Wednesday, February 12, 2025 →

@mattpappas.bsky.social My thanks to my coauthors, to the folks who critiqued the paper and earlier versions of the analysis, and the two folks who got me started on this project, Andy Auerbach and the late David Meyers. (9/9)

Wednesday, February 12, 2025 →

@mattpappas.bsky.social We estimated just one of the downstream harms of broad-spectrum antibiotics. But I hope this approach--trying to rigorously estimate harms for therapies that don't have RCTs, rather than taking associations at face value--can help us be smarter about lots of treatments we use in the hospital. (8/9)

Wednesday, February 12, 2025 →

@mattpappas.bsky.social To my surprise, this analysis suggests that IV vancomycin is maybe the antibiotic that most increases risk of hospital-onset CDI. I'm not entirely sure why that should be, and hope smarter microbiologists can pick up that thread from here. (7/9)

Wednesday, February 12, 2025 →

@mattpappas.bsky.social Patients in shock are very likely to get antibiotics, and completely stable patients are not very likely to get antibiotics. (That's appropriate!) Our approach should approximate a pragmatic RCT where, when it isn't so clear, we flip a coin. (6/9)

Wednesday, February 12, 2025 →

@mattpappas.bsky.social Second, we used a causal inference observational design, emulating a hypothetical trial that would have taken patients where it wasn't clear whether to give an antibiotic or not and randomized them to one of those two conditions. (5/9)