Breakpoints

Breakpoints joins forces with CMI Communications’ Communicable podcast to discuss the highly anticipated SNAP trial updates presented at ESCMID Global 2025. Hosts Drs. Erin McCreary and Angela Huttner interview SNAP trial investigators, Drs. Joshua Davis and Steven Tong, on results from penicillin-susceptible and methicillin-susceptible Staphylococcus aureus domains. 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.

Dr. Jeannette Bouchard is joined by experts Dr. Romney Humphries, Emily Fox, and Matt Miller to discuss the hot topic of blood culture stewardship and the details of how these experts persevered through the recent blood culture bottle shortage that caused chaos throughout health care institutions at the end of 2024! This medical education was provided by an education grant from bioMerieux. References: Fabre BCx Stewardship Article doi: 10.1128/JCM.01005-21 ED Bcx Stewardship doi: 10.1016/j.ajic.2024.04.198 CT Surgery Stewardship doi: 10.1093/icvts/ivaf005 Every Crisis is an Opportunity doi:  10.1093/ofid/ofae479 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

Drs. Pier Giorgio Cojutti and Navaneeth Narayanan join Dr. Megan Klatt to break down what you need to know about amoxicillin/clavulanate dosing. Tune in to learn more about the PK/PD of amoxicillin and clavulanic acid, how we landed on certain ratios for the treatment of common infections, strategies to optimize dosing for serious infections, and more! References: 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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.

Dr. Brent Richards joins Dr. Erin McCreary to discuss the growing capability for artificial intelligence (AI) and big data in the healthcare industry. What is AI and machine learning, how can these tools enhance patient care, and what can we expect in the future from this space?   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/

Dr. Amy Mathers, a microbiology expert and IDSA guidance author, joins Dr. Julie Ann Justo, a clinical pharmacist specializing in infectious diseases, for an insightful discussion. They explore the challenges of treating Stenotrophomonas maltophilia, a tricky pathogen known for its resistance. The conversation delves into effective combination therapies and the significance of updated treatment guidelines. They also examine pharmacokinetics, particularly the efficacy of tetracyclines and fluoroquinolones, while emphasizing the importance of tailored approaches for vulnerable patient populations.

Drs. Henry “Chip” Chambers and Warren Rose join Dr. Megan Klatt to tackle rifampin dosing for gram-positive infections. In this episode, they break down rifampin synergy studies and discuss what is the optimal dosing of rifampin for challenging gram-positive bacterial cases, in particular Staphylococcus aureus infections with or without retained hardware/devices.   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: 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. 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. 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.

Nico Cortes-Penfield, an expert in infectious diseases, Jessica Seidelman, a hospital epidemiologist, and Kerry LaPlante, a pioneering pharmacist, delve into the complexities of biofilms in prosthetic joint infections. They discuss the challenges in eradicating biofilms with antibiotics and explore innovative non-pharmacologic strategies like bacteriophages and electromagnetism. Their insights shed light on the need for tailored treatment approaches and the ongoing evolution of testing methods to combat these persistent infections effectively.

Dive into the latest breakthroughs in infectious disease research! Discover how AI is revolutionizing the detection of hospital-acquired infections and learn about groundbreaking HIV prevention strategies for young women. The conversation also covers innovative vaccination techniques, new antifungal therapies, and advancements in pediatric care. Plus, explore the exciting developments in EBV treatments post-transplant. It's a treasure trove of insights for anyone passionate about infectious diseases!

The hosts enthusiastically recap highlights from ID Week 2024, focusing on crucial findings like optimal antibiotic durations for bloodstream infections. They explore groundbreaking trials on maternal microbiome impacts on infant health and innovations in pediatric RSV prevention. A lively discussion on enhancing diversity in antimicrobial stewardship education showcases a successful program. Finally, the panel shares humorous moments from the conference, making it clear that science and laughter go hand-in-hand in advancing infectious disease practices.

Drs. Anne-Grete Märtson, Megan Wimmer, and Evan Clemens join Dr. Erin McCreary to tackle the one of the hottest debates among providers taking care of immunocompromised patients, valganciclovir dosing! Learn all about the history of valganciclovir dosing, what is valganciclovir’s PK/PD target, and even valganciclovir therapeutic drug monitoring. References: 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. 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. This podcast is powered by Pinecast.