Very proud of our team for recruiting over 100 patients to the BALANCE study just published in NEJM
7 versus 14 days of antibiotics for blood stream infections
@muhc
#shorterisbetter
#IDsky
#MEDsky
7 versus 14 days of antibiotics for blood stream infections
@muhc
#shorterisbetter
#IDsky
#MEDsky
Practice changing landmark study
As long as you have source control, 7d abx sufficient for most bloodstream infections. Note still many exceptions exist that need further investigation.
As long as you have source control, 7d abx sufficient for most bloodstream infections. Note still many exceptions exist that need further investigation.
🔥BALANCE RCT🔥
74 hospitals in 7 countries
3,608 patients
A 7-day course of antibiotics for hospitalized patients with bloodstream infections was non inferior to 14d within a 4% prespecified margin for mortality at 90 days #idsky
www.nejm.org/doi/full/10....
74 hospitals in 7 countries
3,608 patients
A 7-day course of antibiotics for hospitalized patients with bloodstream infections was non inferior to 14d within a 4% prespecified margin for mortality at 90 days #idsky
www.nejm.org/doi/full/10....
November 20, 2024 at 7:34 PM
Very proud of our team for recruiting over 100 patients to the BALANCE study just published in NEJM
7 versus 14 days of antibiotics for blood stream infections
@muhc
#shorterisbetter
#IDsky
#MEDsky
7 versus 14 days of antibiotics for blood stream infections
@muhc
#shorterisbetter
#IDsky
#MEDsky
Shorter is better table is updated
Wow, 4 RCTs [non S.aureus] bactremia
7d is non inferior to 14d
Spread the word
Credit goes to my friend: Dr.Brad Spellberg #shorterisbetter #idsky #medsky #tbsky
Wow, 4 RCTs [non S.aureus] bactremia
7d is non inferior to 14d
Spread the word
Credit goes to my friend: Dr.Brad Spellberg #shorterisbetter #idsky #medsky #tbsky
🔥Everyone's favorite #shorterisbetter table is updated🔥
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
November 21, 2024 at 2:56 PM
Shorter is better table is updated
Wow, 4 RCTs [non S.aureus] bactremia
7d is non inferior to 14d
Spread the word
Credit goes to my friend: Dr.Brad Spellberg #shorterisbetter #idsky #medsky #tbsky
Wow, 4 RCTs [non S.aureus] bactremia
7d is non inferior to 14d
Spread the word
Credit goes to my friend: Dr.Brad Spellberg #shorterisbetter #idsky #medsky #tbsky
From @drtoddlee.bsky.social @dremilymcd.bsky.social @angelahuttner.bsky.social @josemolinagb.bsky.social et al in @jama.com Network Open:
Systematic review & Non-inferiority Meta-Analysis of 7 vs 14 days for GNR BSI
4 RCTs, 7 non-inf to 14
#IDSky #ShorterIsBetter
jamanetwork.com/journals/jam...
Systematic review & Non-inferiority Meta-Analysis of 7 vs 14 days for GNR BSI
4 RCTs, 7 non-inf to 14
#IDSky #ShorterIsBetter
jamanetwork.com/journals/jam...
March 23, 2025 at 5:20 PM
From @drtoddlee.bsky.social @dremilymcd.bsky.social @angelahuttner.bsky.social @josemolinagb.bsky.social et al in @jama.com Network Open:
Systematic review & Non-inferiority Meta-Analysis of 7 vs 14 days for GNR BSI
4 RCTs, 7 non-inf to 14
#IDSky #ShorterIsBetter
jamanetwork.com/journals/jam...
Systematic review & Non-inferiority Meta-Analysis of 7 vs 14 days for GNR BSI
4 RCTs, 7 non-inf to 14
#IDSky #ShorterIsBetter
jamanetwork.com/journals/jam...
Cannot thank @drandrekalil.bsky.social enough for inviting me to write this commentary on the BALANCE trial for ACP Journal Club in @annalsofim.bsky.social this month!
#ShorterIsBetter #IDSky @unmc-id.bsky.social
www.acpjournals.org/doi/10.7326/...
#ShorterIsBetter #IDSky @unmc-id.bsky.social
www.acpjournals.org/doi/10.7326/...
March 4, 2025 at 3:44 AM
Cannot thank @drandrekalil.bsky.social enough for inviting me to write this commentary on the BALANCE trial for ACP Journal Club in @annalsofim.bsky.social this month!
