Breakpoints

Dr. Ed Septimus, a board-certified physician from Texas A&M and Harvard, and Whitney Buckel, an antimicrobial stewardship expert at Intermountain Health, discuss innovative EHR tools for improving antibiotic use. They share insights on optimizing antibiotic order systems and managing penicillin allergies within EHRs. The duo emphasizes the importance of real-time alerts and collaboration for enhancing patient safety. Additionally, they reveal exciting details about the INSPIRE trials, showcasing advancements in healthcare through technology.

Drs. Cesar Arias (@SuperBugDoc) and Katie Barber join Dr. Julie Ann Justo (@julie_justo) to discuss what is hot-off-the-presses for gram-positive bacterial infections and it’s a total party vibe! They review the latest news for recent and ongoing clinical trials (DOTS, DISRUPT, and SNAP trials), discuss hope for novel clinical tests of the cefazolin inoculum effect in staphylococci, and explore the fascinating changes in virulence and potential therapeutic options for the most challenging enterococci. 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 Climate Change and Antimicrobial Resistance. Editors in Conversation Podcast. American Society for Microbiology. Oct 2023. Is More Better? The Role of Combination Therapy for MRSA. Breakpoints Podcast Episode #30. Society of Infectious Diseases Pharmacists. Turner NA, et al. DOTS: Dalbavancin as an Option for Treatment of Staphylococcus aureus Bacteremia. ESCMID Global 2024. April 2024. NCT04775953. 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. 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. @snap_trial tweet of Breaking News. Aug 2024. Investigator Resources for the SNAP trial. Sept 2024: https://www.snaptrial.com.au/for-investigators#interim 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. 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. 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. 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. 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. This podcast is powered by Pinecast.

In this discussion, experts Chuck Peloquin, a TB treatment guideline contributor from the University of Florida, and Gerry Davies, an infection pharmacology professor at the University of Liverpool, delve into the complexities of rifampin dosing. They debate whether higher doses improve outcomes and explore toxicity thresholds. The duo also discusses alternative rifamycins and management strategies for patients with complications. Tune in for insights on optimizing treatment through therapeutic drug monitoring, especially for those with concurrent infections.

Drs. Jim Rhodes and Molly Steed join host Jeannette Bouchard to discuss all things related to optimal dosing of daptomycin. This podcast episode provides insight on why dosing matters with this antibiotic, especially with certain organisms (looking at you, E. faecium), why weight matters with dosing, and what that pesky CPK means. 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: Fixed-dose daptomycin in Staphylococcus aureus: doi 10.1002/phar.4602 High dose daptomycin for VRE: doi 10.1093/cid/ciw815 This podcast is powered by Pinecast.

In this engaging discussion, Dr. Erica Stohs, an infectious diseases physician and policy advisor, Dr. Ryan Stevens, a pharmacist specializing in antimicrobial stewardship, and Jayme McRae, a clinical pharmacology consultant, dive into the nuances of antibiotic stewardship. They share best practices for managing outpatient antibiotic use, the importance of clear communication during patient transitions, and innovative strategies like the 'viral RX pad.' The trio also addresses challenges like diagnosing infections in elderly patients and the role of pharmacists in enhancing care.

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

Drs. Jeffrey Pearson and Jason Pogue join Dr. Jeannette Bouchard as they take on all things tetracyclines. Starting with tetracycline, they walk through differences between each generation and drug in this class, from dosing all the way to pertinent resistance mechanisms. You will not want to miss out on this one! This podcast was supported by an unrestricted grant from Paratek Pharmaceuticals Inc. 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

Dr. Yohei Doi, a leading expert in antimicrobial resistance from the University of Pittsburgh, and Dr. Emily Heil, a professor and antimicrobial stewardship coordinator at the University of Maryland, discuss the complexities of treating Acinetobacter baumannii, particularly its carbapenem-resistant form (CRAB). They highlight innovative treatment options, including promising drug combinations, and delve into the challenges faced in clinical practice. Real-world experiences and research insights offer listeners a nuanced understanding of this formidable pathogen.

Experts in infectious diseases and UTIs discuss challenges in diagnosis, urine analysis nuances, white blood cell thresholds, 'pill in the pocket' strategy, evolving landscape of uncomplicated vs. complicated UTIs, new antibiotics, and diagnostic uncertainties in UTI treatment.

In this lively discussion, Dr. Emily Heil, a leading infectious diseases specialist, and Mandee Noval, a presenter of ID literature, unveil the latest advancements in infectious diseases from MAD-ID 2024. They delve into ventilator-associated pneumonia prevention studies and the complexities of antibiotic stewardship. Highlights include findings on MRSA treatment interactions and novel STI prophylaxis with doxycycline. The duo also celebrates new UK regulations on antibiotic usage, urging thoughtful practices in the field.