Complicated UTIs just got a whole lot less complicated—or did they? Dr. Dana Bowers and Kyle Molina (@kcmolinaID) join Dr. Whitney Buckel to break down what’s new, what’s controversial, and what this means for your day‑to‑day antimicrobial decisions. Join us as we dig into the biggest updates, the evidence behind them, and the clinical pearls you won’t want to miss.

References:

Nelson Z, Aslan AT, Beahm NP, et al. Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults: A WikiGuidelines Group Consensus Statement. JAMA Netw Open. 2024 Nov 4;7(11):e2444495.

Trautner BW, Cortes-Penfield NW, Gupta K, et al. Complicated Urinary Tract Infections (cUTI): Clinical Guidelines for Treatment and Management. Published July 17, 2025. https://www.idsociety.org/practice-guideline/complicated-urinary-tract-infections/

Kadry N, Natarajan M, Bein E, Kim P, Farley J. Discordant Clinical and Microbiological Outcomes Are Associated With Late Clinical Relapse in Clinical Trials for Complicated Urinary Tract Infections. Clin Infect Dis 2023;76(10:1768-1775. https://academic.oup.com/cid/article/76/10/1768/6980780

USCAST Oral cephalosporin STIC against S. aureus and E. coli meeting recording. https://www.youtube.com/watch?v=HieaVFAC08s

MacDougall C. A Cloudy Crystal Ball: Critically Assessing and Rethinking the Antibiogram. Clin Infect Dis. 2023;77(11):1501-1503. doi:10.1093/cid/ciad468

Koehl J, Spolsdoff D, Negaard B, et al. Cephalosporins for Outpatient Pyelonephritis in the Emergency Department: COPY-ED Study. Ann Emerg Med. 2025;85(3):240-248. doi:10.1016/j.annemergmed.2024.10.013

Dunne MW, Aronin SI, Das AF, et al. Sulopenem for the Treatment of Complicated Urinary Tract Infections Including Pyelonephritis: A Phase 3, Randomized Trial. Clin Infect Dis. 2023;76(1):78-88. doi:10.1093/cid/ciac704

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References

1. WHO handbook for guideline development, 2nd Edition, https://www.who.int/publications/i/item/9789241548960

2. The WHO AWaRe (Access, Watch, Reserve) antibiotic book https://www.who.int/publications/i/item/9789240062382

3. IDSA 2024 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections, https://www.idsociety.org/practice-guideline/amr-guidance/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About

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Facebook: https://www.facebook.com/sidprx

LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

This episode also qualifies for 1 hour of BCIDP credit! How to Obtain BCIDP Recertification Credit for this Episode: Visit sidp.org/BCIDP for more information.

References:

1. Bradley JS, Garonzik SM, Forrest A, Bhavnani SM. Pharmacokinetics, pharmacodynamics, and Monte Carlo simulation: selecting the best antimicrobial dose to treat an infection. Pediatr Infect Dis J. 2010 Nov;29(11):1043-6. doi: 10.1097/INF.0b013e3181f42a53. PMID: 20975453.

2. Craig WA. Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men. Clin Infect Dis. 1998 Jan;26(1):1-10; quiz 11-2. doi: 10.1086/516284. PMID: 9455502.

3. Hakenbeck R, Grebe T, Zähner D, Stock JB. beta-lactam resistance in Streptococcus pneumoniae: penicillin-binding proteins and non-penicillin-binding proteins. Mol Microbiol. 1999 Aug;33(4):673-8. doi: 10.1046/j.1365-2958.1999.01521.x. PMID: 10447877.

4. Bax R. Development of a twice daily dosing regimen of amoxicillin/clavulanate. Int J Antimicrob Agents. 2007 Dec;30 Suppl 2:S118-21. doi: 10.1016/j.ijantimicag.2007.09.002. Epub 2007 Nov 5. PMID: 17983732.

5. Bielicki JA, Stöhr W, Barratt S, Dunn D, Naufal N, Roland D, Sturgeon K, Finn A, Rodriguez-Ruiz JP, Malhotra-Kumar S, Powell C, Faust SN, Alcock AE, Hall D, Robinson G, Hawcutt DB, Lyttle MD, Gibb DM, Sharland M; PERUKI, GAPRUKI, and the CAP-IT Trial Group. Effect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial. JAMA. 2021 Nov 2;326(17):1713-1724. doi: 10.1001/jama.2021.17843. Erratum in: JAMA. 2021 Dec 7;326(21):2208. doi: 10.1001/jama.2021.20219. PMID: 34726708; PMCID: PMC8564579.

How to Obtain BCIDP Recertification Credit for this Episode: Visit sidp.org/BCIDP for more information

Visit our website! https://breakpoints-sidp.org/

References:

1. Am J Respir Crit Care Med. 2025 Jul 18. doi: 10.1164/rccm.202507-1692ST. Online ahead of print.

2. IDSA Sepsis Task Force. Infectious Diseases Society of America (IDSA) POSITION STATEMENT: Why IDSA Did Not Endorse the Surviving Sepsis Campaign Guidelines. Clin Infect Dis. 2018 May 2;66(10):1631-1635. doi: 10.1093/cid/cix997. PMID: 29182749; PMCID: PMC6927848.

This podcast was supported by an unrestricted grant from Nestlé Health Science.

References:

1. Helpful review from one of our guest experts: Gens KD, et al. Fecal microbiota transplantation and emerging treatments for Clostridium difficile infection. J Pharm Pract. 2013 Oct;26(5):498-505. doi: 10.1177/0897190013499527. PMID: 23966282.

2. More modern review: Herbin SR, et al. Breaking the Cycle of Recurrent Clostridioides difficile Infections: A Narrative Review Exploring Current and Novel Therapeutic Strategies. J Pharm Pract. 2024 Dec;37(6):1361-1373. doi: 10.1177/08971900241248883. Epub 2024 May 13. PMID: 38739837.

3. Review on designing microbiota based therapies (pre-print only): Ke S, et al. Rational Design of Live Biotherapeutic Products for the Prevention of Clostridioides difficile Infection. 2024 May 02. doi: 10.1101/2024.04.30.591969.

4. [FDA Guidance regarding IND requirements for fecal microbiota transplant](https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enforcement-policy-regarding-investigational-new-drug-requirements-use-fecal-microbiota). 2022 Nov.

5. OpenBiome webpage with resources for hospitals: How to Start an FMT Program. 2025.

6. Peery AF, et al. AGA Clinical Practice Guideline on Fecal Microbiota-Based Therapies for Select Gastrointestinal Diseases. Gastroenterology. 2024 Mar;166(3):409-434. doi: 10.1053/j.gastro.2024.01.008. PMID: 38395525.

7. Johnson S, et al. Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults. Clin Infect Dis. 2021 Sep 7;73(5):755-757. doi: 10.1093/cid/ciab718. PMID: 34492699.

8. Henry Ford’s experience getting fecal microbiota products for patients: Abene S. Fecal Microbiota Capsules Improve CDI Access Through Specialty Pharmacy Integration. Contagion Live. 2025 Jul 11.

9. An international view on CDI management: Mendo-Lopez R, et al. Best Practices in the Management of Clostridioides difficile Infection in Developing Nations. Trop Med Infect Dis. 2024 Aug 19;9(8):185. doi: 10.3390/tropicalmed9080185. PMID: 39195623.

10. Review on investigational LBP agents: Monday L, et al. Microbiota-Based Live Biotherapeutic Products for Clostridioides Difficile Infection- The Devil is in the Details. Infect Drug Resist. 2024 Feb 15;17:623-639. doi: 10.2147/IDR.S419243. PMID: 38375101.

11. More on quorum sensing: Falà AK, et al. Quorum sensing in human gut and food microbiomes: Significance and potential for therapeutic targeting. Front Microbiol. 2022 Nov 25;13:1002185. doi: 10.3389/fmicb.2022.1002185. PMID: 36504831.

12. Economic impacts of CDI pts: Reilly J, et al. Economic impact of multiple recurrent Clostridioides difficile infection in a community teaching hospital. Infect Control Hosp Epidemiol. 2025 Sep 29:1-3. doi: 10.1017/ice.2025.10295. Epub ahead of print. PMID: 41020576.

This episode was sponsored by an unrestricted grant from Shionogi Inc.

References:

1. Spencer HK, Spitznogle SL, Borjan J, Aitken SL. An Overview of the Treatment of Less Common Non-Lactose-Fermenting Gram-Negative Bacteria. Pharmacotherapy. 2020 Sep;40(9):936-951. doi: 10.1002/phar.2447. Epub 2020 Aug 14. PMID: 32687670.
2. Defining antimicrobial susceptibility testing methods and breakpoints among Achromobacter species
3. SIDP 2025 Webinar | Mind the Gap: CLSI M100 Updates to Optimize Stewardship and Patient Care Outcomes
4. Yasmin M, Rojas LJ, Marshall SH, Hujer AM, Cmolik A, Marshall E, Boucher HW, Vila AJ, Soldevila M, Diene SM, Rolain JM, Bonomo RA. Characterization of a Novel Pathogen in Immunocompromised Patients: Elizabethkingia anophelis-Exploring the Scope of Resistance to Contemporary Antimicrobial Agents and β-lactamase Inhibitors. Open Forum Infect Dis. 2023 Jan 31;10(2):ofad014. doi: 10.1093/ofid/ofad014. PMID: 36820316; PMCID: PMC9938519.
5. Warner NC, Bartelt LA, Lachiewicz AM, Tompkins KM, Miller MB, Alby K, Jones MB, Carr AL, Alexander J, Gainey AB, Daniels R, Burch AK, Brown DE, Brownstein MJ, Cheema F, Linder KE, Shields RK, Longworth S, van Duin D. Cefiderocol for the Treatment of Adult and Pediatric Patients With Cystic Fibrosis and Achromobacter xylosoxidans Infections. Clin Infect Dis. 2021 Oct 5;73(7):e1754-e1757. doi: 10.1093/cid/ciaa1847. PMID: 33313656; PMCID: PMC8678443.
6. El Chakhtoura NG, Saade E, Wilson BM, Perez F, Papp-Wallace KM, Bonomo RA. A 17-Year Nationwide Study of Burkholderia cepacia Complex Bloodstream Infections Among Patients in the United States Veterans Health Administration. Clin Infect Dis. 2017 Oct 15;65(8):1253-1259. doi: 10.1093/cid/cix559. PMID: 29017247; PMCID: PMC5848224.

References:

1. Barreto EF, et al. Setting the Beta-Lactam Therapeutic Range for Critically Ill Patients: Is There a Floor or Even a Ceiling? Crit Care Explor. 2021 Jun 11;3(6):e0446.PMID: https://pubmed.ncbi.nlm.nih.gov/34136822/
2. Barreto EF, et al. Adequacy of cefepime concentrations in the early phase of critical illness: A case for precision pharmacotherapy. Pharmacotherapy. 2023 Nov;43(11):1112-1120. https://pubmed.ncbi.nlm.nih.gov/36648390/
3. ** **Udy AA, et al. Augmented renal clearance: implications for antibacterial dosing in the critically ill. Clin Pharmacokinet. 2010;49(1):1-16. https://pubmed.ncbi.nlm.nih.gov/20000886/
4. Lipman J, Wallis SC, Boots RJ. Cefepime versus cefpirome: the importance of creatinine clearance.   Anesth Analg. 2003 Oct;97(4):1149-1154. doi: 10.1213/01.ANE.0000077077.54084.B0.PMID: 14500173
5. Roberts JA, Ulldemolins M, Roberts MS, McWhinney B, Ungerer J, Paterson DL, Lipman J. Therapeutic drug monitoring of beta-lactams in critically ill patients: proof of concept.  Int J Antimicrob Agents. 2010 Oct;36(4):332-9. doi: 10.1016/j.ijantimicag.2010.06.008. Epub 2010 Aug 3.PMID: 20685085

1. Ciapponi A, Bardach A, Sandoval MM, Palermo MC, Navarro E, Espinal C, Quirós R. Systematic review and meta-analysis of deaths attributable to antimicrobial resistance, Latin America. Emerg Infect Dis. 2023 Nov;29(11):2335-44. doi:10.3201/eid2911.230753. PMID:37877573; PMCID:PMC10617342.
2. Antimicrobial Resistance Collaborators. The burden of antimicrobial resistance in the Americas in 2019: a cross-country systematic analysis. Lancet Reg Health Am. 2023 Aug 8;25:100561. doi:10.1016/j.lana.2023.100561. Erratum in: Lancet Reg Health Am. 2023 Nov 10;28:100632. doi:10.1016/j.lana.2023.100632. PMID:37727594; PMCID:PMC10505822.
3. Fabre V, Secaira C, Cosgrove SE, Lessa FC, Patel TS, Alvarez AA, Anchiraico LM, Del Carmen Bangher M, Barberis MF, Burokas MS, Castañeda X, Colque AM, De Ascencao G, Esquivel C, Ezcurra C, Falleroni LA, Frassone N, Garzón MI, Gomez C, Gonzalez JA, Hernandez D, Laplume D, Lemir CG, Maldonado Briones H, Melgar M, Mesplet F, Martinez G, Pertuz CM, Moreno C, Nemirovsky C, Nuccetelli Y, Palacio B, Sandoval N, Vergara H, Videla H, Villamandos S, Villareal O, Viteri A, Quiros R. Deep dive into gaps and barriers to implementation of antimicrobial stewardship programs in hospitals in Latin America. Clin Infect Dis. 2023 Jul 5;77(Suppl 1):S53-S61. doi:10.1093/cid/ciad184. PMID:37406044; PMCID:PMC10321692.
4. Charani E, Smith I, Skodvin B, Perozziello A, Lucet JC, Lescure FX, Birgand G, Poda A, Ahmad R, Singh S, Holmes AH. Investigating the cultural and contextual determinants of antimicrobial stewardship programmes across low-, middle- and high-income countries: a qualitative study. PLoS One. 2019 Jan 16;14(1):e0209847. doi:10.1371/journal.pone.0209847. PMID:30650099; PMCID:PMC6335060.
5. Bavestrello L, Cabello Á, Casanova D. Impact of regulatory measures on antibiotic sales in Chile. Rev Med Chil. 2002 Nov;130(11):1265-72. doi:10.4067/S0034-98872002001100009. ISSN 0034-9887.
6. Díaz-Madriz JP, et al. Impact of a pharmacist-driven antimicrobial stewardship program in a private hospital in Costa Rica. Rev Panam Salud Publica. 2020;44:e57. doi:10.26633/RPSP.2020.57.
7. Díaz-Madriz JP, et al. Impact of a pharmacist-driven antimicrobial stewardship program on the prescription of antibiotics by intensive care physicians in a Latin American hospital: a retrospective study. J Am Coll Clin Pharm. 2022;5(11):1148-55. doi:10.1002/jac5.1708.
8. Domínguez I, et al. Evaluación del consumo de antimicrobianos en 15 hospitales chilenos: resultados de un trabajo colaborativo, 2013. Rev Chil Infectol. 2016 Jun;33(3):307-12. doi:10.4067/S0716-10182016000300010. ISSN 0716-1018.
9. Ministerio de Salud de Chile. Norma general técnica N°210 para la racionalización del uso de antimicrobianos en la atención clínica. Resolución Exenta N°1146, 2020. Disponible en: https://diprece.minsal.cl/wp-content/uploads/2021/01/RES.-EXENTA-N%C2%B01146-Aprueba-Norma-Gral.-Te%CC%81cnica-N%C2%B00210-para-la-racionalizacio%CC%81n-del-uso-de-antimicrobianos-en-la-Atencio%CC%81n-Cli%CC%81nica_v2.pdf

References:

1. Ciapponi A, Bardach A, Sandoval MM, Palermo MC, Navarro E, Espinal C, Quirós R. Systematic review and meta-analysis of deaths attributable to antimicrobial resistance, Latin America. Emerg Infect Dis. 2023 Nov;29(11):2335-44. doi:10.3201/eid2911.230753. PMID:37877573; PMCID:PMC10617342.
2. Antimicrobial Resistance Collaborators. The burden of antimicrobial resistance in the Americas in 2019: a cross-country systematic analysis. Lancet Reg Health Am. 2023 Aug 8;25:100561. doi:10.1016/j.lana.2023.100561. Erratum in: Lancet Reg Health Am. 2023 Nov 10;28:100632. doi:10.1016/j.lana.2023.100632. PMID:37727594; PMCID:PMC10505822.
3. Fabre V, Secaira C, Cosgrove SE, Lessa FC, Patel TS, Alvarez AA, Anchiraico LM, Del Carmen Bangher M, Barberis MF, Burokas MS, Castañeda X, Colque AM, De Ascencao G, Esquivel C, Ezcurra C, Falleroni LA, Frassone N, Garzón MI, Gomez C, Gonzalez JA, Hernandez D, Laplume D, Lemir CG, Maldonado Briones H, Melgar M, Mesplet F, Martinez G, Pertuz CM, Moreno C, Nemirovsky C, Nuccetelli Y, Palacio B, Sandoval N, Vergara H, Videla H, Villamandos S, Villareal O, Viteri A, Quiros R. Deep dive into gaps and barriers to implementation of antimicrobial stewardship programs in hospitals in Latin America. Clin Infect Dis. 2023 Jul 5;77(Suppl 1):S53-S61. doi:10.1093/cid/ciad184. PMID:37406044; PMCID:PMC10321692.
4. Charani E, Smith I, Skodvin B, Perozziello A, Lucet JC, Lescure FX, Birgand G, Poda A, Ahmad R, Singh S, Holmes AH. Investigating the cultural and contextual determinants of antimicrobial stewardship programmes across low-, middle- and high-income countries: a qualitative study. PLoS One. 2019 Jan 16;14(1):e0209847. doi:10.1371/journal.pone.0209847. PMID:30650099; PMCID:PMC6335060.
5. Bavestrello L, Cabello Á, Casanova D. Impact of regulatory measures on antibiotic sales in Chile. Rev Med Chil. 2002 Nov;130(11):1265-72. doi:10.4067/S0034-98872002001100009. ISSN 0034-9887.
6. Díaz-Madriz JP, et al. Impact of a pharmacist-driven antimicrobial stewardship program in a private hospital in Costa Rica. Rev Panam Salud Publica. 2020;44:e57. doi:10.26633/RPSP.2020.57.
7. Díaz-Madriz JP, et al. Impact of a pharmacist-driven antimicrobial stewardship program on the prescription of antibiotics by intensive care physicians in a Latin American hospital: a retrospective study. J Am Coll Clin Pharm. 2022;5(11):1148-55. doi:10.1002/jac5.1708.
8. Domínguez I, et al. Evaluación del consumo de antimicrobianos en 15 hospitales chilenos: resultados de un trabajo colaborativo, 2013. Rev Chil Infectol. 2016 Jun;33(3):307-12. doi:10.4067/S0716-10182016000300010. ISSN 0716-1018.
9. Ministerio de Salud de Chile. Norma general técnica N°210 para la racionalización del uso de antimicrobianos en la atención clínica. Resolución Exenta N°1146, 2020. Disponible en: https://diprece.minsal.cl/wp-content/uploads/2021/01/RES.-EXENTA-N%C2%B01146-Aprueba-Norma-Gral.-Te%CC%81cnica-N%C2%B00210-para-la-racionalizacio%CC%81n-del-uso-de-antimicrobianos-en-la-Atencio%CC%81n-Cli%CC%81nica_v2.pdf

