Samuel De l'Étoile-Morel @SamuelDM18
Medical Microbiologist & Infectious Diseases Specialist @ciusss_csmtl / @McgillU Grad / Espresso lover Montréal, Québec Joined February 2019-
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@JulienPrvost5 @sebpoule @DrToddLee Le Granulicatella n'a pas assez poussé lorsqu'ils ont fait une microdilution pour obtenir une CMI/antibiogramme. Ils ont dû incuber de façon prolongée j'imagine et rien n'a poussé.
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@IDiots_pod @DrToddLee @snap_trial You should invite professor @DrToddLee on ID:IOTS :-)
@BradSpellberg " BUT MY PATIENTS ARE DIFFERENT ! "
@JulienPrvost5 @drkeithsiau @BradSpellberg @ABsteward @DiorIzzy @Zaydovudine @zacroBID @DrToddLee Sounds like a good case for good old clavulin :-)
@JulienPrvost5 3 jours d'amoxicilline ? 😅
@JulienPrvost5 @emilie_courval C'est pas un très bon test l'antigène strep urinaire.
@JulienPrvost5 On a une clinique de provocation orale pour la PCN/Céphalo/TMPSMX.
@ABsteward "But my patients are different" 😬
@JulienPrvost5 Dosage correct d'amox-clav dans ce contexte, 500 TID ? 875 TID ? amox-clav 875 BID + un extra amox en PM ?
@DrToddLee @sebpoule @BradSpellberg @ABsteward Seems to be done at Ste-Justine. The why is here inesss.qc.ca/publications/r…
@DiorIzzy @BradSpellberg @DrToddLee @ABsteward Team 12.
@drtimothyli My workhorse :D
@venkat_id @DrNeilStone Hib is a very scary pathogen as well
@DrToddLee @AnilMakam @MatthewPCheng @GBL_Unit Please repost your centipede meme with bilateral cellulitis 😂
@DiorIzzy @BradSpellberg @lh_innovations @DrToddLee @AliSMV7 Whenever I see a colleague prescribe the right empiric drug at the right dose and appropriate PO switch.
@claude99fort Un dogme bien encré dans les hôpitaux du Québec !
Colleagues, do you currently dose metronidazole as BID or TID for anaerobic infections (excluding C.diff and brain abscess) ? #idXposts #twitterrx
Slowly but surely spreading the BID dosing knowledge in Québec. All my Rx are now BID.
Colleagues, do you currently dose metronidazole as BID or TID for anaerobic infections (excluding C.diff and brain abscess) ? #idXposts #twitterrx
Samuel De l'Étoile-Morel retweeted
🆕🔥🦴 Our 2025 Update to @WikiGuidelines for the Management of Pyogenic Osteomyelitis in Adults 🌟 @BradSpellberg 🧪 Diagnosis 🔹 Nuclear scans & paravertebral biopsies → high accuracy 🔹 Bone histopathology > culture 🔹 MRSA nares negative → >90% NPV for DFO 🔹 PEDD > CT-guided biopsy for spinal osteomyelitis ⚠️ ESR, procalcitonin, CRP → poor reliability 💊 Treatment ✅ Combined medical + surgical care improves outcomes ✅ Oral ≈ IV therapy; IV lead-in optional (POvIV 10th RCT confirms) ✅ Cephradine, cephalexin, cefadroxil, doxycycline, tedizolid → oral options 🧬 Rifampin adjunct → may reduce PJI/vertebral osteomyelitis failure ⚠️ Long-acting lipoglycopeptides → limited data, high cost 🔪 Surgery ⚖️ One- vs two-stage prosthetic exchange → similar outcomes 🩻 MRI pre-amputation (DFI) → lower re-amputation risk (16% vs 32%) 📌 Residual osteomyelitis on histopathology → poor predictor 💡 Takeaway: Oral therapy works; combine medical & surgical care; tailor surgery with imaging. 🔗 Full WikiGuideline: [link] amjmed.com/article/S0002-…
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