Semi-Annual Recap Episode

In this special episode of Inpatient Update, Dr. Mason Turner looks back at the first 10 episodes and distills the biggest practice-changing lessons from more than 25 recent studies.

If you're new to the show, this is the fastest way to understand what Inpatient Update is all about: practical evidence that changes what hospitalists do on rounds tomorrow.

From pneumonia treatment and antibiotic duration to anticoagulation, flu vaccination, and asymptomatic inpatient hypertension, these are the five changes most likely to improve patient care right now.

#5 Pneumonia Care Should Be More Deliberate

The theme: stop reflexive treatment decisions and individualize care.

Featured Article

Short Versus Longer Antibiotic Duration for Community-Acquired Pneumonia: A Multicenter Target Trial Emulation
Annals of Internal Medicine, 2026

Original Episode:
Shorter CAP Antibiotics + The Cipro QTc Myth — with Dr. Ernest Murray

Supporting Articles

Predicting Benefit from Adjuvant Therapy with Corticosteroids in Community-Acquired Pneumonia: A Data-Driven Analysis of Randomized Trials
Lancet Respiratory Medicine, 2025

Original Episode:
Apixaban vs Rivaroxaban + Steroids in Community-Acquired Pneumonia — with Dr. Adam Jaffe

Associations Between Antibiotic Use and Outcomes in Patients Hospitalized with Community-Acquired Pneumonia and Positive Respiratory Viral Assays
Clinical Infectious Diseases, 2026

Original Episode:
Asymptomatic Inpatient Hypertension + Viral Pneumonia Antibiotics — with Dr. Austin White

Takeaway

For carefully selected, clinically improving patients with community-acquired pneumonia:

• Three days of antibiotics may be enough
• CRP may help identify who benefits from steroids
• A positive viral panel should make us pause before reflexively prescribing antibiotics

The lesson is not "do less."

The lesson is to be more deliberate.

#4 Give Your Heart Failure Patients the Flu Shot Before Discharge

Featured Article

Influenza Vaccination to Improve Outcomes for Patients with Acute Heart Failure (PANDA II)
Lancet, 2025

Original Episode:
SHM Converge 2026 Recap — with Dr. Emily Reams

Takeaway

A one-time intervention that many hospitalized patients still miss.

For patients admitted with heart failure during flu season:

• Reduced mortality
• Reduced readmissions
• Number needed to treat ≈ 17

Hospitalization creates an opportunity that should not be missed.

If they're eligible and willing, vaccinate before discharge.

#3 With Blood Thinners, Sometimes Less Is More

Featured Article

Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation (AQUATIC Trial)
New England Journal of Medicine, 2025

Original Episode:
Aspirin Plus Anticoagulation + 7 vs 14 Days for Bacteremia — with Dr. Andres Ospina

Supporting Articles

Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism (API-CAT Trial)
New England Journal of Medicine, 2025

Original Episode:
Pilot Episode — Solo

Bleeding Risk with Apixaban vs Rivaroxaban in Acute Venous Thromboembolism
New England Journal of Medicine, 2026

Original Episode:
Apixaban vs Rivaroxaban + Steroids in Community-Acquired Pneumonia — with Dr. Adam Jaffe

Takeaway

Several recent studies point in the same direction:

• Stop aspirin when stable CAD patients begin long-term anticoagulation
• Consider reduced-dose apixaban for extended VTE treatment in selected patients
• Apixaban appears safer than rivaroxaban for bleeding

Less anticoagulation is not always better.

But less unnecessary anticoagulation often is.

#2 We Are Entering an Era of Shorter Antibiotic Durations

Featured Article

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections (BALANCE Trial)
New England Journal of Medicine, 2025

Original Episode:
Aspirin Plus Anticoagulation + 7 vs 14 Days for Bacteremia — with Dr. Andres Ospina

Supporting Articles

Antibiotic De-escalation in Adults Hospitalized for Community-Onset Sepsis
JAMA Internal Medicine, 2026

Original Episode:
De-escalating Sepsis Antibiotics + When to Pull the IV — with Nicholas Linde, PA

Dalbavancin for Treatment of Staphylococcus aureus Bacteremia: The DOTS Randomized Clinical Trial
JAMA, 2025

Original Episode:
Faster Hypernatremia Correction + Long-Acting Antibiotics for Staph Bacteremia — with Dr. Kevin Baker

Takeaway

Across multiple infections, the trend is consistent:

• Seven days often beats fourteen
• Earlier de-escalation appears safe
• Long-acting antibiotics may help some patients avoid prolonged IV therapy and hospitalization

The question is no longer:

"Can we shorten antibiotics?"

The question is:

"Why are we still giving so many patients long courses?"

#1 Stop Treating Asymptomatic Inpatient Blood Pressure Numbers

Featured Article

As-Needed Blood Pressure Medication and Adverse Outcomes in VA Hospitals
JAMA Internal Medicine, 2025

Original Episode:
Asymptomatic Inpatient Hypertension + Viral Pneumonia Antibiotics — with Dr. Austin White

Takeaway

This was the most practice-changing study discussed on the show so far.

For hospitalized patients with:

• Elevated blood pressure
• No symptoms
• No evidence of end-organ damage

The reflexive response should not be:

"What PRN should I give?"

Instead ask:

• Why is the blood pressure elevated?
• Is the patient in pain?
• Anxious?
• Post-operative?
• Does this patient actually need acute treatment?

Acute treatment of asymptomatic inpatient hypertension was associated with:

• More AKI
• More large blood pressure drops
• Worse clinical outcomes

Treat the patient.

Not the number.

Bottom Line

If you change nothing else from the first six months of Inpatient Update:

1. Stop treating asymptomatic inpatient hypertension.
2. Shorten antibiotics when the evidence supports it.
3. Reconsider aspirin when starting anticoagulation.
4. Give eligible heart failure patients a flu shot before discharge.
5. Be more deliberate in your pneumonia management.

Small changes.

Huge reach.

Real impact.

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