References:

1. BALANCE Investigators, et al. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. N Engl J Med. 2025 March. DOI: https://doi.org/10.1056/NEJMoa2404991

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/. Visit our website! https://breakpoints-sidp.org/

References:

1. Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. PMID: 31573350; PMCID: PMC6812437.
2. Chaudhuri D, Nei AM, Rochwerg B, Balk RA, Asehnoune K, Cadena R, Carcillo JA, Correa R, Drover K, Esper AM, Gershengorn HB, Hammond NE, Jayaprakash N, Menon K, Nazer L, Pitre T, Qasim ZA, Russell JA, Santos AP, Sarwal A, Spencer-Segal J, Tilouche N, Annane D, Pastores SM. 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Crit Care Med. 2024 May 1;52(5):e219-e233. doi: 10.1097/CCM.0000000000006172. Epub 2024 Jan 19. PMID: 38240492.
3. Odeyemi Y, Tekin A, Schanz C, Schreier D, Cole K, Gajic O, Barreto E. Comparative effectiveness of azithromycin versus doxycycline in hospitalized patients with community acquired pneumonia treated with beta-lactams: A multicenter matched cohort study. Clin Infect Dis. 2025 May 16:ciaf252. doi: 10.1093/cid/ciaf252. Epub ahead of print. PMID: 40378193.
4. Butler AM, Nickel KB, Olsen MA, Sahrmann JM, Colvin R, Neuner E, O'Neil CA, Fraser VJ, Durkin MJ. Comparative safety of different antibiotic regimens for the treatment of outpatient community-acquired pneumonia among otherwise healthy adults. Clin Infect Dis. 2024 Oct 23:ciae519. doi: 10.1093/cid/ciae519. Epub ahead of print. PMID: 39442057; PMCID: PMC12355227.
5. Furukawa Y, Luo Y, Funada S, Onishi A, Ostinelli E, Hamza T, Furukawa TA, Kataoka Y. Optimal duration of antibiotic treatment for community-acquired pneumonia in adults: a systematic review and duration-effect meta-analysis. BMJ Open. 2023 Mar 22;13(3):e061023. doi: 10.1136/bmjopen-2022-061023. PMID: 36948555; PMCID: PMC10040075
6. Schober T, Wong K, DeLisle G, et al. Clinical outcomes of rapid respiratory virus testing in emergency departments. JAMA Intern Med. 2024;184(5):528-536.
7. Clark T, Lindsley K, Wigmosta T, et al. Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: results of a systematic review and meta-analysis. J Infect. 2023;86(5):462-475.
8. May L, Robbins EM, Canchola JA, Chugh K, Tran NK. A study to assess the impact of the cobas point-of-care RT-PCR assay (SARS-CoV-2 and Influenza A/B) on patient clinical management in the emergency department of the University of California at David Medical Center. J Clin Virol. 2023:168:105597.
9. Cartuliares MB, Rosenvinge FS, Mogensen CB, Skovsted TA, Andersen SL, Østergaard C, et al. Evaluation of point-of-care multiplex polymerase chain reaction in guiding antibiotic treatment of patients acutely admitted with suspected community-acquired pneumonia in Denmark: a multicentre randomised controlled trial. PLoS Med. 2023;20:e1004314. doi: 10.1371/ journal.pmed.1004314.
10. Vaughn VM, Dickson RP, Horowitz JK, Flanders SA. Community-acquired pneumonia: a review. JAMA. 2024;332(15):1282-1295.
11. Davis MR, McCreary EK, Trzebucki AM. Things we do for no reason – ordering Streptococcus pneumoniae urinary antigen in patients with community-acquired pneumonia. Open Forum Infect Dis. 2024;11(3):ofae089.
12. Centers for Disease Control and Prevention. Laboratory Testing for Legionella. Updated June 9, 2025. Accessed July 13, 2025. https://www.cdc.gov/legionella/php/laboratories/index.html.
13. Jain S, Self WH, Wunderink RG. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373(5):415-427.
14. Kamat IS, Ramachandram V, Eswaran H, Guffey D, Musher DM. Procalcitonin to distinguish viral from bacterial pneumonia: a systematic review and meta-analysis. Clin Infect Dis. 2020;70(3):538-542.
15. Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single blinded intervention trial. Lancet. 2004;363:600–7. doi: 10.1016/S0140- 6736(04)15591-8.
16. Schuetz P, Christ-Crain M, Thomann R, Falconnier C, Wolbers M, Widmer I, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA. 2009;302:1059–66.
17. Schuetz P, Muller B, Christ-Crain M, Stolz D, Tamm M, Bouadma L, et al. Procalci- € tonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Datab System Rev. 2017;10(10):CD007498. doi: 10.1002/14651858. cd007498.pub2.
18. Huang DT, Yealy DM, Filbin MR, Brown AM, Chang C-CH, Doi Y, et al. Procalcitonin-guided use of antibiotics for lower Respiratory tract infection. New Engl J Med. 2018;379:236–49. doi: 10.1056/NEJMoa1802670.
19. Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in severe community-acquired pneumonia. N Engl J Med. 2023;389(19):1623-1634. doi:10.1056/NEJMoa2215145.
20. Gupta AB, Flanders SA, Petty LA, et al. Inappropriate diagnosis of pneumonia among hospitalized adults. JAMA Intern Med. 2024;184(5):548-556.
21. Jones BE, Chapman AB, Ying J, et al. Diagnostic Discordance, Uncertainty, and Treatment Ambiguity in Community-Acquired Pneumonia: A National Cohort Study of 115 U.S. Veterans Affairs Hospitals. Ann Intern Med. 2024;177(9):1179-1189. doi:10.7326/M23-2505.
22. Hartlage W, Imlay H, Spivak ES. The role of empiric atypical antibiotic coverage in non-severe community-acquired pneumonia. Antimicrob Steward Healthc Epidemiol. 2024;4(1):e214. doi:10.1017/ash.2024.453.
23. Dinh A, Barbier F, Bedos JP, et al. Update of guidelines for management of community acquired pneumonia in adults by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF). Endorsed by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF); endorsed by the French Intensive Care Society (SRLF), the French Microbiology Society (SFM), the French Radiology Society (SFR), and the French Emergency Society (SFMU). Respir Med and Res. 2025.
24. El Moussaoui R, de Borgie CAJM, van den Broek P, et al. Effectiveness of discontinuing antibiotic treatment after three days versus eight days in mild to moderate-severe community acquired pneumonia: randomised, double blind study. BMJ. 2006;332(7554):1355. doi:10.1136/bmj.332.7554.1355.
25. Dinh A, Ropers J, Duran C, et al. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia: a randomized, non-inferiority trial. Lancet. 2021;397(10280):1195-1203.

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References:

1. Fluconazole PK Variability in Critically Ill: DOI 10.3390/microorganisms9102068
2. DALI Antifungal Follow-up: DOI 10.1186/s13054-015-0758-3

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References:

1. Basic stats/epi on chorioamnionitis: Romero R, et al. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques. J Perinat Med. 2015 Jan;43(1):19-36. doi: 10.1515/jpm-2014-0249. PMID: 25720095.
2. ACOG 2017 Guideline for IAI: Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. Obstet Gynecol. 2017 Aug;130(2):e95-e101. doi: 10.1097/AOG.0000000000002236. PMID: 28742677.
3. ACOG 2024 Update on clinical criteria for IAI: ACOG Clinical Practice Update: Update on Criteria for Suspected Diagnosis of Intraamniotic Infection. Obstetrics & Gynecology 144(1):p e17-e19, July 2024. doi: 10.1097/AOG.0000000000005593
4. Helpful review with more recent microorganisms : Jung E, et al. Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment. Am J Obstet Gynecol. 2024 Mar;230(3S):S807-S840. doi: 10.1016/j.ajog.2023.02.002. PMID: 38233317.
5. Cochrane Review: Chapman E, et al. Antibiotic regimens for management of intra-amniotic infection. Cochrane Database Syst Rev. 2014 Dec 19;2014(12):CD010976. doi: 10.1002/14651858.CD010976.pub2. PMID: 25526426.
6. Helpful recent review on intrapartum infections: Bailey, P, et al_._ Out with the Old, In with the New: A Review of the Treatment of Intrapartum Infections. Curr Infect Dis Rep. 2024;26:107–113 doi: 10.1007/s11908-024-00838-8.
7. Role of genital mycoplasmas in IAI: Romero R, et al. Evidence that intra-amniotic infections are often the result of an ascending invasion - a molecular microbiological study. J Perinat Med. 2019 Nov 26;47(9):915-931. doi: 10.1515/jpm-2019-0297. PMID: 31693497.
8. Regimens without enterococcal coverage with similar clinical outcomes: Blanco JD, et al. Randomized comparison of ceftazidime versus clindamycin-tobramycin in the treatment of obstetrical and gynecological infections. Antimicrob Agents Chemother. 1983 Oct;24(4):500-4. doi: 10.1128/AAC.24.4.500. PMID: 6360038.
9. Bookstaver PB, et al. A review of antibiotic use in pregnancy. Pharmacotherapy. 2015 Nov;35(11):1052-62. doi: 10.1002/phar.1649. PMID: 26598097.
10. Updated review in pregnancy, includes data on frequency of antibiotic use in pregnancy: Nguyen J, et al. A review of antibiotic safety in pregnancy-2025 update. Pharmacotherapy. 2025 Apr;45(4):227-237. doi: 10.1002/phar.70010. Epub 2025 Mar 19. PMID: 40105039.
11. Locksmith GJ, et al. High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels. Obstet Gynecol. 2005 Mar;105(3):473-9. doi: 10.1097/01.AOG.0000151106.87930.1a. PMID: 15738010.
12. Clindamycin CDI Risk: Miller AC, et al. Comparison of Different Antibiotics and the Risk for Community-Associated Clostridioides difficile Infection: A Case-Control Study. Open Forum Infect Dis. 2023 Aug 5;10(8):ofad413. doi: 10.1093/ofid/ofad413. PMID: 37622034.
13. Impact of penicillin allergy on clindamycin use & cites 47% clindamycin resistance per CDC among GBS: Snider JB, et al. Antibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes. BMC Pregnancy Childbirth. 2023 May 30;23(1):400. doi: 10.1186/s12884-023-05697-0. PMID: 37254067.
14. Clindamycin anaerobic coverage data: Hastey CJ, et al. Changes in the antibiotic susceptibility of anaerobic bacteria from 2007-2009 to 2010-2012 based on the CLSI methodology. Anaerobe. 2016 Dec;42:27-30. doi: 10.1016/j.anaerobe.2016.07.003. PMID: 27427465.
15. Older PK study of ampicillin & gentamicin for chorioamnionitis: Gilstrap LC 3rd, Bawdon RE, Burris J. Antibiotic concentration in maternal blood, cord blood, and placental membranes in chorioamnionitis. Obstet Gynecol. 1988 Jul;72(1):124-5. PMID: 3380500.
16. Paper putting out the call for modernization of OB/Gyn antibiotic regimens: Pek Z, Heil E, Wilson E. Getting With the Times: A Review of Peripartum Infections and Proposed Modernized Treatment Regimens. Open Forum Infect Dis. 2022 Sep 5;9(9):ofac460. doi: 10.1093/ofid/ofac460. PMID: 36168554.
17. Vanderbilt University Medical Center experience with modernizing OB/Gyn infection regimens: Smiley C, et al. Implementing Updated Intraamniotic Infection Guidelines at a Large Academic Medical Center. Open Forum Infect Dis. 2024 Sep 5;11(9):ofae475. doi: 10.1093/ofid/ofae475. PMID: 39252868.
18. Prisma Health/University of South Carolina experience with modernizing OB/Gyn infection regimens: Bailey P, et al. Cefoxitin for Intra-amniotic Infections and Endometritis: A Retrospective Comparison to Traditional Antimicrobial Therapy Regimens Within a Healthcare System. Clin Infect Dis. 2024 Jul 19;79(1):247-254. doi: 10.1093/cid/ciae042. PMID: 38297884.

Conflict of Interest for DSMC Members: Conflicts of interest were evaluated when choosing individuals to serve on the SNAP DSMC. Aside from being compensated for their duties on the committee, DSMC members have no ongoing financial relationship that relate to the trial and are not involved in the conduct of the trial in any role other than that of a DSMC member. DSMC members have no intellectual conflict of interest or bias and reviewed SNAP data in a fully objective manner. Each DSMC candidate was well vetted.

References:

1. Fabre BCx Stewardship Article doi: 10.1128/JCM.01005-21
2. ED Bcx Stewardship doi: 10.1016/j.ajic.2024.04.198
3. CT Surgery Stewardship doi: 10.1093/icvts/ivaf005
4. Every Crisis is an Opportunity doi:  10.1093/ofid/ofae479
5. Fun IV Coconut Water from I Feel Nerdy section: https://dr-martins.com/wp-content/uploads/2015/07/2000_the-intravenous-use-of-coconut-water.pdf

References:

1. Oral amoxicillin and amoxicillin-clavulanic acid: properties, indications and usage. Clin Microbiol Infect. 2020 Jul;26(7):871-879. doi: 10.1016/j.cmi.2019.11.028. Epub 2019 Dec 4. PMID: 31811919.
2. New formulations of amoxicillin/clavulanic acid: a pharmacokinetic and pharmacodynamic review. Clin Pharmacokinet. 2005;44(11):1097-115. doi: 10.2165/00003088-200544110-00001. PMID: 16231964.
3. Non-linear absorption pharmacokinetics of amoxicillin: consequences for dosing regimens and clinical breakpoints. J Antimicrob Chemother. 2016 Oct;71(10):2909-17. doi: 10.1093/jac/dkw226. Epub 2016 Jun 20. PMID: 27330071.
4. Augmentin (amoxicillin/clavulanate) in the treatment of community-acquired respiratory tract infection: a review of the continuing development of an innovative antimicrobial agent. J Antimicrob Chemother. 2004 Jan:53 Suppl 1:i3-20. doi: 10.1093/jac/dkh050. PMID: 14726431.
5. Is the standard dose of amoxicillin-clavulanic acid sufficient? BMC Pharmacol Toxicol. 2014 Jul 21:15:38. doi: 10.1186/2050-6511-15-38. PMID: 25047044.
6. MIC of amoxicillin/clavulanate according to CLSI and EUCAST: discrepancies and clinical impact in patients with bloodstream infections due to Enterobacteriaceae. J Antimicrob Chemother. 2017 May 1;72(5):1478-1487. doi: 10.1093/jac/dkw562. PMID: 28093484.
7. Amoxicillin-Clavulanate Breakpoints Against Enterobacterales: Rationale for Revision by the Clinical and Laboratory Standards Institute. Clin Infect Dis. 2024 Aug 16;79(2):516-523. doi: 10.1093/cid/ciae201. PMID: 38626241.
8. Amoxicillin-Clavulanate Breakpoints Against Haemophilus influenzae: Rationale for Revision by the Clinical and Laboratory Standards Institute. Clin Infect Dis. 2025 Feb 24;80(2):481-482. doi: 10.1093/cid/ciae246. PMID: 38709848.
9. No evidence of difference in mortality with amoxicillin versus co-amoxiclav for hospital treatment of community-acquired pneumonia. J Infect. 2024 Jun;88(6):106161. doi: 10.1016/j.jinf.2024.106161. Epub 2024 Apr 23. PMID: 38663754.
10. Population pharmacokinetics and dosing simulations of amoxicillin in obese adults receiving co-amoxiclav. J Antimicrob Chemother. 2020 Dec 1;75(12):3611-3618. doi: 10.1093/jac/dkaa368. PMID: 32888018.
11. Comprehensive guidance for antibiotic dosing in obese adults: 2022 update. Pharmacotherapy. 2023 Mar;43(3):226-246. doi: 10.1002/phar.2769. Epub 2023 Feb 18. PMID: 36703246.

References:

1. Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections. Clin Infect Dis. 2024 Aug 7:ciae403. doi: 10.1093/cid/ciae403. PMID: 39108079.
2. Clinical challenges treating Stenotrophomonas maltophilia infections: an update. JAC Antimicrob Resist. 2022 May 5;4(3):dlac040. doi: 10.1093/jacamr/dlac040. PMID: 35529051.
3. Alterations of the Oral Microbiome and Cumulative Carbapenem Exposure Are Associated With Stenotrophomonas maltophilia Infection in Patients With Acute Myeloid Leukemia Receiving Chemotherapy. Clin Infect Dis. 2021 May 4;72(9):1507-1513. doi: 10.1093/cid/ciaa778. PMID: 32544947.
4. An Overview of the Treatment of Less Common Non–Lactose-Fermenting Gram-Negative Bacteria. Pharmacotherapy. 2020 Sep;40(9):936-951. doi: 10.1002/phar.2447. PMID: 32687670.

References:

1. Deconstructing the Dogma: Systematic Literature Review and Meta-analysis of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve Endocarditis. Open Forum Infect Dis. 2022 Oct 31;9(11):ofac583. doi: 10.1093/ofid/ofac583. PMID: 36408468.
2. Effectiveness of adjunctive rifampicin for treatment of Staphylococcus aureus bacteraemia: a systematic review and meta-analysis of randomized controlled trials. J Antimicrob Chemother. 2023 Oct 3;78(10):2419-2427. doi: 10.1093/jac/dkad214. PMID: 37583062.
3. Adjunctive Rifampin Following Debridement and Implant Retention for Staphylococcal Prosthetic Joint Infection: Is it Effective if not Combined With a Fluoroquinolone? Open Forum Infect Dis. 2022 Oct 31;9(12):ofac582. doi: 10.1093/ofid/ofac582. PMID: 36504699.

