SNAP trial results reported
Cefazolin was the champion for MSSA
🏆 Less nephrotoxicity than flucoxacillin
🏆 Reduced early mortality
Not published but I think the answer is clear:
Cefazolin now generally 1st line tx for MSSA
"Innoculum effect" with nafcillin= debunked
Updated IBCC (#1/2) #EMIMCC
Cefazolin was the champion for MSSA
🏆 Less nephrotoxicity than flucoxacillin
🏆 Reduced early mortality
Not published but I think the answer is clear:
Cefazolin now generally 1st line tx for MSSA
"Innoculum effect" with nafcillin= debunked
Updated IBCC (#1/2) #EMIMCC
April 12, 2025 at 4:43 PM
SNAP trial results reported
Cefazolin was the champion for MSSA
🏆 Less nephrotoxicity than flucoxacillin
🏆 Reduced early mortality
Not published but I think the answer is clear:
Cefazolin now generally 1st line tx for MSSA
"Innoculum effect" with nafcillin= debunked
Updated IBCC (#1/2) #EMIMCC
Cefazolin was the champion for MSSA
🏆 Less nephrotoxicity than flucoxacillin
🏆 Reduced early mortality
Not published but I think the answer is clear:
Cefazolin now generally 1st line tx for MSSA
"Innoculum effect" with nafcillin= debunked
Updated IBCC (#1/2) #EMIMCC
📢 Our latest commentary, "Old Drugs, New Evidence: SNAP and the Randomized Case for Cefazolin in MSSA Bacteremia," is now available. Explore the evolving evidence and its implications for clinical practice.
@gurujosh.bsky.social @steventong.bsky.social
clarityinitiative.org/commentaries...
@gurujosh.bsky.social @steventong.bsky.social
clarityinitiative.org/commentaries...
September 29, 2026 at 1:42 AM
📢 Our latest commentary, "Old Drugs, New Evidence: SNAP and the Randomized Case for Cefazolin in MSSA Bacteremia," is now available. Explore the evolving evidence and its implications for clinical practice.
@gurujosh.bsky.social @steventong.bsky.social
clarityinitiative.org/commentaries...
@gurujosh.bsky.social @steventong.bsky.social
clarityinitiative.org/commentaries...
Really enjoyed writing this with Ahmad Mourad & @cortes-penfield.bsky.social! See our take on the SNAP trial's results.
Well-designed trials supported by other RCTs and observational data warrant elevation of cefazolin to the top spot in MSSA bacteremia treatment #IDSky
Well-designed trials supported by other RCTs and observational data warrant elevation of cefazolin to the top spot in MSSA bacteremia treatment #IDSky
📢 Our latest commentary, "Old Drugs, New Evidence: SNAP and the Randomized Case for Cefazolin in MSSA Bacteremia," is now available. Explore the evolving evidence and its implications for clinical practice.
@gurujosh.bsky.social @steventong.bsky.social
clarityinitiative.org/commentaries...
@gurujosh.bsky.social @steventong.bsky.social
clarityinitiative.org/commentaries...
September 29, 2026 at 4:30 AM
Really enjoyed writing this with Ahmad Mourad & @cortes-penfield.bsky.social! See our take on the SNAP trial's results.
Well-designed trials supported by other RCTs and observational data warrant elevation of cefazolin to the top spot in MSSA bacteremia treatment #IDSky
Well-designed trials supported by other RCTs and observational data warrant elevation of cefazolin to the top spot in MSSA bacteremia treatment #IDSky
Move over, MAGA... MSSA it's what's up!
March 26, 2025 at 8:30 PM
Move over, MAGA... MSSA it's what's up!
The next Clarity commentary. On the SNAP trial. Neither I nor @gurujosh.bsky.social had anything to do with this commentary (deliberately).
Conclusions though are in line with my interpretation of the data. i.e., use cefazolin for MSSA bacteremia.
@angelahuttner.bsky.social @cmicomms.bsky.social
Conclusions though are in line with my interpretation of the data. i.e., use cefazolin for MSSA bacteremia.
@angelahuttner.bsky.social @cmicomms.bsky.social
📢 Our latest commentary, "Old Drugs, New Evidence: SNAP and the Randomized Case for Cefazolin in MSSA Bacteremia," is now available. Explore the evolving evidence and its implications for clinical practice.