#ShorterIsBetter #IDSky @unmc-id.bsky.social
www.acpjournals.org/doi/10.7326/...
#ShorterIsBetter #IDSky @unmc-id.bsky.social
www.acpjournals.org/doi/10.7326/...
"If you’re going to give antibiotics to patients who don’t need them, at least do the courtesy of giving them for a brief period of time." @bradspellberg.bsky.social #IDQuotes 🌟 #IDSky #shorterisbetter
May 19, 2026 at 4:22 AM
"If you’re going to give antibiotics to patients who don’t need them, at least do the courtesy of giving them for a brief period of time." @bradspellberg.bsky.social #IDQuotes 🌟 #IDSky #shorterisbetter
Instant follow my dear friend
Welcome to #idsky
@bradspellberg.bsky.social
Wouldn't imagine #idsky without him, his knowledge and wisdom
He's the myths buster
#shorterisbetter
A legend & jedi master for #IDTwitter and everyone #mustfollow him #medsky #AMSsky #utisky #tbsky
Welcome to #idsky
@bradspellberg.bsky.social
Wouldn't imagine #idsky without him, his knowledge and wisdom
He's the myths buster
#shorterisbetter
A legend & jedi master for #IDTwitter and everyone #mustfollow him #medsky #AMSsky #utisky #tbsky
December 1, 2024 at 4:59 AM
Instant follow my dear friend
Welcome to #idsky
@bradspellberg.bsky.social
Wouldn't imagine #idsky without him, his knowledge and wisdom
He's the myths buster
#shorterisbetter
A legend & jedi master for #IDTwitter and everyone #mustfollow him #medsky #AMSsky #utisky #tbsky
Welcome to #idsky
@bradspellberg.bsky.social
Wouldn't imagine #idsky without him, his knowledge and wisdom
He's the myths buster
#shorterisbetter
A legend & jedi master for #IDTwitter and everyone #mustfollow him #medsky #AMSsky #utisky #tbsky
5-7 days for SSSI coz source controlled. #ShorterIsBetter
November 25, 2024 at 10:55 PM
5-7 days for SSSI coz source controlled. #ShorterIsBetter
🔥Everyone's favorite #shorterisbetter table is updated🔥
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
November 20, 2024 at 10:18 PM
🔥Everyone's favorite #shorterisbetter table is updated🔥
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
#IDSky I updated all-in-one table for #ShorterIsBetter approach based on @bradspellberg.bsky.social original work. All references of mentioned studies in the table are available on: www.bradspellberg.com/shorter-is-b...
PDF document is availabe on demand (send me DM).
PDF document is availabe on demand (send me DM).
February 23, 2025 at 3:48 PM
#IDSky I updated all-in-one table for #ShorterIsBetter approach based on @bradspellberg.bsky.social original work. All references of mentioned studies in the table are available on: www.bradspellberg.com/shorter-is-b...
PDF document is availabe on demand (send me DM).
PDF document is availabe on demand (send me DM).
Not a RCT, but more evidence for #Shorterisbetter in GAS pharyngitis. @bradspellberg.bsky.social
Effect of a widespread reduction in treatment duration for group A streptococcal pharyngitis on outcomes including household transmission
✅ Just Accepted
#IDSky
✅ Just Accepted
#IDSky
Effect of a widespread reduction in treatment duration for group A streptococcal pharyngitis on outcomes including household transmission
Shorter-course treatment for group A streptococcal pharyngitis may be equivalent to ten-days for clinical cure but effectiveness for pharyngeal GAS eradication is uncertain.
doi.org
June 9, 2025 at 4:35 PM
Not a RCT, but more evidence for #Shorterisbetter in GAS pharyngitis. @bradspellberg.bsky.social
Now that the master of #ShorterIsBetter is here, is there any reason to stay on Twitter? Welcome @bradspellberg.bsky.social !!
December 1, 2024 at 1:59 PM
Now that the master of #ShorterIsBetter is here, is there any reason to stay on Twitter? Welcome @bradspellberg.bsky.social !!
Only 58 patients to go!
Recruitment is moving along as planned, and fingers crossed, we’ll be done before summer.
Huge shoutout to the @shorten2trial.bsky.social team for keeping up the great work!
#AMSsky #IDSky #ShorterIsBetter
Recruitment is moving along as planned, and fingers crossed, we’ll be done before summer.