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References

1. Nixing the Nidus: Managing Retained Sources in Prosthetic Joint Infections. Breakpoints Podcast Episode #67. Society of Infectious Diseases Pharmacists.
2. Dosing Consult: Rifampin Part 1. Breakpoints Podcast Episode #104. Society of Infectious Diseases Pharmacists.
3. Review on Staphylococcal biofilm development: Schilcher K, Horswill AR. 2020 Aug 12;84(3):e00026-19. doi: 10.1128/MMBR.00026-19. PMID: 32792334.
4. Antibiotics can fail to kill biofilm cells even if they penetrate the biofilm: Singh R, et al. Pathog Dis. 2016 Aug;74(6):ftw056. doi: 10.1093/femspd/ftw056. Epub 2016 Jul 7. PMID: 27402781.
5. Subinhibitory antibiotic concentrations can promote biofilm formation: Schilcher K, et al. Antimicrob Agents Chemother. 2016 Sep 23;60(10):5957-67. doi: 10.1128/AAC.00463-16. PMID: 27458233.
6. Clinical and genetic risk factors for biofilm-forming Staphylococcus aureus: Luther MK, et al. Antimicrob Agents Chemother. 2018 Apr 26;62(5):e02252-17. doi: 10.1128/AAC.02252-17. PMID: 29530854.
7. Meta-analysis showing poor clinical outcomes with debridement, antibiotics, and implant retention (DAIR): Kunutsor SK, et al. J Infect. 2018 Dec;77(6):479-488. doi: 10.1016/j.jinf.2018.08.017. PMID: 30205122.
8. Thieme L, et al. MBEC versus MBIC: the lack of differentiation between biofilm reducing and inhibitory effects as a current problem in biofilm methodology. Biol Proced Online 21, 18 (2019). https://doi.org/10.1186/s12575-019-0106-0.
9. Ongoing trial investigating use of MBEC in the treatment of PJIs: Tillander JAN, et al. BMJ Open. 2022 Sep 15;12(9):e058168. doi: 10.1136/bmjopen-2021-058168. PMID: 36109038.
10. Maale, G. Complete eradication of biofilm using low frequency electromagnetic force (EMF) and antibiotics at MIC. 34th Annual Meeting Musculoskeletal Infection Society. 2024 Aug. Abstract 1232 (see full program).
11. Meta-analysis on bacteriophages for biofilm: Kovacs CJ, et al. Mil Med. 2024 May 18;189(5-6):e1294-e1302. doi: 10.1093/milmed/usad385. PMID: 37847552.
12. Berking BB, et al. Biofilm disruption from within: light-activated molecular drill-functionalized polymersomes bridge the gap between membrane damage and quorum sensing-mediated cell death. ACS Biomater Sci Eng. 2024 Sep 9;10(9):5881-5891. doi: 10.1021/acsbiomaterials.4c01177. PMID: 39176452.
13. Aboelnaga N, et al. Deciphering the dynamics of methicillin-resistant Staphylococcus aureus biofilm formation: from molecular signaling to nanotherapeutic advances. Cell Commun Signal. 2024 Mar 22;22(1):188. doi: 10.1186/s12964-024-01511-2. PMID: 38519959.
14. Conway J, et al. Phase 1 study of the pharmacokinetics and clinical proof-of-concept activity of a biofilm-disrupting human monoclonal antibody in patients with chronic prosthetic joint infection of the knee or hip. Antimicrob Agents Chemother. 2024 Aug 7;68(8):e0065524. doi: 10.1128/aac.00655-24. PMID: 39012102.
15. Mulpur P, et al. Efficacy of intrawound vancomycin in prevention of periprosthetic joint infection after primary total knee arthroplasty: a prospective double-blinded randomized control trial. J Arthroplasty. 2024 Jun;39(6):1569-1576. doi: 10.1016/j.arth.2024.01.003. PMID: 38749600.
16. Dong Y, et al. Synergy of ultrasound microbubbles and vancomycin against Staphylococcus epidermidis biofilm. J Antimicrob Chemother. 2013 Apr;68(4):816-26. doi: 10.1093/jac/dks490. PMID: 23248238.
17. Miltenberg B, et al. Intraosseous Regional Administration of Antibiotic Prophylaxis for Total Knee Arthroplasty: A Systematic Review. J Arthroplasty. 2023 Apr;38(4):769-774. doi: 10.1016/j.arth.2022.10.023. PMID: 36280158.
18. Viswanathan VK, et al. Intraosseous regional antibiotic prophylaxis in total joint arthroplasty (TJA): Systematic review and meta-analysis. J Clin Orthop Trauma. 2024 Oct 3;57:102553. doi: 10.1016/j.jcot.2024.102553. PMID: 39435324.
19. SOLARIO trial: Dudareva M, et al. The European Bone and Joint Infection Society Meeting, 2024 Sept.
20. SOLARIO trial press release from BoneSupportTM. 2024 Oct 3.
21. Fehring TK, et al. Does treatment at a specialized prosthetic joint infection center improve the rate of reimplantation. J Arthroplasty. 2023 Jun;38(6S):S314-7. PMID 37004968.
22. ROADMAP trial website. 2024.

References:

1. Perret et al. Application of OpenAI GPT-4 for the retrospective detection of catheter-associated urinary tract infections in a fictitious and curated patient data set. 10.1017/ice.2023.189
2. Wiemken et al. Assisting the infection preventionist: Use of artificial intelligence for health care–associated infection surveillance. 10.1016/j.ajic.2024.02.007
3. Leekha et al. Evaluation of hospital-onset bacteraemia and fungaemia in the USA as a potential healthcare quality measure: a cross-sectional study. 10.1136/bmjqs-2023-016831
4. Diekema et al. Are Contact Precautions "Essential" for the Prevention of Healthcare-associated Methicillin-Resistant Staphylococcus aureus? 10.1093/cid/ciad571
5. Martin et al. Contact precautions for MRSA and VRE: where are we now? A survey of the Society for Healthcare Epidemiology of America Research Network. 10.1017/ash.2024.350
6. Browne et al. Investigating the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections in Australia (CLEEN): a stepped-wedge, cluster randomised, controlled trial. 10.1016/S1473-3099(24)00399-2
7. Protect trial: Decolonization in Nursing Homes to Prevent Infection and Hospitalization. 10.1056/NEJMoa2215254
8. Aldardeer et al. Early Versus Late Antipseudomonal β-Lactam Antibiotic Dose Adjustment in Critically Ill Sepsis Patients With Acute Kidney Injury: A Prospective Observational Cohort Study. 10.1093/ofid/ofae059
9. Schmiemann et al. Effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women: parallel, cluster randomised, controlled trial. 10.1136/bmj-2023-076305
10. Vernacchio et al. Improving Short Course Treatment of Pediatric Infections: A Randomized Quality Improvement Trial. 10.1542/peds.2023-063691
11. Advani et al. Bacteremia From a Presumed Urinary Source in Hospitalized Adults With Asymptomatic Bacteriuria. 10.1001/jamanetworkopen.2024.2283
12. Saif et al. Clinical decision support for gastrointestinal panel testing. 10.1017/ash.2024.15
13. Bekker et al. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women. 10.1056/NEJMoa2407001
14. Montini et al. Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections: A Randomized Trial. 10.1542/peds.2023-062598
15. Nielsen et al. Oral versus intravenous empirical antibiotics in children and adolescents with uncomplicated bone and joint infections: a nationwide, randomised, controlled, non-inferiority trial in Denmark. 10.1016/S2352-4642(24)00133-0
16. Kaasch et al. Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial. 10.1016/S1473-3099(23)00756-9
17. AMIKINHAL: Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia. 10.1056/NEJMoa2310307
18. PROPHY-VAP: Ceftriaxone to prevent early ventilator-associated pneumonia in patients with acute brain injury: a multicentre, randomised, double-blind, placebo-controlled, assessor-masked superiority trial. 10.1016/S2213-2600(23)00471-X
19. AVENIR: Azithromycin to Reduce Mortality — An Adaptive Cluster-Randomized Trial. 10.1056/NEJMoa2312093
20. Thomas et al. Comparison of Two High-Dose Versus Two Standard-Dose Influenza Vaccines in Adult Allogeneic Hematopoietic Cell Transplant Recipients. 10.1093/cid/ciad458
21. Schuster et al. The Durability of Antibody Responses of Two Doses of High-Dose Relative to Two Doses of Standard-Dose Inactivated Influenza Vaccine in Pediatric Hematopoietic Cell Transplant Recipients: A Multi-Center Randomized Controlled Trial. 10.1093/cid/ciad534
22. Mahadeo et al. Tabelecleucel for allogeneic haematopoietic stem-cell or solid organ transplant recipients with Epstein-Barr virus-positive post-transplant lymphoproliferative disease after failure of rituximab or rituximab and chemotherapy (ALLELE): a phase 3, multicentre, open-label trial. 10.1016/S1470-2045(23)00649-6
23. Khoury et al. Third-party virus-specific T cells for the treatment of double-stranded DNA viral reactivation and posttransplant lymphoproliferative disease after solid organ transplant. 10.1016/j.ajt.2024.04.009
24. Spec et al. MSG-15: Super-Bioavailability Itraconazole Versus Conventional Itraconazole in the Treatment of Endemic Mycoses—A Multicenter, Open-Label, Randomized Comparative Trial. 10.1093/ofid/ofae010

References:

1. BALANCE Trial: Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. 10.1056/NEJMoa2404991
2. White et al. Antibiotic stewardship targets in the outpatient setting. 10.1016/j.ajic.2019.01.027
3. Wattengel et al. Outpatient antimicrobial stewardship: Optimizing patient care via pharmacist led microbiology review. 10.1016/j.ajic.2019.07.018
4. Augostini et al. An evaluation of antimicrobial prophylaxis for transrectal prostate biopsies: A potential stewardship target. 10.1016/j.ajic.2024.05.012
5. Cotter et al. Antibiotic use and outcomes among children hospitalized with suspected pneumonia. 10.1002/jhm.13002

References:

1. Märtson AG, Edwina AE, Kim HY, Knoester M, Touw DJ, Sturkenboom MGG, Alffenaar JC. Therapeutic Drug Monitoring of Ganciclovir: Where Are We? Ther Drug Monit. 2022 Feb 1;44(1):138-147. doi: 10.1097/FTD.0000000000000925. PMID: 34610621; PMCID: PMC8746890.
2. Wiltshire H, Paya CV, Pescovitz MD, Humar A, Dominguez E, Washburn K, Blumberg E, Alexander B, Freeman R, Heaton N, Zuideveld KP; Valganciclovir Solid Organ Transplant Study Group. Pharmacodynamics of oral ganciclovir and valganciclovir in solid organ transplant recipients. Transplantation. 2005 Jun 15;79(11):1477-83. doi: 10.1097/01.tp.0000164512.99703.ad. PMID: 15940035.

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References:

1. INSPIRE PNA: doi:10.1001/jama.2024.6248
2. INSPIRE UTI: doi:10.1001/jama.2024.6259
3. Order set study by Kufel et al: doi:10/1017/ice.2023.293

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References

1. Climate Change and Antimicrobial Resistance. Editors in Conversation Podcast. American Society for Microbiology. Oct 2023.
2. Is More Better? The Role of Combination Therapy for MRSA. Breakpoints Podcast Episode #30. Society of Infectious Diseases Pharmacists.
3. Turner NA, et al. DOTS: Dalbavancin as an Option for Treatment of Staphylococcus aureus Bacteremia. ESCMID Global 2024. April 2024. NCT04775953.
4. Real-world dalbavancin observational cohort: Rebold N, et al. Infect Dis Ther. 2024 Mar;13(3):565-579. doi: 10.1007/s40121-024-00933-2. PMID: 38427289.
5. Exebacase DISRUPT trial : Fowler VG Jr, et al. Clin Infect Dis. 2024 Jun 14;78(6):1473-1481. doi: 10.1093/cid/ciae043. PMID: 38297916.
6. @snap_trial tweet of Breaking News. Aug 2024.
7. Investigator Resources for the SNAP trial. Sept 2024: https://www.snaptrial.com.au/for-investigators#interim
8. Cefazolin inoculum effect on mortality in MSSA bacteremia : Miller WR, et al. Open Forum Infect Dis. 2018 May 23;5(6):ofy123. doi: 10.1093/ofid/ofy123. PMID: 29977970.
9. Prevalence of cefazolin inoculum effect in MSSA and modified rapid nitrocefin test for detection: Carvajal LP, et al. Antimicrob Agents Chemother. 2024 Sep 30:e0089824. doi: 10.1128/aac.00898-24. PMID: 39345182.
10. LiaX as surrogate for cell envelope stress in Enterococus faecium: Axell-House DB, et al. Antimicrob Agents Chemother. 2024 Mar 6;68(3):e0106923. doi: 10.1128/aac.01069-23. PMID: 38289081.
11. Shorter is better for uncomplicated streptococcal bacteremia: Clutter DS, et al. Antimicrob Agents Chemother. 2024 Aug 7;68(8):e0022024. doi: 10.1128/aac.00220-24. PMID: 38975753.
12. Short vs. long antibiotic duration in Streptococcus pneumoniae bacteremia: Crotty M, et al. Open Forum Infect Dis. 2024 Aug 30;11(9):ofae478. doi: 10.1093/ofid/ofae478. PMID: 39257675.

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References:

1. Efficacy and Safety of High-Dose Rifampin in Pulmonary Tuberculosis. A Randomized Controlled Trial. Am J Respir Crit Care Med. 2018 Sep 1;198(5):657-666. doi: 10.1164/rccm.201712-2524OC.
2. Rifampin vs. rifapentine: what is the preferred rifamycin for tuberculosis? Expert Rev Clin Pharmacol. 2017 Oct;10(10):1027-1036. doi: 10.1080/17512433.2017.1366311.
3. Rifabutin for treating pulmonary tuberculosis. Cochrane Database Syst Rev. 2007 Oct; 2007(4): CD005159. doi: 10.1002/14651858.CD005159.pub2.
4. Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease. Clin Infect Dis. 2023 Oct 5;77(7):1053-1062. doi: 10.1093/cid/ciad312.

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References:

1. Fixed-dose daptomycin in Staphylococcus aureus: doi 10.1002/phar.4602
2. High dose daptomycin for VRE: doi 10.1093/cid/ciw815

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References:

1. Pharmacist-Driven Transitions of Care Practice Model for Prescribing Oral Antimicrobials at Hospital Discharge. 10.1001/jamanetworkopen.2022.11331
2. From concept to reality: Building an ambulatory antimicrobial stewardship program. 10.1002/jac5.1528
3. Cracking the code(s): Optimization of encounter-level diagnosis coding to inform outpatient antimicrobial stewardship data modeling. 10.1017/ice.2023.296
4. Antibiotic Prescribing Variability in a Large Urgent Care Network: A New Target for Outpatient Stewardship. 10.1093/cid/ciz910
5. DART communication for respiratory illness treatment resources: Dialogue Around Respiratory Illness Treatment (DART) – iMTR (uwimtr.org)

Join Prof Jason Roberts and Dr. Erin McCreary for this episode dedicated to discussing the results of the BLING III trial, which explored the use of continuous versus intermittent infusion of a beta-lactam antibiotic in critically ill patients.

Reference: Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis: The BLING III Randomized Clinical Trial. 10.1001/jama.2024.9779

References:

• Omadacycline for Mycobacterium abscessus full case series data set: 10.1128/aac.00824-23
• Long term safety of omadacycline in Mycobacterium abscessus: 10.1093/ofid/ofad335
• USCAST Acinetobacter baumannii Recommendations for Susceptibility Test Interpretive Criteria: https://www.uscast.org/uploads/1/1/9/0/119044870/uscast_alepak_acbc_stic_08feb23.pdf

References:

1. SNAP doi:10.1128/mbio.02759-2
2. ATTACK doi:10.1016/S1473-3099(23)00184-6
3. CRAB among COVID patients: doi:10.1093/jac/dkad042

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References:

• Proposing the "Continuum of UTI" doi: 10.1097/JU.0000000000003874
• UTIs exciting new frontier doi: 10.1016/j.cmi.2022.07.016
• Fosfo vs Nitro doi: 10.1001/jama.2018.3627

Google Drive to Slides from Live Session: https://drive.google.com/file/d/1L4zq0ZC5LW9cCySE0AiJL7m8qDxS9MGM/view?usp=sharing

Submit your 100th Episode videos at: sidp@affinity-strategies.com

Check out more information on ID Pharmacists Day on May 22nd, 2024 at SIDP.org/IDPharmacistsDay

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The Society of Infectious Diseases Pharmacists is excited to invite you to the first ever meeting (via Breakpoints) of The Tortured Stewards & Surgeons Department. Today’s agenda items: optimal management of perioperative antibiotics and prevention of surgical site infections.

Drs. Trisha Peel (@DrTrishaPeel), Michael Calderwood (@CalderwoodMD) and Patch Dellinger join Dr. Jillian Hayes (@thejillianhayes) to discuss some of the controversies we encounter while managing antibiotics in the perioperative space. Does anyone really need post-op antimicrobial prophylaxis longer than 24 hours? Where should vancomycin be fitting into surgical prophylaxis regimens? Can we truly give pre-operative cefazolin to patients with a penicillin allergy? Tune in for the answers to these questions and more!

