Inpatient Update
Inpatient Update delivers short, practical reviews of new studies that matter to hospitalists—focused on what actually changes decisions on rounds tomorrow. Efficient, evidence-based, and built for the working clinician.
Inpatient Update
Episode 3: Stop the Aspirin in CAD? Shorter Antibiotics for Bacteremia? (with Dr. Andres Ospina)
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In this episode of Inpatient Update, Dr. Mason Turner is joined by Dr. Andres Ospina, fellow hospitalist, to discuss two recent trials with immediate impact on hospital practice:
- Aspirin plus anticoagulation in chronic coronary disease (AQUATIC Trial) — does keeping aspirin help or harm when long-term anticoagulation is started?
- Seven vs fourteen days of antibiotics for bloodstream infection (BALANCE Trial) — can we safely cut bacteremia treatment in half?
Practical take-homes, clear links to the evidence, and what to change on rounds tomorrow.
Articles & PubMed Links
Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation (AQUATIC Trial)
New England Journal of Medicine (October 2025)
Key Findings:
- Higher morbidity and mortality with dual therapy (HR 1.53)
Bottom Line:
In stable CAD >6 months from revascularization, if anticoagulation is started, stop the aspirin.
Pubmed: https://pubmed.ncbi.nlm.nih.gov/40888725/
Antibiotic Treatment for Bloodstream Infection (BALANCE Trial)
New England Journal of Medicine (November 2024)
Multicenter, randomized, non-inferiority trial (n≈3,600)
Bottom Line:
In uncomplicated bacteremia with source control and no severe immunocompromise, 7 days is non-inferior to 14.
Pubmed: https://pubmed.ncbi.nlm.nih.gov/39565030/
Practice-Changing Takeaways
- Stable CAD + new anticoagulation? Stop aspirin if >6 months from PCI/CABG.
- Uncomplicated bacteremia? Seven days of antibiotics is sufficient in most cases (excluding Staph aureus and deep-seated infection).