Huge shoutout to the @shorten2trial.bsky.social team for keeping up the great work!
#AMSsky #IDSky #ShorterIsBetter
December 2, 2024 at 5:34 PM
Only 58 patients to go!
Recruitment is moving along as planned, and fingers crossed, we’ll be done before summer.
Huge shoutout to the @shorten2trial.bsky.social team for keeping up the great work!
#AMSsky #IDSky #ShorterIsBetter
Recruitment is moving along as planned, and fingers crossed, we’ll be done before summer.
Huge shoutout to the @shorten2trial.bsky.social team for keeping up the great work!
#AMSsky #IDSky #ShorterIsBetter
🔥Everyone's favorite #shorterisbetter table is updated🔥
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
November 20, 2024 at 10:23 PM
#idsky #shorterisbetter outpatient oncology pts w/uncomplicated infections treated for 7d vs 14d for UTI, SSTI and LRTI showed no worse outcomes with shorter duration #idmeded #meded
Is shorter better in oncology patients, too? A retrospective cohort study of short- versus long-course antibiotic therapy for uncomplicated infections in solid tumor patients receiving care in ambulatory oncology clinics
✅ Just Accepted
#IDSky
✅ Just Accepted
#IDSky
Is shorter better in oncology patients, too? A retrospective cohort study of short- versus long-course antibiotic therapy for uncomplicated infections in solid tumor patients receiving care
This retrospective cohort study evaluated short- vs. long-course antibiotics for uncomplicated infections in ambulatory solid tumor patients.
bit.ly
August 28, 2025 at 6:56 PM
#idsky #shorterisbetter outpatient oncology pts w/uncomplicated infections treated for 7d vs 14d for UTI, SSTI and LRTI showed no worse outcomes with shorter duration #idmeded #meded
With our @shorten2trial.bsky.social RCT we will hopefully provide further specific data on P. aeruginosa BSIs, including those occurring in immunocompromised hosts 🤞🏻
#ShorterIsBetter #PsWatch #AMSsky #IDSky #IDOnc #TxID
#ShorterIsBetter #PsWatch #AMSsky #IDSky #IDOnc #TxID
November 24, 2024 at 4:44 PM
With our @shorten2trial.bsky.social RCT we will hopefully provide further specific data on P. aeruginosa BSIs, including those occurring in immunocompromised hosts 🤞🏻
#ShorterIsBetter #PsWatch #AMSsky #IDSky #IDOnc #TxID
#ShorterIsBetter #PsWatch #AMSsky #IDSky #IDOnc #TxID
👍Fantastic study 👀 at whether #shorterisbetter in Neutropenic Bacteremia in adults. >80% GNB with almost 18% MDRO, profound neutropenia in 83% of enrollees & post therapy Abx PPX in 65%. Adequate source control in 70%-100%. No diff in relapse or ☠️ if <10 vs > 10 ABX days. #IDSky #TIDSky
Congratulations to @nischalr3.bsky.social and his team for their paper being selected as the @thetxidjournal.bsky.social 2024 Bob Rubin Clinical Impact Awardee - this award selects the paper felt to have the biggest impact on clinical care in #TxID!
#IDSky
onlinelibrary.wiley.com/doi/10.1111/...
#IDSky
onlinelibrary.wiley.com/doi/10.1111/...
Evaluating antimicrobial duration for Gram‐negative bacteremia in patients with neutropenia due to hematologic malignancy or hematopoietic stem cell transplantation
In the management of immunocompromised patients with neutropenia and Gram-negative bloodstream infection, short antimicrobial courses (≤10 days) had comparable propensity score-adjusted 90-day outcom...
onlinelibrary.wiley.com
November 18, 2024 at 3:53 PM
👍Fantastic study 👀 at whether #shorterisbetter in Neutropenic Bacteremia in adults. >80% GNB with almost 18% MDRO, profound neutropenia in 83% of enrollees & post therapy Abx PPX in 65%. Adequate source control in 70%-100%. No diff in relapse or ☠️ if <10 vs > 10 ABX days. #IDSky #TIDSky
This metaanalysis of observational studies in SOT suggests that non-complicated graft infections could be treated 7d, and yet transplant patients have been excluded from most RCT on duration.
Time for a #ShorterIsBetter RCT in #TxID!
kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F... #IDsky #AMSsky
Time for a #ShorterIsBetter RCT in #TxID!
kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F... #IDsky #AMSsky
July 4, 2025 at 10:44 PM
This metaanalysis of observational studies in SOT suggests that non-complicated graft infections could be treated 7d, and yet transplant patients have been excluded from most RCT on duration.