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About X: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp

If you’d like more information about the CALIPSO trial, please visit this link: https://www.anzca.edu.au/profiles/ctn-trials/underway/calipso

Bibliography

1. SSI Infection Prevention Review: https://jamanetwork.com/journals/jama/article-abstract/2800424#:~:text=Six%20are%20supported%20by%20randomized,use%20a%20chlorhexidine%20gluconate%2Dalcoho
2. Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/strategies-to-prevent-surgical-site-infections-in-acutecare-hospitals-2022-update/2F824B9ADD6066B29F89C8A2A127A9D
3. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update: https://journals.lww.com/journalacs/citation/2017/01000/american_college_of_surgeons_and_surgical.8.aspx 
4. 2017 CDC Guidelines: https://jamanetwork.com/journals/jamasurgery/fullarticle/2623725 
5. 2018 WHO Guidelines: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y 
6. ASHP Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery: https://www.ashp.org/surgical-guidelines 
7. Surgeons as Stewards: https://journals.lww.com/journalacs/citation/2020/12000/perioperative_antibiotic_prophylaxis__surgeons_as.23.aspx 
8. Li et al, Arthroplasty 2022: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y 
9. Dutch Arthroplasty Register Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023957/ 
10. de Jonge Meta-Analysis on duration and incidence of SSI: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30084-0/abstract 
11. Prolonged Antibiotic Prophylaxis After Cardiovascular Surgery and Its Effect on Surgical Site Infections and Antimicrobial Resistance: https://www.ahajournals.org/doi/10.1161/01.cir.101.25.2916?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
12. RCT - Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs: https://jamanetwork.com/journals/jama/article-abstract/2810510 
13. NYU Langone Study - Preventing Surgical Site Infections: A Randomized, Open-Label Trial of Nasal Mupirocin Ointment and Nasal Povidone-Iodine Solution: https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=91dee3e1445adb80d533f2c210816a3285254e3a 
14. Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty: https://www.nejm.org/doi/full/10.1056/NEJMoa2301401
15. What Is the Primary Driver of Preoperative Vancomycin Use? It’s Not Methicillin-resistant Staphylococcus aureus—or Allergy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744972/ 
16. Drug allergy: a 2022 practice parameter update: https://www.jacionline.org/article/S0091-6749(22)01186-1/fulltext 
17. Perioperative use of cefazolin without preliminary skin testing in patients with reported penicillin allergy: https://www.surgjournal.com/article/S0039-6060(18)30307-6/abstract#%20 
18. Timing of Surgical Prophylaxis RCT: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30176-7/abstract 
19. Propensity Score-Weighted Analysis of Postoperative Infection in Patients With and Without Preoperative Urine Culture: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815528

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About X: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp

References

1. An analysis of antibacterial drug development trends in the United States, 1980-2019: Dheman N, et al. Clin Infect Dis. 2021 Dec 6;73(11):e4444-e4450. doi:10.1093/cid/ciaa859. PMID: 32584952.
2. Antibacterial R&D at a crossroads: we’ve pushed as hard as we can…now we need to start pulling!: Rex JH, Outterson K. Clin Infect Dis. 2021 Dec 6;73(11):e4451-4453. doi:10.1093/cid/ciaa852. PMID: 32584949.
3. No Patient Left Behind (website): https://www.nopatientleftbehind.org/ (many useful explainers of how the investment, innovation cycle, and drug pricing work)
4. ISPOR special task force report on defining elements of value in health care – a health economics approach: Lakdawalla DN, et al. Value Health. 2018 2018 Feb;21(2):131-139. doi: 10.1016/j.jval.2017.12.007. PMID: 29477390.
5. Generalized cost-effectiveness analysis to assess treatment value in hepatitis C: Chou JW, et al. Am J Manag Care. 2023 Dec;29(12):696-703. doi: 10.37765/ajmc.2023.89468. PMID: 38170486.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About X: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp

References

1. https://drive.google.com/file/d/1K0A4Bomhbcn7AZJ1JFOWW8EdEZq-aZcd/view?usp=sharing
2. https://drive.google.com/file/d/1PRoQzEKJ1c0pa1XFc4yasxsMhx2A1DFU/view?usp=sharing
3. Helpful antimicrobial lock review: Justo JA, Bookstaver PB. Infect Drug Resist. 2014 Dec 12;7:343-63. doi: 10.2147/IDR.S51388. PMID: 25548523.
4. LOCK IT-100 Trial: Agarwal AK, et al. Clin J Am Soc Nephrol. 2023 Nov 1;18(11):1446-1455. doi: 10.2215/CJN.0000000000000278. PMID: 37678222.
5. Cochrane review: Arechabala MC, et al. Cochrane Database Syst Rev. 2018 Apr 3;4(4):CD010597. doi: 10.1002/14651858.CD010597.pub2. PMID: 29611180.
6. Cost-effectiveness of ethanol lock ppx with newer dehydrated alcohol product: Raghu VK, et al. JPEN J Parenter Enteral Nutr. 2022 Feb;46(2):324-329. doi: 10.1002/jpen.2130. PMID: 33908050.
7. Antimicrobial lock development/implementation in a pediatric hospital: Zembles TN, et al. Am J Health Syst Pharm. 2018 Mar 1;75(5):299-303. doi: 10.2146/ajhp161056. PMID: 29472511.
8. Dr. Topf’s tweet surveying the prevalence of antimicrobial lock use in dialysis units
9. CRBSIs in hemodialysis patients before and during the COVID-19 pandemic: Johansen KL, et al. Clin J Am Soc Nephrol. 2022 Mar;17(3):429-433. doi: 10.2215/CJN.11360821. PMID: 35110377.
10. Antiseptic barrier caps review and meta-analysis: Gillis VELM, et al. Am J Infect Control. 2023 Jul;51(7):827-835. doi: 10.1016/j.ajic.2022.09.005. PMID: 36116679.

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Drs. Thomas Holland and Vance Fowler (@VanceFowler5) join Drs. Steven Tong (@syctong) and Erin McCreary (@ErinMcCreary) to discuss the ERADICATE study and the role of ceftobiprole for the treatment of complicated Staphylococcus aureus bacteremia. This session was recorded live on Tuesday, February 6th, 2024 featuring an international audience.

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Article: https://www.nejm.org/doi/full/10.1056/NEJMoa2300220

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Drs. Robert Bonomo, Ryan Shields (@ryankshields), and Erin McCreary (@ErinMcCreary) deep dive into the world of metallo-beta-lactamases. This riveting discussion is full of the nerdiest pub trivia nuggets and the “must know” details of novel beta lactams and beta-lactamase inhibitors, and their uses for MBLs. Funding for this podcast was provided by Shionogi Inc.

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References:

1. Urgent need for metallo B lactamase: DOI: 10.1016/S1473-3099(20)30868-9
2. NDM-9 Resistance to Taniborbactam: DOI 10.1016/S1473-3099(23)00069-5
3. AAC Taniborbactam inhibition of NDM-1: DOI 10.1128/aac.01332-23
4. OFID NDM E. coli with cefiderocol and aztreonam/avibactam resistance: DOI 10.1093/ofid/ofad276

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New accreditation standards making your head spin? Are you stressed and don’t know where to start? Well, on this episode of Breakpoints Drs. Arjun Srinivasan and Jose Alexander (Alex) join Luis Plaza from Let’s Talk Micro (@letstalkmicro1) and Dr. Jeannette Bouchard (@jlbouchard001) to breakdown what you need to know and where to start when it comes to the NHSN Antimicrobial Resistance (AR) module and the new College of American Pathologist’s standards.   Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/ 

References:

1. CDC AR Validation Guide: https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/aur/ar-validation-508.pdf
2. CLSI Toolkit: https://clsi.org/meetings/ast/breakpoints-in-use-toolkit/

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We are back with more exciting IDWeek 2023 content! If you listened to the last episode and want more? Than look no further.

Join your Breakpoints hosts, Drs. Erin McCreary (@ErinMcCreary), Julie Ann Justo (@julie_justo), and Jeannette Bouchard (@jlbouchard001) for a review of key pipeline agents at IDWeek and highlights from everyone’s favorite session “Clinical Trials That May Change Your Practice”.

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References:

1. Oral Amphotericin for Cryptococcal Meningitis: doi 10.1093/cid/ciad440
2. PALACE: doi 10.1001/jamainternmed.2023.2986
3. DoxyPEP: doi 10.1056/NEJMoa2211934
4. RSV Vaccine in Pregnancy: doi 10.1056/NEJMoa2216480
5. RSV Vaccines in Older Adults: doi 10.1056/NEJMoa2209604 and doi 10.1056/NEJMoa2213836
6. AURORA: doi 10.1093/cid/ciad709
7. Mycoses Mapping: doi 10.1093/cid/ciac882

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Need help narrowing down your IDWeek re-watch content? Or maybe you were unable to make IDWeek so you want the pharmacy driven highlights? Well, look no further, Breakpoints has what you need!   Join your Breakpoints hosts, Drs. Erin McCreary (@ErinMcCreary), Julie Ann Justo (@julie_justo), and Jeannette Bouchard (@jlbouchard001) for a review of some of the late breaking clinical trials presented at IDWeek 2023.   Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Google Podcasts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/    References: 1. Oral Fosfomycin vs IV BL/BLI/Carbapenem in cUTI: doi:10.1093/ofid/ofad500.002 2. Oral Fosfomycin for male UTIs: doi:10.3390/antibiotics11020198 and prostatitis: doi:10.1093/jac/dkz015 3. ATM-AVI for cIAIA or HAP/VAP (REVISIT): doi:10.1093/ofid/ofad500.2476 4. CAZ-AVI for neonates: doi:10.1093/ofid/ofad500.2473 5. ACORN RCT: doi:10.1001/jama.2023.20583

1. HARMONIE RCT: doi:10.1093/ofid/ofad500.005

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Drs. Nicholas Torney (@NPT_PharmD) and Sunish Shah join Dr. Jeannette Bouchard (@jlbouchard001) to discuss our next topic in our Dosing Consult series: BID vs TID dosing for metronidazole. Deep dive into the PK/PD and real-world application of this switch with experts in this dosing strategy.

References:

• Addition of anaerobic coverage in biliary infections: Addition of anaerobic coverage for treatment of biliary tract infections: a propensity score-matched cohort study
• Eggerthella lenta and Pipercillin-tazobactam: Eggerthella lenta Bloodstream Infections Are Associated With Increased Mortality Following Empiric Piperacillin-Tazobactam (TZP) Monotherapy: A Population-based Cohort Study
• Q12H Dose Schedule in Surgery Prophylaxis: Twelve-hourly dosage schedule for oral and intravenous metronidazole
• 2018 Clinical Data on Q12H Dosing in Mixed Infections: Clinical efficacy of 12-h metronidazole dosing regimens in patients with anaerobic or mixed anaerobic infections
• 2021 Clinical Data on Q12H Dosing: Three is a crowd: Clinical outcomes of a twice daily versus a thrice daily metronidazole dosing strategy from a multicenter study

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

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References:

• CAPSIL study: Effect of Preemptive Therapy vs Antiviral Prophylaxis on Cytomegalovirus Disease in Seronegative Liver Transplant Recipients With Seropositive Donors: A Randomized Clinical Trial - PubMed (nih.gov)
• Extended CAPSIL data: Association of CMV DNAemia with Long-Term Mortality in a Randomized Trial of Preemptive Therapy (PET) and Antiviral Prophylaxis (AP) for Prevention of CMV Disease in High-Risk Donor Seropositive, Recipient Seronegative (D+R-) Liver Transplant Recipients - PubMed (nih.gov)
• Kidney transplant review: A Systematic Review and Meta-analysis of Optimized CMV Preemptive Therapy and Antiviral Prophylaxis for CMV Disease Prevention in CMV High-Risk (D+R-) Kidney Transplant Recipients - PubMed (nih.gov)
• Letermovir vs Valganciclovir for Prevention in Kidney Transplant: Letermovir vs Valganciclovir for Prophylaxis of Cytomegalovirus in High-Risk Kidney Transplant Recipients: A Randomized Clinical Trial - PubMed (nih.gov)

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

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Drs. Paul Ambrose and Michael Dudley (@MikeMndudley) join Dr. Julie Ann Justo (@julie_justo) for a review of beta-lactamase inhibitor (BLI) pharmacokinetics & pharmacodynamics. They discuss factors affecting BLI’s restorative activity, the convoluted math behind establishing exposure-response relationships for BLIs, some geeky medicinal chemistry, and a little-known easter egg in the published literature.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

References

1. SIDP Insight on Tazobactam for ESBLs: Monogue M, et al. Pharmacotherapy. 2021 Oct;41(10):864-880. doi: 10.1002/phar.2623. PMID 34689349.
2. Tazobactam with cefepime: VanScoy BD, et al. Antimicrob Agents Chemother. 2017 Nov 22;61(12):e01052-17. doi: 10.1128/AAC.01052-17. PMID: 28947475.
3. Another great review of BLIs: Ambrose PG, et al. Curr Opin Pharmacol. 2017 Oct;36:86-93. doi: 10.1016/j.coph.2017.09.001. PMID: 29096172.
4. Meropenem-vaborbactam target attainment: Bhavnani SM, et al. Antimicrob Agents Chemother. 2022 Dec 20;66(12):e0213021. doi: 10.1128/aac.02130-21. PMID: 36374023.
5. Meropenem-vaborbactam pulmonary exposures: Wenzler E, et al. Antimicrob Agents Chemother. 2015 Dec;59(12):7232-9. doi: 10.1128/AAC.01713-15. PMID: 26349830.
6. Stand-alone BLI discussion based on CB-618: Ambrose PG, et al.. Antimicrob Agents Chemother. 2017 Nov 22;61(12):e00630-17. doi: 10.1128/AAC.00630-17. PMID: 28947474.
7. NDM-9 resistance to taniborbactam: Le Terrier C, et al. Lancet Infect Dis. 2023 Apr;23(4):401-402. doi: 10.1016/S1473-3099(23)00069-5. PMID: 36796395.
8. New boronate drugs and NDM: Lomovskaya O, et al. Antimicrob Agents Chemother. 2023 Aug 31:e0057923. doi: 10.1128/aac.00579-23. PMID: 37650617.
9. Helpful BLI PK-PD review: Crass R, Pai MP. Pharmacotherapy. 2019 Feb;39(2):182–195. doi: 10.1002/phar.2210. PMID 30589457.
10. Discovery of QPX7728 (Xeruborbactam): Hecker SJ, et al. J Med Chem. 2020 Jul 23;63(14):7491-7507. doi: 10.1021/acs.jmedchem.9b01976. PMID 32150407.
11. Xeruborbactam binding to PBPs directly: Lomovskaya O, et al. Antimicrob Agents Chemother. 2022 Feb 15;66(2):e0216821. doi: 10.1128/AAC.02168-21. PMID: 34902261.
12. Xeruborbactam predicted best by fAUC/MIC with oral ceftibuten: Tarazi Z, et al. Open Forum Infect Dis. Volume 9, Issue Supplement_2, December 2022, ofac492.666, https://doi.org/10.1093/ofid/ofac492.666 (Poster 614)
13. Xeruborbactam predicted best by fAUC/MIC with meropenem: Tarazi Z, et al. Open Forum Infect Dis. Volume 9, Issue Supplement_2, December 2022, ofac492.667, https://doi.org/10.1093/ofid/ofac492.667 (Poster 615)
14. First 2013 AAC paper on tazobactam with ceftolozane from Ambrose group: VanScoy B, et al. Antimicrob Agents Chemother. 2013 Jun;57(6):2809-14. doi: 10.1128/AAC.02513-12. PMID: 23629705.
15. Second 2013 AAC paper on tazobactam with ceftolozane from Ambrose group: Vanscoy B, et al. Antimicrob Agents Chemother. 2013 Dec;57(12):5924-30. doi: 10.1128/AAC.00656-13. PMID: 24041895.
16. Electric Telescope, 52 Class 530 Series 1080p LCD/HD; Samsung Group, Seoul, South Korea, available at: https://www.samsung.com/ca/support/model/LN52C530F1FXZC/
17. Tazobactam with Piperacillin from Ambrose group: Nicasio AM, et al. Antimicrob Agents Chemother. 2016 Mar 25;60(4):2075-80. doi: 10.1128/AAC.02747-15. PMID: 26787689.

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Drs. Jason Gallagher (@JGPharmD) and Melissa Johnson (@IDPharmacist) join Dr. Erin McCreary (@ErinMcCreary) to discuss one of the most talked about papers of the year: Antibiotic Myths for the Infectious Diseases Clinician. Tune in to hear these common myths debunked!

Antibiotic Myths for the Infectious Diseases Clinician: https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciad357/7194976?redirectedFrom=fulltext

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

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In this special episode of Breakpoints, pharmacist Hailie Uren joins Dr. Erin McCreary (@ErinMcCreary) to talk about the current practice of medicine in Ukraine, including the extremely drug-resistant war wound infections she frequently encounters.   You won’t want to miss this amazing insight, and can support UK-Med in Ukraine here: https://www.uk-med.org/donate-now

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

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In what has been described on Twitter as the “doing your own taxes of medicine,” Drs. Emily Heil (@emilylheil) and Andrew Fratoni (@AFratty) join Dr. Jillian Hayes (@thejillianhayes) to break down the ins and outs of sulfamethoxazole/trimethoprim dosing! Tune in for a discussion on the use of this agent for methicillin-resistant Staphylococcus aureus, gram-negatives, pneumocystis, and Stenotrophomonas maltophilia.

References:

1. Twitter Thread re: Bactrim dosing: https://twitter.com/IDdocAdi/status/1661174505702674432?s=20
2. PJP OI Guidelines: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/pneumocystis-0
3. IDSA Resistant Gram Negative Guidance Document: https://www.idsociety.org/globalassets/idsa/practice-guidelines/amr-guidance/1.0/idsa-amr-guidance-v3.0.pdf
4. (Lower doses of PJP Treatment): Butler-Laporte G, Smyth E, Amar-Zifkin A, Cheng M, McDonald E, Lee T. Low-dose TMP-SMX in the Treatment of Pneumocystis jirovecii Pneumonia: A Systematic Review and Meta-Analysis. Open Forum Infectious Diseases, Volume 7, Issue 5, May 2020, ofaa112, https://doi-org.proxy-hs.researchport.umd.edu/10.1093/ofid/ofaa112
5. (DS Vs SS for PJP PPX): Schneider MM, Nielsen TL, Nelsing S, et al. Efficacy and toxicity of two doses of trimethoprim-sulfamethoxazole as primary prophylaxis against Pneumocystis carinii pneumonia in patients with human immunodeficiency virus. Dutch AIDS Treatment Group. J Infect Dis. 1995;171(6):1632-1636. Available at: http://www.ncbi.nlm.nih.gov/pubmed/7769306.
6. General Bactrim PK/PD: Trubiano JA, Grayson ML. Trimethoprim and Trimethoprim-Sulfamethoxazole (Cotrimoxazole). Chapter 92, Kucers’ The Use of Antibiotics (7th Edition). Taylor & Francis, 2017.
7. (2014 IDSA SSTI Guidelines). PMID 24973422
8. Cadena J, Nair S, Henao-Martinez AF, Jorgensen JH, Patterson JE, Sreeramoju PV. Dose of trimethoprim-sulfamethoxazole to treat skin and skin structure infections caused by methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2011 Dec;55(12):5430-2. doi: 10.1128/AAC.00706-11. Epub 2011 Sep 19. PMID: 21930870; PMCID: PMC3232808.
9. Halilovic J, Heintz BH, Brown J. Risk factors for clinical failure in patients hospitalized with cellulitis and cutaneous abscess. J Infect. 2012 Aug;65(2):128-34. doi: 10.1016/j.jinf.2012.03.013. Epub 2012 Mar 21. PMID: 22445732.
10. Paul M, Bishara J, Yahav D, Goldberg E, Neuberger A, Ghanem-Zoubi N, Dickstein Y, Nseir W, Dan M, Leibovici L. Trimethoprim-sulfamethoxazole versus vancomycin for severe infections caused by meticillin resistant Staphylococcus aureus: randomised controlled trial. BMJ. 2015 May 14;350:h2219. doi: 10.1136/bmj.h2219. PMID: 25977146; PMCID: PMC4431679.
11. Lasko MJ, Gethers ML, Tabor-Rennie JL, Nicolau DP, Kuti JL. In Vitro Time-Kill Studies of Trimethoprim/Sulfamethoxazole against Stenotrophomonas maltophilia versus Escherichia coli Using Cation-Adjusted Mueller-Hinton Broth and ISO-Sensitest Broth. Antimicrob Agents Chemother. 2022 Mar 15;66(3):e0216721. doi: 10.1128/aac.02167-21. Epub 2022 Jan 10. PMID: 35007135; PMCID: PMC8923228.
12. Lasko MJ, Tabor-Rennie JL, Nicolau DP, Kuti JL. Trimethoprim/sulfamethoxazole pharmacodynamics against Stenotrophomonas maltophilia in the in vitro chemostat model. J Antimicrob Chemother. 2022 Oct 28;77(11):3187-3193. doi: 10.1093/jac/dkac304. PMID: 36101486.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

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In this special LIVE podcast episode, Drs. Jason Pogue (@jpogue1) and Erin McCreary (@Erin McCreary) present from MAD-ID 2023 (@MAD_ID_ASP) and give a rundown of some of the best ID papers, abstracts, studies, and other cool stuff from late 2022 and early 2023! They cover everything from #ECCMID2023 late breakers to published RCTs to stewardship (but NOT COVID-19!).

