIHRresearch Academic Clinical Lecturer | Paediatric Immunology and Infectious Diseases | Clinical trials | Vaccines | Antibiotics | @apsmunro.bsky.social
United Kingdom
Joined April 2013
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I’ve noticed many comments criticising RCTs of masks or filters come from engineers
These criticisms are often, understandably, caused by misunderstandings about what RCTs are for (engineers do not usually use RCTs)
Here is my attempt to explain
munro-link.alasdairmunro.wor…
Alasdair Munro retweeted
🛡️ Why are transplant recipients especially vulnerable to infections as they age?
At #IDWeek2026, Anoma Nellore, MD, explored how immunosenescence + “inflammaging” compound the effects of transplantation.
Key takeaways 🧵👇
Alasdair Munro retweeted
Agree, of we’re not all moving to Bluesky or Roon, we might as well ask me on here and intermittently clean our feeds to keep it all the politics/racism
#IDtwitter forever!
An unpopular opinion:
The Bluesky experiment for the ID community has officially failed, IMHO.
Remember when so many ID folks migrated? Did we build a stronger community—or just split it across platforms?
#IDWeek2026 #IDXposts @BradSpellberg @PaulSaxMD @PulmCrit @IDstewardship
Alasdair Munro retweeted
We have a commentary out on some really interesting findings by colleagues in UCL and Finland on some of the maths behind some of the high profile shingles -> dementia analyses. In brief +
Paper: pubmed.ncbi.nlm.nih.gov/4245…
Commentary: kwnsfk27.r.eu-west-1.awstrac…
I make a special effort to be over-interactive with ID/Med tweets to keep them on my timeline
Otherwise a lot of "viral" slop makes its way on
Alasdair Munro retweeted
The coolest part to me though was the protocol had patients switch to PO (cephalexin, cefadroxil, or linezolid) at 48-72hr after blood culture clearance. Nice to see early PO protocolized like this, especially with cephalexin and cefadroxil. I'm sure @BradSpellberg will be a fan
I think this is true for many, but I’m surprised how many people have eventually reverse osmosed back here…
Alasdair Munro retweeted
Had another discussion with an MD concerned re fosfomycin for pyelo because "it doesn't get into the kidney". The damage guidelines have done medicine is incalculable. Perpetetuators of myth & legend. Forcing patients to get IV when they don't need it. It is time for a reckoning.
Alasdair Munro retweeted
The 1st of 2 new articles in CID critical of clinical guideline process is out. See
academic.oup.com/cid/article…
It is long past time clinical guidelines incorporate the humility of uncertainty & stop creating standards of care absent of reproducible prospective studies.
@ABsteward
Alasdair Munro retweeted
Underpinning this is a concept that became very apparent during #COVID19
Is the presentation missed, delayed or or late?
blogs.bmj.com/bmj/2020/08/15…
When undertaking reviews of these cases understanding these subtle differences critical to ensure true learning for the future
Alasdair Munro retweeted
A tour-de-force in healthcare communication from @apsmunro
The contradiction of a healthcare campaign promoting illness recognition only to see it potentially make the problem worse....
alasdairmunro.substack.com/p…
Alasdair Munro retweeted
Nice explanation from @apsmunro
Sepsis is rare, but devastating. It is a needle in a haystack for emergency care. Campaigns for ‘early awareness’ makes the haystack bigger, meaning that the needles are even more difficult to find.
There is a massive amount of attention on sepsis and "increasing awareness" among the public
There seems to be little recognition that increasing the amount of early presentations will also, paradoxically, increase the number of "missed" diagnoses
munro-link.alasdairmunro.wor…
Increasing awareness of sepsis simultaneously increases the number of "missed" diagnoses, whilst also increasing the number of diagnoses made early
This confusing paradox stems from the difficulties of assessing children earlier in the disease process
munro-link.alasdairmunro.wor…
There is a massive amount of attention on sepsis and "increasing awareness" among the public
There seems to be little recognition that increasing the amount of early presentations will also, paradoxically, increase the number of "missed" diagnoses
munro-link.alasdairmunro.wor…