@gurujosh.bsky.social @steventong.bsky.social
clarityinitiative.org/commentaries...
@gurujosh.bsky.social @steventong.bsky.social
clarityinitiative.org/commentaries...
September 29, 2026 at 2:40 AM
The next Clarity commentary. On the SNAP trial. Neither I nor @gurujosh.bsky.social had anything to do with this commentary (deliberately).
Conclusions though are in line with my interpretation of the data. i.e., use cefazolin for MSSA bacteremia.
@angelahuttner.bsky.social @cmicomms.bsky.social
Conclusions though are in line with my interpretation of the data. i.e., use cefazolin for MSSA bacteremia.
@angelahuttner.bsky.social @cmicomms.bsky.social
🔥SNAP passed 3500🔥
Writing papers:
Cefazolin (MSSA) and penicillin (PSSA) vs (flu)clox
Recruiting:
Adj clinda vs not (all)
Adj cefazolin vs not (MRSA)
Oral switch vs IV (all)
Cefazolin +/- Erta/Placebo (MSSA)
Dapto vs Vanco (MRSA)
Coming "soon":
Rifampin vs. none for PVIE (all)
Ref: Dr.Lee #idsky
Writing papers:
Cefazolin (MSSA) and penicillin (PSSA) vs (flu)clox
Recruiting:
Adj clinda vs not (all)
Adj cefazolin vs not (MRSA)
Oral switch vs IV (all)
Cefazolin +/- Erta/Placebo (MSSA)
Dapto vs Vanco (MRSA)
Coming "soon":
Rifampin vs. none for PVIE (all)
Ref: Dr.Lee #idsky
November 17, 2024 at 8:19 PM
🔥SNAP passed 3500🔥
Writing papers:
Cefazolin (MSSA) and penicillin (PSSA) vs (flu)clox
Recruiting:
Adj clinda vs not (all)
Adj cefazolin vs not (MRSA)
Oral switch vs IV (all)
Cefazolin +/- Erta/Placebo (MSSA)
Dapto vs Vanco (MRSA)
Coming "soon":
Rifampin vs. none for PVIE (all)
Ref: Dr.Lee #idsky
Writing papers:
Cefazolin (MSSA) and penicillin (PSSA) vs (flu)clox
Recruiting:
Adj clinda vs not (all)
Adj cefazolin vs not (MRSA)
Oral switch vs IV (all)
Cefazolin +/- Erta/Placebo (MSSA)
Dapto vs Vanco (MRSA)
Coming "soon":
Rifampin vs. none for PVIE (all)
Ref: Dr.Lee #idsky
Kristy Berington has been in the hospital with a massive infection where she had surgery on her elbow earlier this summer. They've figured out one of the bacteria strain as MSSA. 😳 #MusherSky
August 5, 2025 at 6:31 AM
Kristy Berington has been in the hospital with a massive infection where she had surgery on her elbow earlier this summer. They've figured out one of the bacteria strain as MSSA. 😳 #MusherSky
#SNAP MSSA silo results
is there any role for Fluclox for S aureus bacteraemia anymore?
Sounds like we should be using Benzylpencillin (PSSA) or Cephazolin (MSSA) alone
#escmidglobal
@steventong.bsky.social @gurujosh.bsky.social
is there any role for Fluclox for S aureus bacteraemia anymore?
Sounds like we should be using Benzylpencillin (PSSA) or Cephazolin (MSSA) alone
#escmidglobal
@steventong.bsky.social @gurujosh.bsky.social
April 12, 2025 at 3:01 PM
#SNAP MSSA silo results
is there any role for Fluclox for S aureus bacteraemia anymore?
Sounds like we should be using Benzylpencillin (PSSA) or Cephazolin (MSSA) alone
#escmidglobal
@steventong.bsky.social @gurujosh.bsky.social
is there any role for Fluclox for S aureus bacteraemia anymore?
Sounds like we should be using Benzylpencillin (PSSA) or Cephazolin (MSSA) alone
#escmidglobal
@steventong.bsky.social @gurujosh.bsky.social
OMG I found the one card in the @empiricgame.bsky.social deck made just for ortho bros!