Download the slides to view as you listen along here: https://drive.google.com/file/d/130YsgVg9J9di41WVKnB3tBhScYNujUdi/view?usp=sharing

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

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Drs. Zack Nelson (@zacroBID), Alison Dittmer, and Michael Pulia (@DrMichaelPulia) join Dr. Jillian Hayes (@thejillianhayes) to discuss the ins and outs of antimicrobial stewardship in one of the busiest parts of the hospital: the emergency department! Tune in for a discussion on communication considerations in the ED, the role of lipoglycopeptides for common gram-positive syndromes, and a rapid-fire round discussing common stewardship interventions. This podcast was supported by an educational grant from Melinta Therapeutics.

References:

1. Pulia M, et al. Antimicrobial Stewardship in the Emergency Department. Emerg Med Clin N Am 2018;36(4):853-872. doi: 10.1016/j.emc.2018.06.012. PMID: 30297009.
2. Rech, Megan A et al. “PHarmacist Avoidance or Reductions in Medical Costs in Patients Presenting the EMergency Department: PHARM-EM Study.” Critical Care Explorations 2021;3(4):e0406. doi:10.1097/CCE.0000000000000406. PMID: 33912836.
3. Sacdal JPA, Cheon E et al. Oritavancin versus oral antibiotics for treatment of skin and skin structure infections in the emergency department. Am J Emerg Med 2022;60:223-224.
4. Jenkins TC, Jaukoos JS et al. Patterns of use and perceptions of an institution-specific antibiotic stewardship application among emergency department and urgent care clinicians. Infection Control and Hospital Epidemiology 2020;41:212-215.
5. Dretske D, Schulz L, Werner E, Sharp B, Pulia M. Effectiveness of oritavancin for management of skin and soft tissue infections in the emergency department: A case series. The American Journal of Emergency Medicine 2021;43:77-80. doi: 10.1016/j.ajem.2021.01.050. PMID: 33545550.
6. Paul M, Pulia M, Pulcini C. Antibiotic stewardship in the emergency department: not to be overlooked. Clin Microbiol Infect 2021;27(2):172-174. doi: 10.1016/j.cmi.2020.11.015. PMID: 33253938.
7. Baxa J, McCreary E, Schulz L, Pulia M. Finding the niche: An interprofessional approach to defining oritavancin use criteria in the emergency department. Am J Emerg Med. 2020;38(2):321-324. doi:10.1016/j.ajem.2019.158442.
8. Pulia MS, Hesse S, Schwei RJ, Schulz LT, Sethi A, Hamedani A. Inappropriate Antibiotic Prescribing for Respiratory Conditions Does Not Improve Press Ganey® Patient Satisfaction Scores in the Emergency Department. Open Forum Infect Dis 2020;7(6): ofaa214. doi:10.1093/ofid/ofaa214.
9. Pulia MS, Lindenauer PK. Annals for Hospitalists Inpatient Notes - A Critical Look at Procalcitonin Testing in Pneumonia. Ann Intern Med. 2021;174(6):HO2-HO3. doi:10.7326/M21-1913.
10. Redwood R, Knobloch MJ, Pellegrini DC, Ziegler MJ, Pulia M, Safdar N. Reducing unnecessary culturing: a systems approach to evaluating urine culture ordering and collection practices among nurses in two acute care settings. Antimicrob Resist Infect Control. 2018;7. doi:10.1186/s13756-017-0278-9.
11. Pulia MS, Schwei RJ, Hesse SP, Werner NE. Characterizing barriers to antibiotic stewardship for skin and soft-tissue infections in the emergency department using a systems engineering framework. Antimicrob Steward Healthc Epidemiol. 2022;2(1):e180. doi:10.1017/ash.2022.316.
12. May L, Gudger G, Armstrong P, et al. Multisite exploration of clinical decision making for antibiotic use by emergency medicine providers using quantitative and qualitative methods. Infect Control Hosp Epidemiol. 2014;35(9):1114-1125. doi:10.1086/677637.
13. May L, Cosgrove S, L’archeveque M, et al. A Call to Action for Antimicrobial Stewardship in the Emergency Department: Approaches and Strategies. Ann Emerg Med 2013;62(1):69-77.e2. doi: 10.1016/j.annemergmed.2012.09.002. PMID: 23122955.
14. Schoffelen T, Schouten JA, Hoogerwerf JJ, et al. Quality indicators for appropriate antimicrobial therapy in the emergency department: a pragmatic Delphi procedure. Clin Microbiol Infect 2021;27(2):210-214. doi: 10.1016/j.cmi.2020.10.027. PMID: 33144204.
15. Yadav K, Stahmer A, Mistry RD, May L. An Implementation Science Approach to Antibiotic Stewardship in Emergency Departments and Urgent Care Centers. Academic Emergency Medicine 2020; 27(1):31-42. doi: 10.1111/acem.13873. PMID: 31625653.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/   SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

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Drs. Kate Kyler (@kedkyler) and Amit Pai (@DosingMatters) join Dr. Jeannette Bouchard (@jlbouchard001) for a discussion on dosing antibiotics in children and adults affected by obesity! Learn when practitioners should be concerned about drug dosing, what disease states and populations matter most, when we should explore TDM, and more!

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

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Drs. Dahlia Blake (@dblake096), Owen Albin (@owenralb), and Ryan Rivosecchi join Dr. Erin McCreary (@ErinMcCreary) for a discussion on HAP and VAP! Tune in for a review of the role of dual anti-pseudomonal coverage, optimal anti-MRSA therapy, duration of therapy, and more!

This funding for this episode was provided by Shionogi Inc. 

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

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Drs. Emily Kirkpatrick, Paul Sax, and Jill Strayer join Dr. Rachel Britt to discuss their experiences using injectable long-acting antiretrovirals, especially cabotegravir/rilpivirine, in their clinics. Listen to learn not only about logistical challenges with these drugs, but also creative solutions to overcome them.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

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Drs. Jim Lewis, Mike Satlin (@MSatlin) and Jason Pogue (@jpogue1) are back with Dr. Erin McCreary (@ErinMcCreary) for the grand finale of our five-episode miniseries all about breakpoints! Join our panelists for a great discourse on breakpoint updates for non-fermenters.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.

Drs. Jim Lewis, Mike Satlin (@MSatlin) and Jason Pogue (@jpogue1) are back with Dr. Erin McCreary (@ErinMcCreary) for episode four of a five-episode miniseries all about breakpoints! Join our panelists for a magically delicious episode all about breakpoint updates on fluoroquinolones.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

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Drs. Jim Lewis, Mike Satlin (@MSatlin) and Jason Pogue (@jpogue1) are back with Dr. Erin McCreary (@ErinMcCreary) for episode three of a five-episode miniseries all about breakpoints! Join our panelists as they discuss breakpoint updates on aminoglycosides.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.

Drs. Jim Lewis, Mike Satlin (@MSatlin) and Jason Pogue (@jpogue1) are back with Dr. Erin McCreary (@ErinMcCreary) for episode two of a five-episode miniseries all about breakpoints! Join our panelists as they discuss breakpoint updates on piperacillin/tazobactam.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.

Drs. Jim Lewis, Mike Satlin (@MSatlin) and Jason Pogue (@jpogue1) join Dr. Erin McCreary (@ErinMcCreary) for episode one of a five-episode miniseries all about breakpoints!

Over the next five weeks, our panelists will cover breakpoint updates on piperacillin/tazobactam, aminoglycosides, fluoroquinolones, and non-fermenters. You won’t want to miss this series!

Our first episode will tackle questions related to breakpoints themselves – a seemingly mystical art! How does a breakpoint become a breakpoint? How often are breakpoints updated? How do we implement all of these recent breakpoint changes into clinical practice? Tune in for answers to these questions and more!

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

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Drs. Saima Aslam (@DocSaimaAslam) and Daria Van Tyne (@DariaVanTyne) join Dr. Rachel Britt (@RachelBPharmD) for a discussion on bacteriophage therapy! Tune in for a review of their role in therapy, logistical considerations, the future of phage therapy, and more!

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

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Episode Notes

Inspired by lamentations on Twitter, Drs. Bobbi Jo Stoner (@BobbiJo_Stoner), Jonathan Ryder (@JonathanRyderMD) and Sami El-Dalati join Dr. Jillian Hayes (@thejillianhayes) to hash out some of the controversies we encounter while managing infective endocarditis. Do we really need gentamicin and rifampin for all cases of staphylococcal prosthetic valve endocarditis? Where do oral antimicrobials fit into this disease state? Who should have a seat at the table to provide the most comprehensive care to these patients? Tune in for the answers to these questions and more!

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

References: IDSA/AHA Infective Endocarditis Guidelines: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000296 Deconstructing the Dogma: Systematic Literature Review and Meta-analysis of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve Endocarditis: https://pubmed.ncbi.nlm.nih.gov/36408468/ Twitter Poll – Gabe Vilchez (March 2021): https://twitter.com/IdVilchez/status/1372148761112240131?s=20&t=fYuyNWGmzZACWrpUb7Fp3g Survey of ID Physicians on Gent and Rifampin Use: https://pubmed.ncbi.nlm.nih.gov/32964063/ Bacteriological outcome of combination versus single-agent treatment for staphylococcal endocarditis: https://academic.oup.com/jac/article/52/5/820/760105 Treatment of experimental foreign body infection caused by methicillin-resistant Staphylococcus aureus: https://journals.asm.org/doi/abs/10.1128/AAC.34.12.2312 Successful therapy of experimental chronic foreign-body infection due to methicillin-resistant Staphylococcus aureus by antimicrobial combinations: https://journals.asm.org/doi/abs/10.1128/aac.35.12.2611 Rifampin Combination Therapy for Nonmycobacterial Infections: https://journals.asm.org/doi/10.1128/CMR.00034-09 ARREST Trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32456-X/fulltext Is Rifampin Use Associated With Better Outcome in Staphylococcal Prosthetic Valve Endocarditis? A Multicenter Retrospective Study: https://pubmed.ncbi.nlm.nih.gov/32706879/ Nephrotoxicity of vancomycin, alone and with an aminoglycoside: https://pubmed.ncbi.nlm.nih.gov/2351627/ Clinical Data on Daptomycin plus Ceftaroline versus Standard of Care Monotherapy in the Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia: https://journals.asm.org/doi/10.1128/AAC.02483-18 Multicenter Cohort of Patients With Methicillin-Resistant Staphylococcus aureus Bacteremia Receiving Daptomycin Plus Ceftaroline Compared With Other MRSA Treatments: https://academic.oup.com/ofid/article/7/1/ofz538/5691187 CERT Trial (in process): https://clinicaltrials.gov/ct2/show/NCT04886284 Rifampin for Surgically Treated Staphylococcal Infective Endocarditis: A Propensity Score-Adjusted Cohort Study: https://pubmed.ncbi.nlm.nih.gov/26872729/ A step-by-step guide to implementing a multidisciplinary endocarditis team: https://journals.sagepub.com/doi/10.1177/20499361211065596 Management of Infective Endocarditis in People Who Inject Drugs: A Scientific Statement from the American Heart Association: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001090?cookieSet=1 Infectious Complications of Addiction: A Call for a New Subspecialty Within Infectious Diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319263/ A Cross-sectional Analysis of Linezolid in Combination with Methadone or Buprenorphine as a Cause of Serotonin Toxicity: https://academic.oup.com/ofid/article/9/7/ofac331/6625822 POET Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1808312 Risk of New Bloodstream Infections and Mortality Among People Who Inject Drugs With Infective Endocarditis: https://pubmed.ncbi.nlm.nih.gov/32785635/ Comparing right- and left sided injection-drug related infective endocarditis: https://pubmed.ncbi.nlm.nih.gov/33441950/ Evaluation of Partial Oral Antibiotic Treatment for Persons Who Inject Drugs and Are Hospitalized With Invasive Infections: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745005/ Dalbavancin as Primary and Sequential Treatment for Gram-Positive Infective Endocarditis: 2-Year Experience at the General Hospital of Vienna: https://pubmed.ncbi.nlm.nih.gov/29659732/ Impact of the duration of antibiotic therapy on relapse and survival following surgery for active infective endocarditis: https://academic.oup.com/ejcts/article/55/4/760/5126415 Bacteriological Outcome after Valve Surgery for Active Infective Endocarditis: Implications for Duration of Treatment after Surgery: https://academic.oup.com/cid/article/41/2/187/529954 Long-term Risk of Hemorrhagic Stroke in Patients With Infective Endocarditis: A Danish Nationwide Cohort Study: https://academic.oup.com/cid/article/68/4/668/5039147 Sign of the Times: Updating Infective Endocarditis Diagnostic Criteria to Recognize Enterococcus faecalis as a Typical Endocarditis Bacterium: https://pubmed.ncbi.nlm.nih.gov/35262664/ Prevalence of colorectal disease in Enterococcus faecalis infective endocarditis: results of an observational multicenter study: https://pubmed.ncbi.nlm.nih.gov/31444092/

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Drs. Valerie Vaughn (@ValerieVaughnMD), Jason Newland (@JasonGNewland) and Libby Dodds Ashley (@The_Real_LDA) join Dr. Erin McCreary (@ErinMcCreary) for a discussion on how to harness the power of data to move through those common stewie struggles. Tune in for a review of common barriers, the art of communication within stewardship, and more!

This podcast is sponsored by bioMérieux.

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Your Breakpoints hosts, Drs. Erin McCreary (@ErinMcCreary), Julie Ann Justo (@julie_justo), Rachel Britt (@RachelBPharmD) and Jillian Hayes (@thejillianhayes) are back for a second week of IDWeek review. Tune in for publications that may change your practice, and a segment of I Feel Nerdy that is sure to Swiftly become one of your favorites!

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References: Bacterial: _  GRACE-VAP: https://pubmed.ncbi.nlm.nih.gov/35394515/ Follow-up Blood Cultures: https://pubmed.ncbi.nlm.nih.gov/36136334/  SABATO: https://clinicaltrials.gov/ct2/show/NCT01792804  ZeNix: https://pubmed.ncbi.nlm.nih.gov/36053506/   SHINE: https://pubmed.ncbi.nlm.nih.gov/35263517/    _Viral:   MYR301: doi: 10.1016/j.dld.2022.01.047, https://www.natap.org/2021/EASL/EASL_14.htm   STOMP: https://clinicaltrials.gov/ct2/show/NCT05534984   MINMON: https://pubmed.ncbi.nlm.nih.gov/35026142/  ANCHOR: https://pubmed.ncbi.nlm.nih.gov/35704479/  HPTN083: https://pubmed.ncbi.nlm.nih.gov/34379922/  HPTN084: https://pubmed.ncbi.nlm.nih.gov/35378077/  ATLAS-2M: https://pubmed.ncbi.nlm.nih.gov/34648734/  LAI-ART in an Urban HIV Clinic: https://pubmed.ncbi.nlm.nih.gov/35913500/    Fungal:   CandiSep: https://pubmed.ncbi.nlm.nih.gov/35708758/  1,3 BDG and GM as Diagnostic Tools: https://pubmed.ncbi.nlm.nih.gov/34173659/  Single-Dose Ampho for Crypto: Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis - PubMed (nih.gov) 

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Missing IDWeek already? Hoping for some new content to consume during your holiday travel plans? Have no fear – your IDWeek Breakpoints recap is here!

Join your Breakpoints hosts, Drs. Erin McCreary (@ErinMcCreary), Julie Ann Justo (@julie_justo), Rachel Britt (@RachelBPharmD) and Jillian Hayes (@thejillianhayes) for a review of some new trials and pipeline agents presented at IDWeek 2022.

Be sure to stay tuned for Part II, launching next Friday!

