The Curbsiders Internal Medicine Podcast #357 Hotcakes: Ultra-short Antibiotics for Pneumonia, Acetazolamide for CHF, Psilocybin for AUD, and Asymptomatic Kidney Stone Removal
5 snips
Sep 28, 2022 AI Snips
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Episode notes
Short Antibiotic Courses Need Context
- Retrospective matching can't eliminate unmeasured differences that drive treatment decisions.
- Propensity-matched shorter antibiotic courses looked safe only in patients likely not to have bacterial pneumonia.
Start Antibiotics 'Just In Case' Then Reassess
- Paul described common hospital practice of 'start antibiotics just in case' and stopping once the diagnosis clarifies.
- He illustrated this with patients who improve by day two and are often taken off antibiotics.
Stop Early Only With Clear Stability
- Consider stopping antibiotics early only in patients who are clinically stable with high oxygen saturations.
- Do not generalize ultra-short courses to all hospitalized pneumonia without clear evidence of bacterial infection.