{"id":1440,"date":"2011-03-18T18:30:49","date_gmt":"2011-03-18T22:30:49","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=1440"},"modified":"2015-06-04T15:23:52","modified_gmt":"2015-06-04T19:23:52","slug":"friday-fosfomycins","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/friday-fosfomycins\/2011\/03\/18\/","title":{"rendered":"Friday Fosfomycins"},"content":{"rendered":"<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2011\/03\/fosfomycin1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-1442\" title=\"fosfomycin\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2011\/03\/fosfomycin1.jpg\" alt=\"\" width=\"252\" height=\"252\" \/><\/a>Today&#8217;s ID\/HIV comments and links are named after every ID specialist&#8217;s <a href=\"http:\/\/cid.oxfordjournals.org\/content\/52\/5\/e103.full?ijkey=Evn1QGFzwH8Xrj3&amp;keytype=ref\" target=\"_blank\">favorite new toy<\/a> for UTIs.<\/p>\n<ul>\n<li>This <a href=\"http:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6010a1.htm?s_cid=mm6010a1_w\" target=\"_blank\">HIV transmission from a kidney donor<\/a> is getting quite a bit of media play, as such complications always do. \u00a0I was at a meeting this AM when one of my colleagues (an endocrinologist) commented how horrible she thought it was. \u00a0Yes&#8230; but here&#8217;s what I told her: \u00a0the risk of some sort of infectious complication from transplantation, despite all our vigilance, no matter what tests we use, will <em>never <\/em>be zero. \u00a0The only way to make transplants 100% safe is to stop doing them entirely. \u00a0And that&#8217;s not going to happen, nor should it.<\/li>\n<li>Someone told me that CROI 2012 will be in Seattle &#8220;in late February.&#8221; \u00a0CROI trivia hounds will recall it was in Seattle in 2002, when we all learned the MTD (maximal tolerated dose) of caffeine. No confirmation on the date (naturally) from the <a href=\"http:\/\/www.retroconference.org\/2011\/index.asp?page=310\" target=\"_blank\">CROI web site<\/a>, so I wouldn&#8217;t book your flights just yet.<\/li>\n<li>Those of you who do inpatient ID consults will recognize some of the absurd dynamics in play in\u00a0<a href=\"http:\/\/www.youtube.com\/watch?v=c_kScxiKx5k\" target=\"_blank\">this animated (literally) conversation.<\/a> It&#8217;s an extreme example, but I confess I laughed out loud a few times anyway (sorry).<\/li>\n<li>Speaking of inpatient ID consults, I&#8217;m on service right now, and of course it&#8217;s staph, staph, and more staph. (First-year ID fellows sometimes think they&#8217;re doing a <em>Staph aureus<\/em> fellowship.) \u00a0All this staph means I&#8217;ve had the opportunity to get some anecdotal experience with <a href=\"http:\/\/frx.com\/news\/PressRelease.aspx?ID=1489398\" target=\"_blank\">ceftaroline<\/a> for MRSA. \u00a0Since we learn in Statistics 101 that there&#8217;s nothing less scientific than anecdotal (especially early anecdotal) evidence, I&#8217;ll resist the impulse and see how things go for a bit longer, and will only say that the drug is tricky for home IV administration since it needs to be mixed up each day. \u00a0Any other impressions out there?<\/li>\n<li>Finally, for a pretty pessimistic view of the &#8220;test and treat&#8221; HIV strategy, here&#8217;s a <a href=\"http:\/\/cid.oxfordjournals.org\/content\/52\/6\/793.full\" target=\"_blank\">discouraging review<\/a> of how few of the people living with HIV are actually engaged in care. \u00a0By the estimates presented here, just under 20% of HIV-infected individuals in the United States have an undetectable HIV viral load. If the data are right, <a href=\"http:\/\/cid.oxfordjournals.org\/content\/52\/6\/793\/F2.expansion.html\" target=\"_blank\">this figure<\/a> says it all &#8212; and regardless of whether there are 209,773 \u00a0or 209,774 out of 1,106,400 with suppressed HIV, there&#8217;s <em>plenty <\/em>of room for improvement.<\/li>\n<\/ul>\n<p>Hat tip to the inimitable <a href=\"http:\/\/www.boston.com\/news\/health\/articles\/2008\/04\/21\/the_go_to_person_on_hiv\" target=\"_blank\">Rochelle Walensky<\/a> for the video!<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Today&#8217;s ID\/HIV comments and links are named after every ID specialist&#8217;s favorite new toy for UTIs. This HIV transmission from a kidney donor is getting quite a bit of media play, as such complications always do. \u00a0I was at a meeting this AM when one of my colleagues (an endocrinologist) commented how horrible she thought [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,5,8,9,10],"tags":[170,246,254,371,423,481,912,940],"class_list":["post-1440","post","type-post","status-publish","format-standard","hentry","category-hiv","category-infectious-diseases","category-patient-care","category-policy","category-research","tag-ceftaroline","tag-croi-2012","tag-croi-dates","tag-fosfomycin","tag-hiv","tag-id-consults","tag-test-and-treat","tag-transplantation"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1440","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=1440"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1440\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=1440"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=1440"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=1440"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}