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Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

References:

1. Cortés-Penfield NW, Kulkarni PA. The History of Antibiotic Treatment of Osteomyelitis. Open Forum Infect Dis. 2019 Apr 8;6(5):ofz181. doi: 10.1093/ofid/ofz181. PMID: 31123692.
2. Bernard L, et al. Antibiotic Therapy for 6 or 12 Weeks for Prosthetic Joint Infection. N Engl J Med. 2021 May 27;384(21):1991-2001. doi: 10.1056/NEJMoa2020198. PMID: 34042388. (DATIPO trial)
3. Gallagher C, et al. Impact of Implementing an IV to PO Antibiotic Treatment Protocol for Orthopedic Infections ion Prescribing Habits and Health Utilization Outcomes. IDWeek 2022. Poster 909.
4. Febrile Podcast. Episode #31 – Truth or DAIR. 2022 Feb 28. https://febrilepodcast.com/episode-31-truth-or-dair/
5. Frank JM, et al. The Mark Coventry, MD, Award: Oral Antibiotics Reduce Reinfection After Two-Stage Exchange: A Multicenter, Randomized Controlled Trial. Clin Orthop Relat Res. 2017 Jan;475(1):56-61. doi: 10.1007/s11999-016-4890-4. PMID: 27387759.
6. Kelly MP, et al. Extended Oral Antibiotics Increase Bacterial Resistance in Patients Who Fail 2-Stage Exchange for Periprosthetic Joint Infection. J Arthroplasty. 2022 Aug;37(8S):S989-S996. doi: 10.1016/j.arth.2022.01.027. PMID: 35074446.
7. Payne J, et al. Inducing Antimicrobial Resistance with Long-term Antibiotics at Stage 2 Revision for Periprosthetic Joint Infection. IDWeek 2022. Poster 981.
8. Frost P, et al. Phototoxic potential of minocycline and doxycycline. Arch Dermatol. 1972 May;105(5):681-3. PMID: 5026677.
9. Lode H, et al. Comparative pharmacokinetics of cephalexin, cefaclor, cefadroxil, and CGP 9000. Antimicrob Agents Chemother. 1979 Jul;16(1):1-6. doi: 10.1128/AAC.16.1.1. PMID: 475366.
10. Sader HS, et al. In vitro activity of cefpodoxime compared with other oral cephalosporins tested against 5556 recent clinical isolates from five medical centers. Diagn Microbiol Infect Dis. 1993 Aug-Sep;17(2):143-50. doi: 10.1016/0732-8893(93)90025-3. PMID: 8243035.
11. Green S & Tsai YV. Precision Dosing of To-Marrow: Linezolid Therapeutic Drug Monitoring. ContagionLive: Bench to Bedside with SIDP. 2022 Nov 3. https://www.contagionlive.com/view/precision-dosing-of-to-marrow-linezolid-therapeutic-drug-monitoring

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Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

References

1. Macy E. Why Was There Ever a Warning Not to Use Cephalosporins in the Setting of a Penicillin "Allergy"? J Allergy Clin Immunol Pract. 2021 Nov;9(11):3929-3933. doi: 10.1016/j.jaip.2021.06.059. PMID: 34303019.
2. Liang EH, et al. Adverse Reactions Associated with Penicillins, Carbapenems, Monobactams, and Clindamycin: A Retrospective Population-based Study. J Allergy Clin Immunol Pract. 2020 Apr;8(4):1302-1313.e2. doi: 10.1016/j.jaip.2019.11.035. PMID: 31821919.
3. Macy E, Contreras R. Adverse reactions associated with oral and parenteral use of cephalosporins: A retrospective population-based analysis. J Allergy Clin Immunol. 2015 Mar;135(3):745-52.e5. doi: 10.1016/j.jaci.2014.07.062. PMID: 25262461.
4. Macy E, et al. Population-Based Incidence of New Ampicillin, Cephalexin, Cefaclor, and Sulfonamide Antibiotic "Allergies" in Exposed Individuals with and without Preexisting Ampicillin, Cephalexin, or Cefaclor "Allergies". J Allergy Clin Immunol Pract. 2022 Feb;10(2):550-555. doi: 10.1016/j.jaip.2021.10.043. PMID: 34757066.
5. Picard M, et al. Cross-Reactivity to Cephalosporins and Carbapenems in Penicillin-Allergic Patients: Two Systematic Reviews and Meta-Analyses. J Allergy Clin Immunol Pract. 2019 Nov-Dec;7(8):2722-2738.e5. doi: 10.1016/j.jaip.2019.05.038. PMID: 31170539.
6. Romano A, et al. Cross-reactivity and tolerability of aztreonam and cephalosporins in subjects with a T cell-mediated hypersensitivity to penicillins. J Allergy Clin Immunol. 2016 Jul;138(1):179-186. doi: 10.1016/j.jaci.2016.01.025. PMID: 27016799.
7. Romano A, et al. Cross-Reactivity and Tolerability of Cephalosporins in Patients with IgE-Mediated Hypersensitivity to Penicillins. J Allergy Clin Immunol Pract. 2018 Sep-Oct;6(5):1662-1672. doi: 10.1016/j.jaip.2018.01.020. PMID: 29408440.
8. Blumenthal KG, et al. The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk. Clin Infect Dis. 2018 Jan 18;66(3):329-336. doi: 10.1093/cid/cix794. PMID: 29361015.
9. Blumenthal KG, et al. Risk of meticillin resistant Staphylococcus aureus and Clostridium difficile in patients with a documented penicillin allergy: population based matched cohort study. BMJ. 2018 Jun 27;361:k2400. doi: 10.1136/bmj.k2400. PMID: 29950489.
10. Blumenthal KG, et al. Recorded Penicillin Allergy and Risk of Mortality: a Population-Based Matched Cohort Study. J Gen Intern Med. 2019 Sep;34(9):1685-1687. doi: 10.1007/s11606-019-04991-y. PMID: 31011962.
11. Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin "allergy" in hospitalized patients: A cohort study. J Allergy Clin Immunol. 2014 Mar;133(3):790-6. doi: 10.1016/j.jaci.2013.09.021. PMID: 24188976.
12. AAAI. Choosing Wisely. 2014 Mar 3. https://www.choosingwisely.org/clinician-lists/american-academy-allergy-asthma-immunlogy-non-beta-lactam-antibiotics-penicillin-allergy/
13. Jeffres MN, et al. Systematic review of professional liability when prescribing β-lactams for patients with a known penicillin allergy. Ann Allergy Asthma Immunol. 2018 Nov;121(5):530-536. doi: 10.1016/j.anai.2018.03.010. PMID: 29551402.
14. Macy E, et al. Association Between Removal of a Warning Against Cephalosporin Use in Patients With Penicillin Allergy and Antibiotic Prescribing. JAMA Netw Open. 2021 Apr 1;4(4):e218367. doi: 10.1001/jamanetworkopen.2021.8367. PMID: 33914051.
15. Blumenthal KG, et al. Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation. J Allergy Clin Immunol Pract. 2017 May-Jun;5(3):616-625.e7. doi: 10.1016/j.jaip.2017.02.019. PMID: 28483315.
16. Jeffres M. Penicillin and/or Beta-Lactam Allergy Tip Sheet & Cross-reactivity Table. https://drive.google.com/file/d/1cokYXnSDlO3vk8ke1LaalPz4iavuNSV8/view?usp=share_link
17. Khan DA, et al. Drug allergy: A 2022 practice parameter update. J Allergy Clin Immunol. 2022 Sep 17:S0091-6749(22)01186-1. doi: 10.1016/j.jaci.2022.08.028. Epub ahead of print. PMID: 36122788.
18. Guyer AC, et al. Allergy Electronic Health Record Documentation: A 2022 Work Group Report of the AAAAI Adverse Reactions to Drugs, Biologicals, and Latex Committee. J Allergy Clin Immunol Pract. 2022 Nov;10(11):2854-2867. doi: 10.1016/j.jaip.2022.08.020. PMID: 36151034.
19. Iammatteo M, et al. Safety and Outcomes of Oral Graded Challenges to Amoxicillin without Prior Skin Testing. J Allergy Clin Immunol Pract. 2019 Jan;7(1):236-243. doi: 10.1016/j.jaip.2018.05.008. PMID: 29802906.
20. Bavbek S, et al. Determinants of nocebo effect during oral drug provocation tests. Allergol Immunopathol (Madr). 2015 Jul-Aug;43(4):339-45. doi: 10.1016/j.aller.2014.04.008. PMID: 25088674.
21. DePestel DD, et al. Cephalosporin use in treatment of patients with penicillin allergies. J Am Pharm Assoc (2003). 2008 Jul-Aug;48(4):530-40. doi: 10.1331/JAPhA.2008.07006. PMID: 18653431.

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References Haidar G, Singh N. Fever of unknown origin. N Engl J Med 2022;386:463-77.

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Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

References

1. Hoenigl M, Sprute R, Egger M, et al. The antifungal pipeline: fosmanogepix, ibrexafungerp, olorofim, opelconazole, and rezafungin. Drugs. 2021;81(15):1703-29.

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Drs. Ann Falsey, Crystal Hodge (@Howzzeee) and Michael Ison (@MichaelGIsonMD) join Dr. Jillian Hayes (@thejillianhayes) for a review of non-COVID respiratory viruses. Tune in for a review of current epidemiological changes, the vaccine pipeline, and current treatment options. 

This episode was supported by an educational grant from Janssen Therapeutics, Division of Janssen Products, LP.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp

References

1. Community-acquired respiratory viruses in transplant patients (PMID 31511250)
2. Clinical Transplantation 2019 special issue on Transplant Infectious Diseases Guidelines: ](https://urldefense.com/v3/https:/onlinelibrary.wiley.com/toc/13990012/2019/33/9;!!OToaGQ!ujpO69U-82gjgidcyi6YshodQ4umKoYBRbC6wcHf-7QtOVoXotlCzZSwBl7eXjGal8O6D5qQIF8k7_GUOsi3weedNyWNXbw$)[https://onlinelibrary.wiley.com/toc/13990012/2019/33/9
3. ECIL-4 Fourth European Conference on Infections in Leukaemia (ECIL-4): Guidelines for Diagnosis and Treatment of Human Respiratory Syncytial Virus, Parainfluenza Virus, Metapneumovirus, Rhinovirus, and Coronavirus https://doi.org/10.1093/cid/cis844
4. JID RSV Supplements: https://academic.oup.com/jid/issue/226/Supplement_1, https://academic.oup.com/jid/issue/226/Supplement_2 
5. CID Precision Vaccinology Supplement: https://academic.oup.com/cid/issue/75/Supplement_1 
6. Net State of Immunosuppression (PMID 32803228)
7. Inflammatory and Infectious Syndromes Associated With Cancer Immunotherapies (PMID 30520987)
8. Biologic response modifiers (PMID 28263774)
9. Invasive fungal infections and targeted therapies in hematologic malignancies (PMID 34947040)
10. Impact of COVID-19 on Influenza vaccination strategies (PMID 35607766)
11. Zanamivir vs oseltamivir (PMID 35299245)
12. Peramivir vs oseltamivir (PMIDs 33447633, 33006445)
13. FLAGSTONE (PMID 35085510)
14. CAPSTONE-2 (PMID 32526195) 
15. Neuraminidase inhibitor benefits beyond 48 hours (PMID 33434667, 32898685, 24815805, 24268590)
16. Baloxavir for prophylaxis of household contacts (PMID 32640124)
17. Oral ribavirin for RSV in HCT (PMID 30202920)
18. Ribavirin for RSV and human metapneumovirus in HCT (PMID 32162389)
19. DAS181 for parainfluenza virus (PMID 33569576)

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This podcast was sponsored by an unrestricted medical education grant from Ferring Pharmaceuticals.

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In the second episode of Breakpoints' Dosing Consult series, Drs. Ryan Crass (@crasspofungin) and Amit Pai (@DosingMatters) join Dr. Jillian Hayes (@thejillianhayes) to break down the 5 Ws and 1 H of linezolid TDM. 

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Bibliography

1. Abdul-Aziz MH, et al. Intensive Care Med. 2020 Jun;46(6):1127-1153. doi: 10.1007/s00134-020-06050-1. Epub 2020 May 7. PMID: 32383061.
2. Abdul-Aziz MH, et al. Ther Drug Monit. 2022 Feb 1;44(1):19-31. doi: 10.1097/FTD.0000000000000940. PMID: 34750338.
3. Andes D, et al. Antimicrob Agents Chemother. 2002;46(11):3484-3489. doi:10.1128/AAC.46.11.3484-3489.2002. PMID: 12384354.
4. Bandín-Vilar E, et al. Clin Pharmacokinet. 2022;61(6):789-817. doi:10.1007/s40262-022-01125-2. PMID: 35699914.
5. Boak LM, Rayner CR, Grayson ML, et al. Clinical population pharmacokinetics and toxicodynamics of linezolid. Antimicrob Agents Chemother. 2014;58(4):2334-2343. doi:10.1128/AAC.01885-13. PMID: 24514086.  
6. Crass RL, et al. Antimicrob Agents Chemother. 2019 Jul 25;63(8):e00605-19. doi: 10.1128/AAC.00605-19. PMID: 31109977.  
7. Cojutti P, et al. Clin Pharmacokinet. 2018 Aug;57(8):989-1000. doi: 10.1007/s40262-017-0606-5. PMID: 29080937.
8. Dong HY, et al. Eur J Clin Microbiol Infect Dis. 2014;33(6):1029-1035. doi:10.1007/s10096-013-2041-3. PMID: 24515096. 
9. Matsumoto K, et al. Int J Antimicrob Agents. 2014;44(3):242-247. doi:10.1016/j.ijantimicag.2014.05.010. PMID: 25108880. 
10. Meagher AK, et al. Antimicrob Agents Chemother. 2003;47(2):548-553. doi:10.1128/AAC.47.2.548-553.2003. PMID: 12543657. 
11. Obach RS. Drug Metab Dispos. 2022 Apr;50(4):413-421. doi: 10.1124/dmd.121.000776. PMID: 35042700.
12. Pea F, et al. Antimicrob Agents Chemother. 2010 Nov;54(11):4605-10. doi: 10.1128/AAC.00177-10. Epub 2010 Aug 23. PMID: 20733043. 
13. Pea F, et al. J Antimicrob Chemother. 2012 Aug;67(8):2034-42. doi: 10.1093/jac/dks153. Epub 2012 May 2. PMID: 22553142.
14. Rao GG, et al. Ther Drug Monit. 2020 Feb;42(1):83-92. doi: 10.1097/FTD.0000000000000710. PMID: 31652190.
15. Rayner CR, et al. Clin Pharmacokinet. 2003;42(15):1411-23. doi: 10.2165/00003088-200342150-00007. PMID: 14674791.
16. Taubert M, et al. Antimicrob Agents Chemother. 2016 Aug 22;60(9):5254-61. doi: 10.1128/AAC.00356-16. PMID: 27324768. 
17. Society of Infectious Diseases Pharmacists | Contagion Live

Laboratories that offer linezolid assay results:

1. Infectious Disease Pharmacokinetics Laboratory (https://idpl.pharmacy.ufl.edu/ )
2. Atlantic Diagnostics Laboratories (https://atlanticdiagnosticlaboratories.com/lab-tests )
3. National Jewish Health PK Laboratory (ttps://www.nationaljewish.org/for-professionals/diagnostic-testing/adx/tests/linezolid,-level)

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Handout: https://drive.google.com/file/d/1OdYP9WpNGFmslw_G_vTPYF0cJZoxN8jo/view

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References PMIDs

1. IMPRESU: 34620666
2. TARGET: 35106617
3. MERINO-2: 34395716
4. Tazobactam SIDP Insight: 34689349
5. TMP-SMX vs FQ for Steno: 35097154
6. Elexacaftor-Tezacaftor-Ivacaftor: 35142340
7. Antibiotic Inertia: 34596206
8. Antibiotic Overuse at Discharge: 34554249
9. Pharmacist-Driven TOC: 35536577
10. Tele-stewardship: 34141816
11. MRSA Surveillance Culture: 29340593
12. MRSA Screen Durability: 33788910
13. Antifungal Pipeline: 34626339
14. Antifungal Susceptibility Testing: 347784889
15. Posa vs Vori for Aspergillosis: 33549194
16. AMBITION: 35320642
17. FLAGSTONE: 35085510
18. SOLSTICE: 34864943
19. Probiotics for Primary Prevention: 33972996
20. Probiotics and VAP: 34546300
21. SER-109: 35045228
22. Bayesian vs First-Order Vanc AUC: 35134264
23. Beta-lactam Admin Order: 34606585
24. Candida Endophthalmitis: 34293405
25. FUO Review: 35108471
26. 7 vs 14 Days for Male UTI: 34313686

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This podcast was sponsored by an unrestricted medical education grant from Abbvie.

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References Shields RK, et al. Clin Infect Dis. 2022;ciac097. doi: 10.1093/cid/ciac097.

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References

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2. STI treatment guidelines. Centers for Disease Control and Prevention. https://www.cdc.gov/std/treatment-guidelines/default.htm. Published 2021. Accessed May 12, 2022. 
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17. Hepatitis C State of Medicaid Access: https://stateofhepc.org

