The Pulse - June 2026

Keep your finger on it

Author

Jonathan Kooiman
July 01, 2026

In partnership with

The pulse is a monthly online newsletter summarizing key literature curated for the hospitalist/inpatient provider. Given the brevity, this is not meant to supplant reading primary literature independently.

Greetings Readers! In this monthly edition, we examine 2 practice changing studies.

Help keep this newsletter free by exploring the link to our advertising partner this month, found at the bottom of this email.

  1. Stop Waterboarding Your Patients: They Hates the Prep. The Data Agrees. Hospitalists know that convincing an inpatient to drink 4 liters of bowel prep can be harder than finding the GI consult note. This randomized trial found that both 1- and 2-liter PEG-based regimens were noninferior to the traditional 4-liter prep, achieving adequate bowel cleansing in roughly 80% of hospitalized patients undergoing elective colonoscopy. The 1-liter regimen even produced more high-quality bowel preparation, though it came with more thirst and vomiting, while patients remained surprisingly willing to repeat either low-volume option. For most hospitalized patients, a 2-liter regimen may strike the sweet spot—offering comparable efficacy with better tolerability and potentially fewer negotiations over "just one more cup." Frazzoni L et al. Ann Intern Med 2026 June

    Study Type: Italian multi center, endoscopist-blinded RCT of 665 hospitalized patients undergoing elective colonoscopy

    Link

  2. The PICC Is Up: Early Oral Antibiotics Hold Their Own

    For many serious infections, the shortest path home may no longer require the longest stay on IV antibiotics. In this pragmatic trial, patients transitioned to high-bioavailability oral therapy after a median of just 4 days had outcomes comparable to those who remained on prolonged IV therapy, despite many having bacteremia or bone/joint infections. The biggest win was safety: early oral therapy eliminated line-related complications, which affected one in four patients receiving continued IV antibiotics. The study was small and stopped early, but it adds to the growing pile of evidence that, when appropriate oral options exist, it's time to treat the PICC line as a bridge—not a destination. Juskowich JJ et al. Clin Infect Dis 2026 April 

    Study Type: multi center (West Virginia, USA) RCT of hospitalized adults with infections who were being considered for discharge with plan for at least 2 additional weeks of IV antibiotics then randomized to the experimental (early oral) group vs control (IV only) group.

    Link

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