Time for a #ShorterIsBetter RCT in #TxID!
kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F... #IDsky #AMSsky
Time for a #ShorterIsBetter RCT in #TxID!
kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F... #IDsky #AMSsky
🫁💊 #Shorterisbetter Pauta "corta" vs "larga" en tuberculosis (noviembre 2024)
#EAAD #WAAW #AntimicrobialResistance #KeepAntibioticsWorking
#EAAD #WAAW #AntimicrobialResistance #KeepAntibioticsWorking
November 22, 2024 at 4:15 PM
🫁💊 #Shorterisbetter Pauta "corta" vs "larga" en tuberculosis (noviembre 2024)
#EAAD #WAAW #AntimicrobialResistance #KeepAntibioticsWorking
#EAAD #WAAW #AntimicrobialResistance #KeepAntibioticsWorking
Shorter is better table is updated
Wow, 4 RCTs [non S.aureus] bactremia
7d is non inferior to 14d
Spread the word
Credit goes to my friend: Dr.Brad Spellberg #shorterisbetter #idsky ##medsky #tbsky
Wow, 4 RCTs [non S.aureus] bactremia
7d is non inferior to 14d
Spread the word
Credit goes to my friend: Dr.Brad Spellberg #shorterisbetter #idsky ##medsky #tbsky
🔥Everyone's favorite #shorterisbetter table is updated🔥
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
"BALANCE is now published,
so the table is now updated!
GNB bacteremia is now listed as Bacteremia(non S.aureus)
Neary 5,000 patients have now been randomized to 1 vs. 2 Constantine Units for non S. aureus bacteremia " Dr.Spellberg #idsky
November 21, 2024 at 2:28 PM
Shorter is better table is updated
Wow, 4 RCTs [non S.aureus] bactremia
7d is non inferior to 14d
Spread the word
Credit goes to my friend: Dr.Brad Spellberg #shorterisbetter #idsky ##medsky #tbsky
Wow, 4 RCTs [non S.aureus] bactremia
7d is non inferior to 14d
Spread the word
Credit goes to my friend: Dr.Brad Spellberg #shorterisbetter #idsky ##medsky #tbsky
It’s really cool to see the #IDSky community light up with discussion of the BALANCE trial results. Yet another brick in the #ShorterIsBetter canon.
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM
Bloodstream infections are associated with substantial morbidity and mortality. Early,
appropriate antibiotic therapy is important, but the duration of treatment is uncertain.
In a multicenter, non...
www.nejm.org
November 20, 2024 at 7:28 PM
It’s really cool to see the #IDSky community light up with discussion of the BALANCE trial results. Yet another brick in the #ShorterIsBetter canon.
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
🦠💊Acabamos la #WAAW2024 con la versión actualizada de la tabla #Shorterisbetter de Brad Spellberg (nov 2024)
¡Recuerda! Una pauta "corta" antibióticos es IGUAL de eficaz que "larga"(en gran nº situaciones) y:
⬇️resistencias, efectos adversos, costes
⬆️adherencia
www.bradspellberg.com/shorter-is-b...
¡Recuerda! Una pauta "corta" antibióticos es IGUAL de eficaz que "larga"(en gran nº situaciones) y:
⬇️resistencias, efectos adversos, costes
⬆️adherencia
www.bradspellberg.com/shorter-is-b...
November 22, 2024 at 4:15 PM
🦠💊Acabamos la #WAAW2024 con la versión actualizada de la tabla #Shorterisbetter de Brad Spellberg (nov 2024)
¡Recuerda! Una pauta "corta" antibióticos es IGUAL de eficaz que "larga"(en gran nº situaciones) y:
⬇️resistencias, efectos adversos, costes
⬆️adherencia
www.bradspellberg.com/shorter-is-b...
¡Recuerda! Una pauta "corta" antibióticos es IGUAL de eficaz que "larga"(en gran nº situaciones) y:
⬇️resistencias, efectos adversos, costes
⬆️adherencia
www.bradspellberg.com/shorter-is-b...
🆕 Just published in NEJM!
The BALANCE trial definitively establishes 7-day treatments as the standard of care for uncomplicated BSIs, with more than 3,600 randomized patients.