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References

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3. Barber KE, Loper JT, Morrison AR, Stover KR, Wagner JL. Impact of Obesity on Ceftriaxone Efficacy. Diseases. 2020 Jul 9;8(3):27. doi: 10.3390/diseases8030027. PMID: 32660113; PMCID: PMC7563366.
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5. Herrera-Hidalgo L, Lomas-Cabezas JM, López-Cortés LE, Luque-Márquez R, López-Cortés LF, Martínez-Marcos FJ, de la Torre-Lima J, Plata-Ciézar A, Hidalgo-Tenorio C, García-López MV, Vinuesa D, Gutiérrez-Valencia A, Gil-Navarro MV, De Alarcón A. Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT. J Clin Med. 2021 Dec 21;11(1):7. doi: 10.3390/jcm11010007. PMID: 35011748; PMCID: PMC8745305.
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7. Whittles LK, White PJ, Paul J, Didelot X. Epidemiological Trends of Antibiotic Resistant Gonorrhoea in the United Kingdom. Antibiotics (Basel). 2018 Jul 13;7(3):60. doi: 10.3390/antibiotics7030060. PMID: 30011825; PMCID: PMC6165062.
8. Ackerman A, Zook NR, Siegrist JF, Brummitt CF, Cook MM, Dilworth TJ. Comparison of Clinical Outcomes among Intensive Care Unit Patients Receiving One or Two Grams of Ceftriaxone Daily. Antimicrob Agents Chemother. 2020 May 21;64(6):e00066-20. doi: 10.1128/AAC.00066-20. PMID: 32205348; PMCID: PMC7269488.
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13. Kang N, Housman ST, Nicolau DP. Assessing the Surrogate Susceptibility of Oxacillin and Cefoxitin for Commonly Utilized Parenteral Agents against Methicillin-Susceptible Staphylococcus aureus: Focus on Ceftriaxone Discordance between Predictive Susceptibility and in Vivo Exposures. Pathogens. 2015 Jul 30;4(3):599-605. doi: 10.3390/pathogens4030599. PMID: 26264030; PMCID: PMC4584275.
14. Gern BH, Greninger AL, Weissman SJ, Stapp JR, Tao Y, Qin X. Continued in vitro cefazolin susceptibility in methicillin-susceptible Staphylococcus aureus. Ann Clin Microbiol Antimicrob. 2018 Feb 20;17(1):5. doi: 10.1186/s12941-018-0257-x. PMID: 29463249; PMCID: PMC5819674.
15. Bremmer DN, Balada-Llasat JM, Goff DA, Bauer KA. Ceftriaxone Etest non-susceptible methicillin susceptible Staphylococcus aureus time-kill responses. Diagn Microbiol Infect Dis. 2017 Jun;88(2):192-194. doi: 10.1016/j.diagmicrobio.2017.02.019. Epub 2017 Mar 2. PMID: 28291629.
16. Kosowska-Shick K, McGhee PL, Appelbaum PC. Affinity of ceftaroline and other beta-lactams for penicillin-binding proteins from Staphylococcus aureus and Streptococcus pneumoniae. Antimicrob Agents Chemother. 2010 May;54(5):1670-7. doi: 10.1128/AAC.00019-10. Epub 2010 Mar 1. PMID: 20194704; PMCID: PMC2863635.
17. Palmer SM, Kang SL, Cappelletty DM, Rybak MJ. Bactericidal killing activities of cefepime, ceftazidime, cefotaxime, and ceftriaxone against Staphylococcus aureus and beta-lactamase-producing strains of Enterobacter aerogenes and Klebsiella pneumoniae in an in vitro infection model. Antimicrob Agents Chemother. 1995 Aug;39(8):1764-71. doi: 10.1128/AAC.39.8.1764. PMID: 7486916; PMCID: PMC162823.
18. Craig WA. Interrelationship between pharmacokinetics and pharmacodynamics in determining dosage regimens for broad-spectrum cephalosporins. Diagn Microbiol Infect Dis. 1995 May-Jun;22(1-2):89-96. doi: 10.1016/0732-8893(95)00053-d. PMID: 7587056.
19. Garot D, Respaud R, Lanotte P, Simon N, Mercier E, Ehrmann S, Perrotin D, Dequin PF, Le Guellec C. Population pharmacokinetics of ceftriaxone in critically ill septic patients: a reappraisal. Br J Clin Pharmacol. 2011 Nov;72(5):758-67. doi: 10.1111/j.1365-2125.2011.04005.x. PMID: 21545483; PMCID: PMC3243010.
20. Joynt GM, Lipman J, Gomersall CD, Young RJ, Wong EL, Gin T. The pharmacokinetics of once-daily dosing of ceftriaxone in critically ill patients. J Antimicrob Chemother. 2001 Apr;47(4):421-9. doi: 10.1093/jac/47.4.421. PMID: 11266414.
21. Van Wart SA et al., ICAAC 2009, poster # A1-010
22. Housman ST, Sutherland CA, Nicolau DP. Pharmacodynamic profile of commonly utilised parenteral therapies against meticillin-susceptible and meticillin-resistant Staphylococcus aureus collected from US hospitals. Int J Antimicrob Agents. 2014 Sep;44(3):235-41. doi: 10.1016/j.ijantimicag.2014.05.012. Epub 2014 Jun 24. PMID: 25052866.
23. Zelenitsky SA, Beahm NP, Iacovides H, Ariano RE, Zhanel G. Limitations of ceftriaxone compared with cefazolin against MSSA: an integrated pharmacodynamic analysis. J Antimicrob Chemother. 2018 Jul 1;73(7):1888-1894. doi: 10.1093/jac/dky120. PMID: 29635472.
24. Paul M, Zemer-Wassercug N, Talker O, Lishtzinsky Y, Lev B, Samra Z, Leibovici L, Bishara J. Are all beta-lactams similarly effective in the treatment of methicillin-sensitive Staphylococcus aureus bacteraemia? Clin Microbiol Infect. 2011 Oct;17(10):1581-6. doi: 10.1111/j.1469-0691.2010.03425.x. Epub 2010 Dec 14. PMID: 21073629.
25. Carr DR, Stiefel U, Bonomo RA, Burant CJ, Sims SV. A Comparison of Cefazolin Versus Ceftriaxone for the Treatment of Methicillin-Susceptible Staphylococcus aureus Bacteremia in a Tertiary Care VA Medical Center. Open Forum Infect Dis. 2018 May 18;5(5):ofy089. doi: 10.1093/ofid/ofy089. PMID: 30568987; PMCID: PMC5961173.

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References

• Clinical and Laboratory Standards Institute. Access Our Free Resources: M100 and M60. Accessed at https://clsi.org/standards/products/free-resources/access-our-free-resources/
• Gallagher JC, et al. Open Forum Infect Dis. 2018 Oct 31;5(11):ofy280. doi: 10.1093/ofid/ofy280. PMID: 30488041.
• Castan B, et al. Infect Dis Now. 2021 Sep;51(6):532-539. doi: 10.1016/j.idnow.2021.05.003. Epub 2021 May 17. PMID: 34015539.
• Cultrera R, et al. Antibiotics (Basel). 2020 Sep 24;9(10):640. doi: 10.3390/antibiotics9100640. PMID: 32987821.
• Strich JR, et al. Clin Infect Dis. 2021 Feb 16;72(4):611-621. doi: 10.1093/cid/ciaa061. PMID: 32107536.
• Montravers P, Bassetti M. Curr Opin Infect Dis. 2018 Dec;31(6):587-593. doi: 10.1097/QCO.0000000000000490. PMID: 30299359.
• Strich JR, Heil EL, Masur H. J Infect Dis. 2020 Jul 21;222(Suppl 2):S119-S131. doi: 10.1093/infdis/jiaa221. PMID: 32691833.
• Kumar A, et al. Crit Care Med. 2006 Jun;34(6):1589-96. doi: 10.1097/01.CCM.0000217961.75225.E9. PMID: 16625125.
• Hibbard ML, et al. Surg Infect (Larchmt). 2010 Oct;11(5):427-32. doi: 10.1089/sur.2009.046. PMID: 20818984.
• Rosa RG, Goldani LZ, dos Santos RP. BMC Infect Dis. 2014 May 23;14:286. doi: 10.1186/1471-2334-14-286. PMID: 24884397.
• Benanti GE, et al. Antimicrob Agents Chemother. 2019 Jan 29;63(2):e01813-18. doi: 10.1128/AAC.01813-18. PMID: 30509935.

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References

• 2022 ACCP Global Conference on Clinical Pharmacy. https://www.accp.com/meetings/abstracts.aspx
• Alhazzani W, Alshahrani M, Alshamsi F, Aljuhani O, Eljaaly K, Hashim S, et al. The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section. J Infect Public Health. 2022;15(1):142-151. doi:10.1016/j.jiph.2021.10.005.
• Brink AJ, Messina AP, Feldman C, et al. Antimicrobial stewardship across 47 South African hospitals: an implementation study. Lancet Infect Dis. 2016;16(9):1017-1025. doi:10.1016/S1473-3099(16)30012-3
• Goff DA, Ashiru‐Oredope D, Cairns KA, et al. Global contributions of pharmacists during the COVID‐19 pandemic. J Am Coll Clin Pharm. Published online October 2, 2020:10.1002/jac5.1329. doi:10.1002/jac5.1329
• Eljaaly K, Elarabi S, Alshehri S, Nix DE. Impact of requiring re-authorization of restricted antibiotics on day three of therapy. J Antimicrob Chemother 2018;73(2):527-530. doi:10.1093/jac/dkx384.
• Korayem GB, Badreldin HA, Eljaaly K, et al. Clinical pharmacy definition, required education, training and practice in Saudi Arabia: A position statement by the Saudi society of clinical pharmacy. Saudi Pharm J. 2021;29(11):1343-1347. doi:10.1016/j.jsps.2021.09.008.
• International Pharmaceutical Federation Development Goals: Antimicrobial Stewardship. https://developmentgoals.fip.org/dg17/
• Messina AP, van den Bergh D, Goff DA. Antimicrobial Stewardship with Pharmacist Intervention Improves Timeliness of Antimicrobials Across Thirty-three Hospitals in South Africa. Infect Dis Ther. 2015;4(Suppl 1):5-14. doi:10.1007/s40121-015-0082-x
• Open Access BSAC eBook "Antimicrobial Stewardship: From Principles to Practice". https://www.bsac.org.uk/antimicrobialstewardshipebook/BSAC-AntimicrobialStewardship-FromPrinciplestoPractice-eBook.pdf
• Open Access BSAC course "Antimicrobial Stewardship for the Gulf, Middle East and North Africa". https://www.futurelearn.com/courses/antimicrobial-stewardship-for-the-middle-east
• Saudi Society of Clinical Pharmacy Infectious Disease Pharmacy Specialty Network. https://sscp.org.sa/infectious-disease/
• World Health Organization. Antimicrobial Stewardship Programmes in Health-Care Facilities in Low- and Middle-Income Countries: A WHO Practical Toolkit. World Health Organization; 2019. Accessed March 9, 2022. http://apps.who.int/iris/handle/10665/329404

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References:

• https://aspr.hhs.gov/TestToTreat/Documents/Fact-Sheet.pdf
• Torres, N. S., Abercrombie, J. J., Srinivasan, A., Lopez-Ribot, J. L., Ramasubramanian, A. K., & Leung, K. P. (2016). Screening a commercial library of pharmacologically active small molecules against staphylococcus aureus biofilms. Antimicrobial Agents and Chemotherapy, doi:10.1128/AAC.00377-16
• ASPR. (2022). COVID-19 therapeutics locator. Retrieved from https://covid-19-therapeutics-locator-dhhs.hub.arcgis.com/
• Dunn, A. (2021). Texas appeals court: Judge had no authority to order ivermectin for patient suffering from COVID-19 aftereffects. Retrieved from https://www.law.com/texaslawyer/2021/11/22/texas-appeals-court-judge-had-no-authority-to-order-ivermectin-for-patient-suffering-from-covid-aftereffects/
• Services, Howard Fischer Capitol Media. (). Pharmacists would have to fill ivermectin prescriptions for COVID under arizona proposal. Arizona Daily Star Retrieved from https://tucson.com/news/local/pharmacists-would-have-to-fill-ivermectin-prescriptions-for-covid-under-arizona-proposal/article_eca12e7c-5781-11ec-a775-cb73d778d4fb.html
• Sexton, A. (2022, -01-19). Bill would make it easier to obtain ivermectin in new hampshire. Wmur Retrieved from https://www.wmur.com/article/ivermectin-new-hampshire-state-house-bill/38817240
• Saunders, J. (2022). No ‘legal right’ to force use of ivermectin, court says. Retrieved from https://www.clickorlando.com/news/local/2022/01/29/no-legal-right-to-force-use-of-ivermectin-court-says/
• Tidd, J. (2022, -01-27). Kansas bill would force pharmacists to fill ivermectin, hydroxychloroquine as off-label COVID treatment. The Topeka Capital-Journal Retrieved from https://www.cjonline.com/story/news/coronavirus/2022/01/25/kansas-politicians-off-label-ivermectin-hydroxychloroquine-covid-treatment-pharmacists/9198489002/

This podcast was sponsored by an unrestricted medical education grant from Paratek.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

References:

1. www.doi.org/10.1093/cid/ciaa241
2. www.doi.org/10.1164/rccm.200604-571ST
3. www.doi.org/10.1136/thoraxjnl-2015-207360
4. www.doi.org/10.1136/thoraxjnl-2017-210927
5. www.doi.org/10.1093/ofid/ofaa415
6. www.doi.org/10.1093/ofid/ofab002
7. https://clinicaltrials.gov/ct2/show/NCT04922554

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

References

1. Infectious Diseases Society of America Guidance on the Treatment of Extended-Spectrum β-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR-P. aeruginosa) - PubMed (nih.gov)
2. Infectious Diseases Society of America Guidance on the Treatment of AmpC β-lactamase-Producing Enterobacterales, Carbapenem-Resistant Acinetobacter baumannii, and Stenotrophomonas maltophilia Infections - PubMed (nih.gov)
3. An Overview of the Treatment of Less Common Non-Lactose-Fermenting Gram-Negative Bacteria
4. Alterations of the Oral Microbiome and Cumulative Carbapenem Exposure Are Associated With Stenotrophomonas maltophilia Infection in Patients With Acute Myeloid Leukemia Receiving Chemotherapy

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• Instagram: @SIDPharm (https://www.instagram.com/sidpharm/)
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• LinkedIn: https://www.linkedin.com/company/sidp/

References:

1. PRO: Testing for ESBL production is necessary for ceftriaxone-non-susceptible Enterobacterales: perfect should not be the enemy of progress - PubMed (nih.gov)
2. CON: Testing for ESBL production is unnecessary for ceftriaxone-resistant Enterobacterales - PubMed (nih.gov)
3. Infectious Diseases Society of America Guidance on the Treatment of Extended-Spectrum β-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR-P. aeruginosa) - PubMed (nih.gov)
4. Infectious Diseases Society of America Guidance on the Treatment of AmpC β-lactamase-Producing Enterobacterales, Carbapenem-Resistant Acinetobacter baumannii, and Stenotrophomonas maltophilia Infections - PubMed (nih.gov)

Drs. Timothy Gauthier (@IDstewardship) and Jillian Hayes (@thejillianhayes) join Dr. Zahra Kassamali Escobar (@zkePharmD) to recap some IDWeek 2021 highlights on social media and antimicrobial stewardship.

The views and opinions expressed in this podcast are that of the speakers and do not necessarily reflect those of any past, current, or potential future employer.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ 

References:

1. Vosoughi S et al. The spread of true and false news online. Science 2018;359:1146-1151. doi: 10.1126/science.aap9559.
2. Solis Arce JS et al. COVID-19 vaccine acceptance and hesitancy in low-and middle-income countries. Nature Medicine 2021;27:1385-1394. doi: 10.1038/s41591-021-01454-y.
3. Metlay JP et al. Tensions in antibiotic prescribing: pitting social concerns against the interests of individual patients. J Gen Intern Med 2002;17(2):87-94. doi: 10.1046/j.1525-1497.2002.10711.x.
4. Wang et al. Development of Multifaceted Antimicrobial Stewardship Curriculum for Undergraduate Medical Education: The Antibiotic Stewardship, Safety, utilization, Resistance, and Evaluation (ASSURE) Elective. _Open Forum Infect Dis _2021;8(6): ofab231. https://doi.org/10.1093/ofid/ofab231.
5. Charani E et al. Understanding the Determinants of Antimicrobial Prescribing Within Hospitals: The Role of “Prescribing Etiquette.” Clin Infect Dis 2013;57(2):188-196. doi: 10.1093/cid/cit212.
6. Lines TH et al. Driving antimicrobial use improvement: attitudes of providers of adult hospital care on optimal attribution and feedback. Infect Control Hosp Epidemiol 2018;39(8):983-985. doi: 10.1017/ice.2018.113.
7. Teshome BF et al. Duration of Exposure to Antipseudomonal B-Lactam Antibiotics in the Critically Ill and Development of New Resistance. Pharmacotherapy 2019;39(3):261-270. doi: 10.1002/phar.2201.
8. Teshome BF et al. Evaluation of a ceiling effect on the association of new resistance development to antipseudomonal beta-lactam exposure in the critically ill. Infect Control Hosp Epidemiol 2020;41(4):484-485.
9. Leone M et al. De-escalation versus continuation of empirical antimicrobial treatment in severe sepsis: a multicenter non-blinded randomized noninferiority trial. Intensive Care Med 2014;40: 1399-1408. doi: 10.1007/s00134-014-3411-8.
10. Stevens V et al. Cumulative antibiotic exposures over time and the risk of Clostridium difficile infection. Clin Infect Dis 2011;53(1):42-48. doi: 10.1093/cid/cir301.
11. Bhalodi A et al. Impact of antimicrobial therapy on the gut microbiome. J Antimicrob Chemother 2019;74(Suppl 1):i6-i15. doi: 10.1093/jac/dky530.

Drs. Keith Rodvold and Taylor Morrisette (@TayMorrisette) join Dr. Julie Ann Justo (@julie_justo) to discuss ID pharmacy fellowships, their pros and cons compared to other post-graduate training opportunities, the ID "pharmily tree," and Mai Tais.

Find more information on ID pharmacy fellowships available in the United States here: -SIDP Fellowship Listings -ACCP Directory of Residencies, Fellowships, and Graduate Training Programs

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References:

1. Sinert et al. Guidance for Safe and Appropriate Use of Antibiotics in Hospice Using a Collaborative Decision Support Tool. Accessed October 6, 2021. https://oce-ovid-com.laneproxy.stanford.edu/article/00129191-202008000-00005/HTMLA
2. Albrecht JS, McGregor JC, Fromme EK, Bearden DT, Furuno JP. A Nationwide Analysis of Antibiotic Use in Hospice Care in the Final Week of Life. Journal of Pain and Symptom Management. 2013;46(4):483-490. doi:10.1016/j.jpainsymman.2012.09.010
3. Furuno JP, Noble BN, Fromme EK. Should we refrain from antibiotic use in hospice patients? Expert Review of Anti-infective Therapy. 2016;14(3):277-280. doi:10.1586/14787210.2016.1128823
4. Servid SA, Noble BN, Fromme EK, Furuno JP. Clinical Intentions of Antibiotics Prescribed Upon Discharge to Hospice Care. Journal of the American Geriatrics Society. 2018;66(3):565-569. doi:10.1111/jgs.15246
5. Gaw CE, Hamilton KW, Gerber JS, Szymczak JE. Physician Perceptions Regarding Antimicrobial Use in End-of-Life Care. Infection Control & Hospital Epidemiology. 2018;39(4):383-390. doi:10.1017/ice.2018.6
6. Broom J, Broom A, Good P, Lwin Z. Why is optimisation of antimicrobial use difficult at the end of life? Internal Medicine Journal. 2019;49(2):269-271. doi:10.1111/imj.14200
7. Kwon KT. Implementation of Antimicrobial Stewardship Programs in End-of-Life Care. Infect Chemother. 2019;51(2):89-97. doi:10.3947/ic.2019.51.2.89
8. Datta R, Topal J, McManus D, et al. Perspectives on antimicrobial use at the end of life among antibiotic stewardship programs: A survey of the Society for Healthcare Epidemiology of America Research Network. Infection Control & Hospital Epidemiology. 2019;40(9):1074-1076. doi:10.1017/ice.2019.194
9. Lopez S, Vyas P, Malhotra P, et al. A Retrospective Study Analyzing the Lack of Symptom Benefit With Antimicrobials at the End of Life. Am J Hosp Palliat Care. 2021;38(4):391-395. doi:10.1177/1049909120951748
10. Ito H. Antibiotics in end-of-life care: What is the driving factor? Infectious Diseases Now. Published online July 7, 2021. doi:10.1016/j.idnow.2021.07.003
11. Kates OS, Krantz EM, Lee J, et al. Association of Physician Orders for Life-Sustaining Treatment With Inpatient Antimicrobial Use at End of Life in Patients With Cancer. Open Forum Infectious Diseases. 2021;8(8). doi:10.1093/ofid/ofab361
12. Hickman SE, Nelson CA, Moss AH, Tolle SW, Perrin NA, Hammes BJ. The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form. J Am Geriatr Soc. 2011; 59(11): 2091–2099. doi:10.1111/j.1532-5415.2011.03656.x.
13. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Diseases, Volume 62, Issue 10, 15 May 2016, Pages e51–e77, https://doi.org/10.1093/cid/ciw118

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References:

1. Polack FP, Thomas SJ, Kitchin N, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med 2020;383:2603-2615.
2. Baden LR, El Sahly HM, Essink B, et al. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N Engl J Med 2021;384:403-416.
3. Sadoff J, Gray G, Vandebosch A, et al. Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19. N Engl J Med 2021
4. Rosenblum HG, Hadler SC, Moulia D, et al. Use of COVID-19 Vaccines After Reports of Adverse Events Among Adult Recipients of Janssen (Johnson & Johnson) and mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna): Update from the Advisory Committee on Immunization Practices — United States, July 2021. MMWR Morb Mortal Wkly Rep 2021;70:1094-1099. DOI: http://dx.doi.org/10.15585/mmwr.mm7032e4external icon.
5. Rapaka RR, Hammershaimb EA, Neuzil KM. Are some COVID vaccines better than others? Interpreting and comparing estimates of efficacy in trials of COVID-19 vaccines [published online ahead of print, 2021 Mar 6]. Clin Infect Dis. 2021;ciab213. doi:10.1093/cid/ciab213
6. ACIP Website: https://www.cdc.gov/vaccines/acip/index.html
7. Marcelin JR, Swartz TH, Bernice F, et al. Addressing and Inspiring Vaccine Confidence in Black, Indigenous, and People of Color (BIPOC) during the COVID-19 Pandemic. [published online ahead of print, 2021 Aug 9]. Open Forum Infect Dis. 2021. Doi: 10.1093/ofid/ofab417
8. Abdul-Mutakabbir JC, Casey S, Jews V, et al. A three-tiered approach to address barriers to COVID-19 vaccine delivery in the Black community. Lancet Glob Health. 2021 Jun;9(6):e749-e750. doi: 10.1016/S2214-109X(21)00099-1. Epub 2021 Mar 10.