December 17, 2024 at 8:03 PM
OMG I found the one card in the @empiricgame.bsky.social deck made just for ortho bros!
such a joy to discuss PSSA/MSSA domains of SNAP. incredible work led by @gurujosh.bsky.social @steventong.bsky.social conversation w/ the fabulous @angelahuttner.bsky.social
joint effort @escmid.bsky.social Communicable & @sidpharm.bsky.social Breakpoints podcast
podcasts.apple.com/us/podcast/s...
joint effort @escmid.bsky.social Communicable & @sidpharm.bsky.social Breakpoints podcast
podcasts.apple.com/us/podcast/s...
SNAP Out of It: Rethinking Antistaphylococcal Penicillins for S. Aureus Bacteremia – The SNAP Trial PSSA/MSSA Results
Podcast Episode · Breakpoints · 05/04/2025 · 1h 11m
podcasts.apple.com
May 5, 2025 at 4:08 PM
such a joy to discuss PSSA/MSSA domains of SNAP. incredible work led by @gurujosh.bsky.social @steventong.bsky.social conversation w/ the fabulous @angelahuttner.bsky.social
joint effort @escmid.bsky.social Communicable & @sidpharm.bsky.social Breakpoints podcast
podcasts.apple.com/us/podcast/s...
joint effort @escmid.bsky.social Communicable & @sidpharm.bsky.social Breakpoints podcast
podcasts.apple.com/us/podcast/s...
That’s a semi-good thing. MSSA means Methicillin-SUSCEPTIBLE Staphylococcus aureus, as in it IS treatable with standard antibiotics.
August 5, 2025 at 8:05 AM
That’s a semi-good thing. MSSA means Methicillin-SUSCEPTIBLE Staphylococcus aureus, as in it IS treatable with standard antibiotics.
@steventong.bsky.social @gurujosh.bsky.social presenting results of the MSSA domain of the SNAP 🫰 trial at #ESCMID2025. just amazing work by amazing humans - congratulations on this practice changing effort!! #idsky #medsky #amssky
April 12, 2025 at 3:02 PM
@steventong.bsky.social @gurujosh.bsky.social presenting results of the MSSA domain of the SNAP 🫰 trial at #ESCMID2025. just amazing work by amazing humans - congratulations on this practice changing effort!! #idsky #medsky #amssky
Dr Joshua Davis presents data on Cefazolin vs (Flu)cloxacillin for MSSA.
1. Cefazolin is non-inferior.
2. Less AKI with Cefazolin.
#ESCMIDGlobal
1. Cefazolin is non-inferior.
2. Less AKI with Cefazolin.
#ESCMIDGlobal
April 12, 2025 at 3:13 PM
Dr Joshua Davis presents data on Cefazolin vs (Flu)cloxacillin for MSSA.
1. Cefazolin is non-inferior.
2. Less AKI with Cefazolin.
#ESCMIDGlobal
1. Cefazolin is non-inferior.
2. Less AKI with Cefazolin.
#ESCMIDGlobal
The SNAP trial domain on cefazolin vs cloxacillin for MSSA bacteremia is finally published!
www.nejm.org/doi/full/10....
Cefazolin is already the new standard!
#IDsky #AMSsky
www.nejm.org/doi/full/10....
Cefazolin is already the new standard!
#IDsky #AMSsky
June 17, 2026 at 9:43 PM
The SNAP trial domain on cefazolin vs cloxacillin for MSSA bacteremia is finally published!
www.nejm.org/doi/full/10....
Cefazolin is already the new standard!
#IDsky #AMSsky
www.nejm.org/doi/full/10....
Cefazolin is already the new standard!
#IDsky #AMSsky
Eeeehhhmmm... What about making subways safe? Let's call it MSSA! Make subways safe again!
February 20, 2025 at 9:54 PM
Eeeehhhmmm... What about making subways safe? Let's call it MSSA! Make subways safe again!
