Breakpoints

Drs. Tom Dilworth and Stephanie Shealy May (@stephshealymay) join Dr. Rachel Britt (@RachelBPharmD) in the first episode of Breakpoints Dosing Consults to discuss questions and debates around ceftriaxone dosing. When should we use 1g over 2g? How does critical illness affect what dose to use? Is ceftriaxone the most approachable antibiotic? 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/ References Ettestad PJ, Campbell GL, Welbel SF, Genese CA, Spitalny KC, Marchetti CM, Dennis DT. Biliary complications in the treatment of unsubstantiated Lyme disease. J Infect Dis. 1995 Feb;171(2):356-61. doi: 10.1093/infdis/171.2.356. PMID: 7844372. Hasegawa S, Sada R, Yaegashi M, Morimoto K, Mori T; Adult Pneumonia Study Group-Japan. 1g versus 2 g daily intravenous ceftriaxone in the treatment of community onset pneumonia - a propensity score analysis of data from a Japanese multicenter registry. BMC Infect Dis. 2019 Dec 26;19(1):1079. doi: 10.1186/s12879-019-4552-8. PMID: 31878894; PMCID: PMC6933656. 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. Herrera-Hidalgo L, de Alarcón A, López-Cortes LE, Luque-Márquez R, López-Cortes LF, Gutiérrez-Valencia A, Gil-Navarro MV. Is Once-Daily High-Dose Ceftriaxone plus Ampicillin an Alternative for Enterococcus faecalis Infective Endocarditis in Outpatient Parenteral Antibiotic Therapy Programs? Antimicrob Agents Chemother. 2020 Dec 16;65(1):e02099-20. doi: 10.1128/AAC.02099-20. Erratum in: Antimicrob Agents Chemother. 2021 May 18;65(6): PMID: 33046488; PMCID: PMC7927845. 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. Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. doi: 10.15585/mmwr.rr7004a1. PMID: 34292926; PMCID: PMC8344968. 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. 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. Ulldemolins M, Roberts JA, Rello J, Paterson DL, Lipman J. The effects of hypoalbuminaemia on optimizing antibacterial dosing in critically ill patients. Clin Pharmacokinet. 2011 Feb;50(2):99-110. doi: 10.2165/11539220-000000000-00000. PMID: 21142293. Dailly E, Arnould JF, Fraissinet F, Naux E, Letard de la Bouralière MA, Bouquié R, Deslandes G, Jolliet P, Le Floch R. Pharmacokinetics of ertapenem in burns patients. Int J Antimicrob Agents. 2013 Jul;42(1):48-52. doi: 10.1016/j.ijantimicag.2013.02.021. Epub 2013 Apr 8. PMID: 23578794. Pai MP. Treatment of bacterial infections in obese adult patients: how to appropriately manage antimicrobial dosage. Curr Opin Pharmacol. 2015 Oct;24:12-7. doi: 10.1016/j.coph.2015.06.004. Epub 2015 Jun 25. PMID: 26119488. Mahmood I. Theoretical versus empirical allometry: Facts behind theories and application to pharmacokinetics. J Pharm Sci. 2010 Jul;99(7):2927-33. doi: 10.1002/jps.22073. PMID: 20127826. 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. 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. 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. 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. 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. 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. 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. 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. Van Wart SA et al., ICAAC 2009, poster # A1-010 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. 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. 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. 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. 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. Kate DeSear (@IDPharmD_Kate) and Frank Tverdek (@FTverdek) join Dr. Julie Ann Justo (@julie_justo) to discuss the practice of empiric escalation in this episode of our gram-negative resistance series. Listen in for encouragement on following your intuition and tips on how, when, and why to practice this other side of antimicrobial stewardship. 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 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.

Drs. Debbie Goff (@idpharmd), Khalid Eljaaly (@khalideljaaly), and Angeliki Messina (@AngPharmID) join Dr. David Ha (@DHpharmd) as part of a global panel discussion on international antimicrobial stewardship practices. Listen in to learn about pharmacy practice in South Africa and Saudi Arabia, antimicrobial stewardship practices in these and other countries, and how you too can get involved in global stewardship. 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 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

Dr. Jennifer Morrow joins Dr. Rachel Britt (@RachelBPharmD) on this bonus episode of the Breakpoints podcast to discuss how the introduction of COVID-19 therapeutics and vaccines has affected community pharmacy teams and workflows. Also mentioned are the recent Test to Treat initiative, impacts on future community pharmacy practice, and ways inpatient providers can help our community colleagues. 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: 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/

Drs. Wendi Drummond and Jeff Pearson (@jeffpears0n) join Dr. Rachel Britt (@RachelBPharmD) on the Breakpoints podcast this week to discuss all things on non-tuberculosis mycobacteria pulmonary infections. Listen for answers to all your burning questions like “Are we still using IV amikacin?” and “How do I get omadacycline for my patient?” as well as learning why clofazimine is the coolest drug out there. For more NTM content, check out Dr. Drummond’s podcast, NTMTalk! 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: www.doi.org/10.1093/cid/ciaa241 www.doi.org/10.1164/rccm.200604-571ST www.doi.org/10.1136/thoraxjnl-2015-207360 www.doi.org/10.1136/thoraxjnl-2017-210927 www.doi.org/10.1093/ofid/ofaa415 www.doi.org/10.1093/ofid/ofab002 https://clinicaltrials.gov/ct2/show/NCT04922554

Drs. Pranita Tamma (@pranita_tamma) and Sam Aitken (@OncIDPharmd) are BACK on the podcast this week with Dr. Erin McCreary (@ErinMcCreary) to discuss IDSA guidance on AmpC producers, carbapenem-resistant Acinetobacter baumanii, and Stenotrophomonas as part of our series on gram-negative bacteria. Listen as the panelists navigate the hot mess that is the CRAB treatment landscape, have a minocycline appreciation moment (we stan for Steno Sam!), and throw down some bar trivia in an "I Feel Nerdy" segment that you don't want to miss. 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 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) 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) An Overview of the Treatment of Less Common Non-Lactose-Fermenting Gram-Negative Bacteria Alterations of the Oral Microbiome and Cumulative Carbapenem Exposure Are Associated With Stenotrophomonas maltophilia Infection in Patients With Acute Myeloid Leukemia Receiving Chemotherapy

Drs. Pranita Tamma (@pranita_tamma) and Sam Aitken (@OncIDPharmd), authors of the IDSA Guidance on gram-negative resistance, join Dr. Erin McCreary (@ErinMcCreary) for this exquisitely good episode to discuss the soon-to-be-updated guidance on treatment of ESBL producers, CRE producers, and difficult to treat (DTR) Pseudomonas. Learn more about the Society of Infectious Diseases Pharmacists: Website: 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: PRO: Testing for ESBL production is necessary for ceftriaxone-non-susceptible Enterobacterales: perfect should not be the enemy of progress - PubMed (nih.gov) CON: Testing for ESBL production is unnecessary for ceftriaxone-resistant Enterobacterales - PubMed (nih.gov) 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) 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)

Episode Notes 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: Vosoughi S et al. The spread of true and false news online. Science 2018;359:1146-1151. doi: 10.1126/science.aap9559. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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.

Episode Notes 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 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/

Drs. Molly Sinert and Jon Furuno join Dr. David Ha (@DHpharmd) to discuss the prevalence of antibiotic use and its harms and benefits in reducing suffering and providing comfort during end-of-life care. 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: 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 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 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 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 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 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 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 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 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 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 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 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. 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