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References:

1. https://pubmed.ncbi.nlm.nih.gov/32383061/ 2.    https://clicktime.symantec.com/3BcGw6g11AZY2rSUu7KpT1D7Vc?u=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F34136822%2F3. https://pubmed.ncbi.nlm.nih.gov/33480024/

2. https://pubmed.ncbi.nlm.nih.gov/32910809/

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References:

Fluoroquinolone Prophylaxis 

• Bucaneve et al. Levofloxacin to prevent bacterial infection in patients with cancer and neutropenia. N Engl J Med 2005; 353:977-87. DOI: 10.1056/NEJMoa044097 
• Cullen et al. Antibacterial prophylaxis after chemotherapy for solid tumors and lymphomas. N Engl J Med 2005; 353:988-98. DOI: 10.1056/NEJMoa050078 
• Drayson et al. Levofloxacin prophylaxis in patients with newly diagnosed myeloma (TEAMM): a multicenter, double-blind, placebo-controlled, randomized, phase 3 trial. Lancet Oncology  2019; 20(12):1760-72. DOI: 10.1016/S1470-2045(19)30506-6
• Satlin et al. Colonization with fluoroquinolone-resistant enterobacterales decreases the effectiveness of fluoroquinolone prophylaxis in hematopoietic cell transplant recipients. Clin Infect Dis 2021 May 6. doi: 10.1093/cid/ciab404. 

Antibiotic Treatment and Microbiome Implications

• Aguilar-Guisado M, et al. Optimisation of empirical antimicrobial therapy in patients with haemotological malignancies and febrile neutropenia (How Long study): an open-label, randomized, controlled, phase 4 trial. Lancet Haematol. 2017 Dec;4(12):e573-83. doi: 10.1016/S2352-3026(17)30211-9.
• Shono et al. Gut microbiome injury in allogeneic haematopoietic stem cell transplantation. Nat Rev Cancer. 2018;18(5):283-95. doi: 10.1038/nrc.2018.10. 
• Weber et al. Microbiome disruption induced by early use of broad-spectrum antibiotics is an independent risk factor of outcome after allogeneic stem cell transplantation. Biol Blood Marrow Transplant. 2017;23(5):845-52. doi: 10.1016/j.bbmt.2017.02.006 
• Pinato et al. Association of prior antibiotic treatment with survival and response to immune checkpoint inhibitor therapy in patients with cancer. JAMA Oncol. 2019;5(12):1774-78. doi:10.1001/jamaoncol.2019.2785  

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> Show notes:

• Mary’s paper: Microbiology Comment Nudge Improves Pneumonia Prescribing - PubMed (nih.gov)
• CDC Key Activities and Roles for Microbiology Lab Staff in Antibiotic Stewardship Programs: Key Activities and Roles for Microbiology Laboratory Staff in Antibiotic Stewardship Programs Updated: August 2020 (cdc.gov)
• CDC Selective Reporting: Selective Reporting of Antimicrobial Susceptibility Testing Results: A Primer for Antibiotic Stewardship Programs (cdc.gov)
• CLSI M100
• EUCAST Breakpoints: EUCAST: Clinical breakpoints and dosing of antibiotics
• USCAST Breakpoints: Breakpoints - USCAST

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Dr. Susan Davis (@IDPharmProf), Dr. Emily Spivak (@EmilySpivak), and Dr. Minkey Wungwattana (@minkeyw) join Dr. Erin McCreary (@ErinMcCreary) to discuss individual and shared experiences operationalizing COVID-19 monoclonal antibody therapy across their institutions and states. They tackle big and small hurdles from finding ways to ensure equitable distribution to pronouncing the drug names!

This episode was sponsored by an unrestricted grant from Regeneron Pharmaceuticals.

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References:

1. Sutton J, Stevens V, Chang NN et al. Oral β-Lactam Antibiotics vs Fluoroquinolones or Trimethoprim-Sulfamethoxazole for Definitive Treatment of Enterobacterales Bacteremia From a Urine Source. JAMA Netw Open. 2020 Oct 1;3(10):e2020166.
2. Punjabi C, Tien V, Meng C, et al. Oral Fluoroquinolone or Trimethoprim-Sulfamethoxazole vs ß-Lactams as Step-Down Therapy for Enterobacteriaceae Bacteremia: Systematic Review and Meta-analysis, Open Forum Infect Dis 2019; 6(10):ofz364.
3. Tamma PD, Conley AT, Cosgrove SE, et al. Association of 30-Day Mortality With Oral Step-Down vs Continued Intravenous Therapy in Patients Hospitalized With Enterobacteriaceae Bacteremia. JAMA Intern Med 2019; 179(3):316-323.
4. Mercuro NJ, Stogsdill P, Wungwattana M. Retrospective analysis comparing oral stepdown therapy for enterobacteriaceae bloodstream infections: fluoroquinolones versus beta-lactams. Int J Antimicrob Agents 2018;51(5)687-692.
5. Kutob LF, Justo JA, Bookstaver BA et al. Effectiveness of oral antibiotics for definitive therapy of Gram-negative bloodstream infections. Int J Antimicrob Agents 2016 Nov;48(5):498-503.
6. Mogle BT, Beccari MV, Steele JM, et al. Clinical considerations for oral beta-lactams as step-down therapy for Enterobacteriaceae bloodstream infections. Expert Opin Pharmacother. 2019 Jun;20(8):903-907.
7. Migils C, Rhodes NJ, Kuti JL, et al. Defining the impact of severity of illness on time above the MIC threshold for cefepime in Gram-negative bacteraemia: a 'Goldilocks' window. Int J Antimicrob Agents 2017;50(3):487-490.
8. Sandberg T, Englund G, Lincoln K, Nilsson LG. Randomised double-blind study of norfloxacin and cefadroxil in the treatment of acute pyelonephritis. Eur J Clin Microbiol Infect Dis. 1990;9(5):317-323.
9. Mahoney MV, Swords KE. Fluoroquinolones: Friends or Foe? Clin Infect Dis. Clin Infect Dis. 2021 Feb 19:ciab150.
10. Arensman K, Shields M, Beganovic M, et al. Fluoroquinolone versus beta-lactam oral step-down therapy for uncomplicated streptococcal bloodstream infections. Antimicrob Agents Chemother 2020;64(11):e01515-20. 
11. Seaton RA, Ritchie ND, Robb F, et al. From 'OPAT' to 'COpAT': implications of the OVIVA study for ambulatory management of bone and joint infection. J Antimicrob Chemother. 2019 Aug 1;74(8):2119-2121.

Timestamps

1:16 - Panel introductions 3:19 - Fidaxomicin vs PO vancomycin for first occurrence 7:21 - Fidaxomicin cost effectiveness 11:26 - Factors to consider for health systems when considering switch to fidaxomicin 14:23 - Fidaxomicin vs PO vancomycin for recurrences 17:52 - Role of pulsed and tapered PO vancomycin 19:57 - Role of fecal microbiota transplant (FMT) 22:24 - Challenges of FMT and where pharmacy fits in 27:27 - Bezlotoxumab 31:54 - Feasibility issues with bezlotoxumab and strategies to address them 35:25 - CDI prophylaxis 40:28 - Stewardship's role in reducing C. difficile infections

References

Fidaxomicin Cost-effectiveness

• Reveles KR, et al. Pharmacotherapy. 2017;37(12):1489-97.
• Watt M, et al. Infection. 2016;44(5):599-606.
• Cornely OA, et al. J Antimicrob Chemother. 2018;73(9):2529-39.
• Rubio-Terres C, et al. Eur J Clin Microbiol Infect Dis. 2019;38(6):1105-11.

Bezlotoxumab

• Wilcox MH, et al. N Engl J Med. 2017;376:305-17.
• Oksi J, et al. Eur J Clin Microbiol Infect Dis. 2019;38(10):1947-52.
• Hengel RL, et al. Open Forum Infect Dis. 2020;7(4):ofaa097.

Bezlotoxumab Cost-effectiveness

• Salavert M, et al. Adv Ther. 2018;35(11):1920-34.
• Prabhu VS, et al. Clin Infect Dis. 2018;66(3):355-62.

Primary prophylaxis 

• Pereiras MA, et al. Biol Blood Marrow Transplant. 2017; 23:S395. 
• Ganetsky A, et al. Clin Infect Dis. 2019;68(12):2003-2009.
• Mullane KM, et al. Clin Infect Dis. 2019; 68(2):196–203.

Secondary prophylaxis  

• Carignan A, et al. Am J Gastroenterol. 2016;111:1834-1840.
• Van Hise NW, et al. Clin Infect Dis. 2016;63:651-653.
• Splinter et al. Ann Pharmacother. 2018;52:113-119.
• Knight EM, et al. J Pharm Pract. 2019;:897190019825994.
• Morrisette T, et al. Biol Blood Marrow Transplant. 2019;25(10):2091-2097.

Time stamps: 00:00 Intro, guest bios 03:54 Procalcitonin 10:06 Pneumococcal and legionella antigen testing 16:30 Outpatient CAP therapy 23:40 Newer agents 31:18 Inpatient CAP therapy 39:09 Atypical coverage for admitted patients 44:27 Beta-lactam combination therapy 46:58 Ceftaroline vs ceftriaxone for pneumococcal pneumonia 55:23 Steroid use in CAP

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Join Dr. Julie Szymczak @julieszymczak, Dr. Emily Heil @emilylheil, Dr. Zahra Kassamali Escobar @zkepharmd, and Dr. Erin McCreary @erinmccreary, for a discussion on stewardship burnout—what is it, who is at risk for it, and what can we do about it?

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Antimicrobial stewardship is often an inpatient effort and overlooked at transitions of care. Dr. April Dyer (@aprildyerid) and Dr. Rachel Kenney (@rkenneypharmd) share insight with host Dr. David Ha (@DHpharmD) on current practice and barriers, and strategies for pharmacists to bring antimicrobial stewardship in the discharge process. 

Episode content:

• 00:14: Welcome and introductions:
• 04:39: Project overview: "Developing Patient Safety Outcome Measures and Measurement Tools for Antimicrobial Stewardship Program”
• 06:45: Scope of the problem (Scarpato et al.)
• 07:56: Michigan data (Vaughn et al.)
• 09:13: Building a business case
• 12:32: Where to Start?
• 12:54: Henry Ford Health System experience
• 15:18: IT solutions
• 17:22: 1% rule
• 20:26: Identifying and engaging key players
• 20:47: Outpatient pharmacy
• 22:29: Skilled nursing facilities
• 23:19: Case management relationship
• 24:23: Barriers to implementation
• 29:08: Quantifying total duration 
• 30:00: Identify electronic methods to capture total duration therapy attributable to hospitalization
• 32:16: CDC recommendation "Use the shortest effective antibiotic duration" 
• 33:16: Final remarks & acknowledgements
• 34:38: Outro

References:

1. Scarpato SJ, Timko DR, Cluzet VC, et al. An Evaluation of Antibiotic Prescribing Practices Upon Hospital Discharge. Infection Control and Hospital Epidemiology. 2017;38(3):353-355. doi:10.1017/ice.2016.276
2. Madaras-Kelly KJ, Burk M, Caplinger C, et al. Total duration of antimicrobial therapy in veterans hospitalized with uncomplicated pneumonia: Results of a national medication utilization evaluation. Journal of Hospital Medicine. 2016;11(12):832-839. doi:10.1002/jhm.2648
3. Feller J, Lund BC, Perencevich EN, et al. Post-discharge oral antimicrobial use among hospitalized patients across an integrated national healthcare network. Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2020;26(3):327-332. doi:10.1016/j.cmi.2019.09.016
4. Daniels LM, Weber DJ. Interventions to improve antibiotic prescribing at hospital discharge: A systematic review. Infection Control and Hospital Epidemiology. Published online September 1, 2020:1-4. doi:10.1017/ice.2020.367
5. Vaughn VM, Gandhi TN, Chopra V, et al. Antibiotic Overuse after Hospital Discharge: A Multi-Hospital Cohort Study. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. Published online September 11, 2020. doi:10.1093/cid/ciaa1372
6. Dyer AP, Dodds Ashley E, Anderson DJ, et al. Total duration of antimicrobial therapy resulting from inpatient hospitalization. Infection Control and Hospital Epidemiology. 2019;40(8):847-854. doi:10.1017/ice.2019.118
7. Bianchini ML, Kenney RM, Lentz R, Zervos M, Malhotra M, Davis SL. Discharge Delays and Costs Associated with Outpatient Parenteral Antimicrobial Therapy for High priced Antibiotics. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. Published online October 31, 2019. doi:10.1093/cid/ciz1076

Disclosures Dr. April Dyer and Rachel Kenney report no relevant financial disclosures. SIDP reports no relevant financial disclosures. 

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Papers discussed:

1) Van Duin D, et al. Lancet Infect Dis. 2020 Jun;20(6):731-741. doi: 10.1016/S1473-3099(19)30755-8. 2) Livermore DM, et al. Clin Infect Dis. 2020 Feb 6;ciaa122. doi: 10.1093/cid/ciaa122. 3) Falcone M, et al. Clin Infect Dis. 2020 May 19;ciaa586. doi: 10.1093/cid/ciaa586. 4) Lodise TP, et al. J Antimicrob Chemother. 2020 May 28;dkaa197. doi: 10.1093/jac/dkaa197. 5) O’Donnell JN, et al. Clin Ther. 2020 Jul 16;S0149-2918(20)30315-5. doi: 10.1016/j.clinthera.2020.06.005. 6) Abdul-Aziz MH, et al. Intensive Care Med. 2020 Jun;46(6):1127-1153. doi: 10.1007/s00134-020-06050-1. 7) Cusumano JA, et al. Am J Health Syst Pharm. 2020 Jul 7;77(14):1104-1112. doi: 10.1093/ajhp/zxaa128. 8) Roberts JA, et al. Clin Infect Dis. 2020 Mar 9;ciaa224. doi: 10.1093/cid/ciaa224. 9) Ackerman A, et al. Antimicrob Agents Chemother. 2020 May 21;64(6):e00066-20. doi: 10.1128/AAC.00066-20. 10) Tong SYC, et al. JAMA. 2020 Feb 11;323(6):527-537. doi: 10.1001/jama.2020.0103. 11) Jones BE, et al. JAMA Intern Med. 2020 Feb 17;180(4):552-560. doi: 10.1001/jamainternmed.2019.7495. 12) Cheng MP, et al. Clin Infect Dis. 2020 Jul 15;ciaa1000. doi: 10.1093/cid/ciaa1000.

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Papers discussed:

1) Rybak MJ, et al. Am J Health Syst Pharm. 2020 May 19;77(11):835-864. doi: 10.1093/ajhp/zxaa036. 2) Scheetz MH. Am J Health Syst Pharm. 2020 May 19;77(11):810-811. doi: 10.1093/ajhp/zxaa076. 3) Alosaimy S, et al. Clin Infect Dis. 2020 July 27;ciaa1039. doi: 10.1093/cid/ciaa1039. 4) Rhee C, et al. Clin Infect Dis. 2020 May 6;ciaa059. doi: 10.1093/cid/ciaa059. 5) Heil EL, et al. Pharmacotherapy. 2020 Apr;40(4):368-371. doi: 10.1002/phar.2384. 6) Townsend SR, et al. Clin Infect Dis. 2020 May 6;ciaa458. doi: 10.1093/cid/ciaa458. 7) Satlin MJ, et al. Clin Infect Dis. 2020 Feb 13;ciaa121. doi: 10.1093/cid/ciaa121. 8) Pogue JM, et al. Antimicrob Agents Chemother. 2020 Jan 27;64(2):e01495-19. doi: 10.1128/AAC.01495-19. 9) Ambrose PG, et al. Open Forum Infect Dis. 2020 Mar 13;7(7):ofaa084. doi: 10.1093/ofid/ofaa084. 10) Singh N, et al. JAMA. 2020 Apr 14;323(14):1378-1387. doi: 10.1001/jama.2020.3138. 11) van Delden C, et al. Clin Infect Dis. 2020 Jan 9;ciz1113. doi: 10.1093/cid/ciz1113. 12) Niederman MS, et al. Lancet Infect Dis. 2020 Mar;20(3):330-340. doi: 10.1016/S1473-3099(19)30574-2. 13) von Dach E, et al. JAMA. 2020 Jun 2;323(21):2160-2169. doi: 10.1001/jama.2020.6348. 14) Mergenhagen KA, et al. Antimicrob Agents Chemother. 2020 Feb 21;64(3):e02167-19. doi: 10.1128/AAC.02167-19.

For BCIDP credit, visit https://sidp.org/BCIDP

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Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Get involved with the Peggy Lillis Foundation: https://peggyfoundation.org/get-involved/take-action/

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CDC Poster: https://www.cdc.gov/antibiotic-use/community/pdfs/Hospital-Pharmacist-Poster-508.pdf

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CDC Core Elements 2019: https://www.cdc.gov/antibiotic-use/healthcare/pdfs/hospital-core-elements-H.pdf

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Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

CORRECTION: Piperacillin-tazobactam was dosed 4.5g IV every 6 hours in the Merino trial.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

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Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

This podcast is powered by Pinecast.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/

This podcast is powered by Pinecast.