running late for my first MSSA conference session about compassion fatigue in helping professions 🤪🤪🤪
March 11, 2026 at 1:36 PM
running late for my first MSSA conference session about compassion fatigue in helping professions 🤪🤪🤪
The most anticipated RCT in ID
🔥SNAP RCT🔥The largest RCT 2 date in SA bactermia
N:1341
Cefazolin Vs ASPs ((flu)cloxacillin) for MSSA bacteremia
Cefazolin is non-inferior (90d mortality)& less AKI than ASPs
A practice-changer RCT that must change the guidelines
#ESCMIDGlobal #IDSky
🔥SNAP RCT🔥The largest RCT 2 date in SA bactermia
N:1341
Cefazolin Vs ASPs ((flu)cloxacillin) for MSSA bacteremia
Cefazolin is non-inferior (90d mortality)& less AKI than ASPs
A practice-changer RCT that must change the guidelines
#ESCMIDGlobal #IDSky
April 12, 2025 at 3:09 PM
The most anticipated RCT in ID
🔥SNAP RCT🔥The largest RCT 2 date in SA bactermia
N:1341
Cefazolin Vs ASPs ((flu)cloxacillin) for MSSA bacteremia
Cefazolin is non-inferior (90d mortality)& less AKI than ASPs
A practice-changer RCT that must change the guidelines
#ESCMIDGlobal #IDSky
🔥SNAP RCT🔥The largest RCT 2 date in SA bactermia
N:1341
Cefazolin Vs ASPs ((flu)cloxacillin) for MSSA bacteremia
Cefazolin is non-inferior (90d mortality)& less AKI than ASPs
A practice-changer RCT that must change the guidelines
#ESCMIDGlobal #IDSky
🆕🔥🔥CloCeBa RCT
Cloxacillin versus cefazolin for MSSA Bacteraemia
Cefazolin has a non-inferior efficacy regarding mortality, microbiological or clinical endpoints and was associated with a lower rate of serious adverse events #IDSky
www.thelancet.com/journals/lan...
Cloxacillin versus cefazolin for MSSA Bacteraemia
Cefazolin has a non-inferior efficacy regarding mortality, microbiological or clinical endpoints and was associated with a lower rate of serious adverse events #IDSky
www.thelancet.com/journals/lan...
October 19, 2025 at 4:34 AM
🆕🔥🔥CloCeBa RCT
Cloxacillin versus cefazolin for MSSA Bacteraemia
Cefazolin has a non-inferior efficacy regarding mortality, microbiological or clinical endpoints and was associated with a lower rate of serious adverse events #IDSky
www.thelancet.com/journals/lan...
Cloxacillin versus cefazolin for MSSA Bacteraemia
Cefazolin has a non-inferior efficacy regarding mortality, microbiological or clinical endpoints and was associated with a lower rate of serious adverse events #IDSky
www.thelancet.com/journals/lan...
Today’s list of patients from my community 🏥/❤️general I.D. practice #IDsky
-P.jirovecii pneumonia
-MRSA necrositing fasciitis
-E.faecium bacteremia
-MSSA bacteremia + discitis + septic arthritis (knee)
-Gas gangrene = leg disarticulation (😳)
-MSSA septic arthritis (knee)
-ICU candidemia
-cIAIs
…
-P.jirovecii pneumonia
-MRSA necrositing fasciitis
-E.faecium bacteremia
-MSSA bacteremia + discitis + septic arthritis (knee)
-Gas gangrene = leg disarticulation (😳)
-MSSA septic arthritis (knee)
-ICU candidemia
-cIAIs
…
a cartoon of homer simpson and bart simpson sitting on a couch with the words join us above them .
ALT: a cartoon of homer simpson and bart simpson sitting on a couch with the words join us above them .
media.tenor.com
November 8, 2024 at 1:03 PM
Today’s list of patients from my community 🏥/❤️general I.D. practice #IDsky
-P.jirovecii pneumonia
-MRSA necrositing fasciitis
-E.faecium bacteremia
-MSSA bacteremia + discitis + septic arthritis (knee)
-Gas gangrene = leg disarticulation (😳)
-MSSA septic arthritis (knee)
-ICU candidemia
-cIAIs
…
-P.jirovecii pneumonia
-MRSA necrositing fasciitis
-E.faecium bacteremia
-MSSA bacteremia + discitis + septic arthritis (knee)
-Gas gangrene = leg disarticulation (😳)
-MSSA septic arthritis (knee)
-ICU candidemia
-cIAIs
…
Find me for MSSA swag at #IDWeek2025. Limited quantities. #TeamCefazolin #TeamOxacillin #TeamNafcillin and for our non-US colleagues #TeamFlucloxicillin
October 19, 2025 at 1:32 PM
Find me for MSSA swag at #IDWeek2025. Limited quantities. #TeamCefazolin #TeamOxacillin #TeamNafcillin and for our non-US colleagues #TeamFlucloxicillin
Marlene, mssa TAG #BolsonaroLadrao também está rolando no Instagram
August 22, 2025 at 6:12 PM
Marlene, mssa TAG #BolsonaroLadrao também está rolando no Instagram
Excited that at #ESCMIDGlobal 2025, SNAP trial results for PSSA and MSSA silo backbone domains will be presented.