Fantastic work! @drtoddlee.bsky.social
www.nejm.org/doi/full/10.... #AMSsky #IDSky #ShorterIsBetter
The BALANCE trial definitively establishes 7-day treatments as the standard of care for uncomplicated BSIs, with more than 3,600 randomized patients.
Fantastic work! @drtoddlee.bsky.social
www.nejm.org/doi/full/10.... #AMSsky #IDSky #ShorterIsBetter
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM
Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain. In a multicenter, non...
www.nejm.org
November 20, 2024 at 3:24 PM
🆕 Just published in NEJM!
The BALANCE trial definitively establishes 7-day treatments as the standard of care for uncomplicated BSIs, with more than 3,600 randomized patients.
Fantastic work! @drtoddlee.bsky.social
www.nejm.org/doi/full/10.... #AMSsky #IDSky #ShorterIsBetter
The BALANCE trial definitively establishes 7-day treatments as the standard of care for uncomplicated BSIs, with more than 3,600 randomized patients.
Fantastic work! @drtoddlee.bsky.social
www.nejm.org/doi/full/10.... #AMSsky #IDSky #ShorterIsBetter
#shorterisbetter is prevailing even in immunocompromised/transplant infectious diseases
Thank you Dr.Brad Spellberg, for everything you're doing in ID #idsky #medsky #AMSsky
Thank you Dr.Brad Spellberg, for everything you're doing in ID #idsky #medsky #AMSsky
🆕️🔥Article @thetxidjournal.bsky.social
Not Just an Oxymoron: The Utilitarian's Guide to Antimicrobial Stewardship in Transplant Infectious Diseases
Table ✨️2: TID ASP opportunities & initiatives
#idsky #medsky #Txid
onlinelibrary.wiley.com/doi/full/10....
Not Just an Oxymoron: The Utilitarian's Guide to Antimicrobial Stewardship in Transplant Infectious Diseases
Table ✨️2: TID ASP opportunities & initiatives
#idsky #medsky #Txid
onlinelibrary.wiley.com/doi/full/10....
November 26, 2024 at 4:49 AM
#shorterisbetter is prevailing even in immunocompromised/transplant infectious diseases
Thank you Dr.Brad Spellberg, for everything you're doing in ID #idsky #medsky #AMSsky
Thank you Dr.Brad Spellberg, for everything you're doing in ID #idsky #medsky #AMSsky
In SHORTEN-2, immunocompromised hosts were not excluded if early clinical response and no unresolved source issues exist at randomization.
We hope to generate actionable data to guide the management of Pseudomonas BSI also in this population! 💪🏼
(🧵3/3) #AMSky #IDsky #TxID #IDOnc #ShorterIsBetter
We hope to generate actionable data to guide the management of Pseudomonas BSI also in this population! 💪🏼
(🧵3/3) #AMSky #IDsky #TxID #IDOnc #ShorterIsBetter
April 29, 2025 at 10:29 PM
In SHORTEN-2, immunocompromised hosts were not excluded if early clinical response and no unresolved source issues exist at randomization.
We hope to generate actionable data to guide the management of Pseudomonas BSI also in this population! 💪🏼
(🧵3/3) #AMSky #IDsky #TxID #IDOnc #ShorterIsBetter
We hope to generate actionable data to guide the management of Pseudomonas BSI also in this population! 💪🏼
(🧵3/3) #AMSky #IDsky #TxID #IDOnc #ShorterIsBetter
#ShorterIsBetter in immunocompromised hosts?
Short treatments are feasible in early responders without source control issues.
A significant number of observational studies serve as proof-of-concept on the feasibility of short courses in selected patients (see ⚠️)
#AMSsky #IDOnc #TxID #IDsky
Short treatments are feasible in early responders without source control issues.
A significant number of observational studies serve as proof-of-concept on the feasibility of short courses in selected patients (see ⚠️)
#AMSsky #IDOnc #TxID #IDsky
November 19, 2024 at 7:05 PM
#ShorterIsBetter in immunocompromised hosts?
Short treatments are feasible in early responders without source control issues.
A significant number of observational studies serve as proof-of-concept on the feasibility of short courses in selected patients (see ⚠️)
#AMSsky #IDOnc #TxID #IDsky
Short treatments are feasible in early responders without source control issues.
A significant number of observational studies serve as proof-of-concept on the feasibility of short courses in selected patients (see ⚠️)
#AMSsky #IDOnc #TxID #IDsky