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Breakpoints

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Oct 20, 2023 • 1h 20min

#86 – The Robin to Your Batman: Ensuring Adequate Beta-lactamase Inhibitor Exposure to Restore Beta-lactam Activity

Episode Notes 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 SIDP Insight on Tazobactam for ESBLs: Monogue M, et al. Pharmacotherapy. 2021 Oct;41(10):864-880. doi: 10.1002/phar.2623. PMID 34689349. 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. 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. 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. 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. 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. 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. New boronate drugs and NDM: Lomovskaya O, et al. Antimicrob Agents Chemother. 2023 Aug 31:e0057923. doi: 10.1128/aac.00579-23. PMID: 37650617. Helpful BLI PK-PD review: Crass R, Pai MP. Pharmacotherapy. 2019 Feb;39(2):182–195. doi: 10.1002/phar.2210. PMID 30589457. 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. 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. 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) 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) 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. 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. Electric Telescope, 52 Class 530 Series 1080p LCD/HD; Samsung Group, Seoul, South Korea, available at: https://www.samsung.com/ca/support/model/LN52C530F1FXZC/ 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. 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.
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31 snips
Sep 15, 2023 • 1h 1min

#85 – Who You Gonna Call? Mythbusters! Antibiotic Myths for Infectious Diseases Clinicians

Dr. Jason Gallagher, an infectious disease pharmacist, and Dr. Melissa Johnson, an expert in infectious disease pharmacy, join Dr. Erin McCreary to debunk widespread antibiotic myths. They explore how social media sparked vital discussions among clinicians and review eight common misconceptions regarding antibiotic efficacy. Critical flaws in past testing are revealed, alongside the importance of evidence-based practices. They also tackle physician hesitance in prescribing effective treatments and discuss the reevaluation of guidelines for endocarditis, all while making the topic engaging and accessible.
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Aug 18, 2023 • 44min

#84 – Antimicrobial Stewardship and Disaster Medicine: Perspectives from Ukraine

Episode Notes 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 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.
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Jul 21, 2023 • 53min

#83 – Dosing Consult: Sulfamethoxazole/trimethoprim

Episode Notes 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: Twitter Thread re: Bactrim dosing: https://twitter.com/IDdocAdi/status/1661174505702674432?s=20 PJP OI Guidelines: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/pneumocystis-0 IDSA Resistant Gram Negative Guidance Document: https://www.idsociety.org/globalassets/idsa/practice-guidelines/amr-guidance/1.0/idsa-amr-guidance-v3.0.pdf (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 (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. 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. (2014 IDSA SSTI Guidelines). PMID 24973422 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. 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. 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. 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. 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 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.
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Jun 23, 2023 • 1h 14min

#82 – ID Literature Year in Review (LIVE from MAD-ID)

Episode Notes 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 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.
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Jun 16, 2023 • 1h 9min

#81 – Making the Right Choice Easy: Antimicrobial Stewardship in the Emergency Department

Experts in antimicrobial stewardship in the emergency department, Zack Nelson, Alison Dittmer, and Michael Pulia discuss communication considerations, role of lipoglycopeptides, and common stewardship interventions. They also highlight the value of having a pharmacist in the ED for antimicrobial stewardship, preferred medications in the ED, and the importance of drug choice and antimicrobial stewardship.
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Jun 2, 2023 • 38min

#80 – Weighting on a Miracle: Understanding Unknowns of Dosing Children and Adults with Obesity

Dr. Amit Pai, a professor and chair of clinical pharmacy with expertise in pharmacokinetics, and Dr. Kate Kyler, an assistant professor of pediatrics focused on precision dosing in children, dive into the complexities of drug dosing for individuals with obesity. They discuss how obesity alters pharmacokinetics and the need for tailored dosing strategies, especially in pediatric populations. The conversation highlights the misconceptions around BMI and the pitfalls of traditional weight-based approaches, making a case for more effective therapeutic drug monitoring.
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May 26, 2023 • 1h 21min

#79 – HAP & VAP: Let’s Clear the Air

Episode Notes 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/ 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.
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Apr 28, 2023 • 58min

#78 – New Therapies in HIV: The Long Road to Long-acting Antiretrovirals - Are We There Yet?

Episode Notes 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/ 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.
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Apr 21, 2023 • 40min

#77 – Breakpoints Talks Breakpoints: Non-fermenters

Episode Notes 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.

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