What's more it's a new format 2 hour session! 3 trials (SNAPx2, CLOCEBA), with expert led & audience discussion.
Sat April 12 16:15 - 18:15 Hall 13
Drinks after
@escmid.bsky.social
What's more it's a new format 2 hour session! 3 trials (SNAPx2, CLOCEBA), with expert led & audience discussion.
Sat April 12 16:15 - 18:15 Hall 13
Drinks after
@escmid.bsky.social
March 7, 2025 at 5:06 AM
Excited that at #ESCMIDGlobal 2025, SNAP trial results for PSSA and MSSA silo backbone domains will be presented.
What's more it's a new format 2 hour session! 3 trials (SNAPx2, CLOCEBA), with expert led & audience discussion.
Sat April 12 16:15 - 18:15 Hall 13
Drinks after
@escmid.bsky.social
What's more it's a new format 2 hour session! 3 trials (SNAPx2, CLOCEBA), with expert led & audience discussion.
Sat April 12 16:15 - 18:15 Hall 13
Drinks after
@escmid.bsky.social
"All these doomers and forever maskers saying that COVID somehow disrupts immune function. There is no evidence of that"
Isn't there, though? ISN'T THERE?
"Circumstantial. Correlation is not causation". Correct. Just as wilful ignorance is not the same as skepticism.
#LongCOVID #MedSky #Scisky
Isn't there, though? ISN'T THERE?
"Circumstantial. Correlation is not causation". Correct. Just as wilful ignorance is not the same as skepticism.
#LongCOVID #MedSky #Scisky
March 3, 2026 at 7:23 PM
"All these doomers and forever maskers saying that COVID somehow disrupts immune function. There is no evidence of that"
Isn't there, though? ISN'T THERE?
"Circumstantial. Correlation is not causation". Correct. Just as wilful ignorance is not the same as skepticism.
#LongCOVID #MedSky #Scisky
Isn't there, though? ISN'T THERE?
"Circumstantial. Correlation is not causation". Correct. Just as wilful ignorance is not the same as skepticism.
#LongCOVID #MedSky #Scisky
Stay tuned for the first @cmicomms.bsky.social & #Breakpoints collaboration episode on Sun, May 4th 6PM US EST/Mon May 5th 12 AM CET. Hosts Angela Huttner & Erin McCreary interview SNAP trial investigators, Steven Tong &Joshua Davis, on PSSA and MSSA domain results shared at 2025 ESCMID Global.
April 29, 2025 at 10:01 PM
Stay tuned for the first @cmicomms.bsky.social & #Breakpoints collaboration episode on Sun, May 4th 6PM US EST/Mon May 5th 12 AM CET. Hosts Angela Huttner & Erin McCreary interview SNAP trial investigators, Steven Tong &Joshua Davis, on PSSA and MSSA domain results shared at 2025 ESCMID Global.
"Flu"cloxacillin is out, cefazolin is in.
SNAP RCT + CloCeBa RCT
Cefazolin is non-inferior to Anti Staphylococcal Penicillins (ASPs) for treatment of MSSA bactremia and causes less AKI and should be 1st line therapy #idsky #ESCMIDGlobal2026
SNAP RCT + CloCeBa RCT
Cefazolin is non-inferior to Anti Staphylococcal Penicillins (ASPs) for treatment of MSSA bactremia and causes less AKI and should be 1st line therapy #idsky #ESCMIDGlobal2026
April 24, 2026 at 2:35 PM
"Flu"cloxacillin is out, cefazolin is in.
SNAP RCT + CloCeBa RCT
Cefazolin is non-inferior to Anti Staphylococcal Penicillins (ASPs) for treatment of MSSA bactremia and causes less AKI and should be 1st line therapy #idsky #ESCMIDGlobal2026
SNAP RCT + CloCeBa RCT
Cefazolin is non-inferior to Anti Staphylococcal Penicillins (ASPs) for treatment of MSSA bactremia and causes less AKI and should be 1st line therapy #idsky #ESCMIDGlobal2026