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

From generating 150 liters-worth of E. coli to the first X-ray crystallography of an ESBL, Drs. Robert Bonomo, Ryan Shields (@ryankshields), and Erin McCreary (@ErinMcCreary) take a deep dive into beta-lactamases like AmpCs, KPCs, and more.

Joining the discussion are Robert Bonomo, an expert on antibiotic resistance mechanisms, and Ryan Shields, a specialist in antibacterial treatment. They delve into the stealthy world of gram-negative bacteria, revealing how efflux pumps and porin mutations lead to significant resistance challenges. Their insights on beta-lactam inefficacy and the implications for clinical treatment are riveting. The duo emphasizes the urgent need for awareness and innovation in tackling these evolving bacterial threats to improve patient outcomes.

Pathogen-directed trials are among the most important trials that clinicians need to guide therapy but are also incredibly difficult to design and enroll. Rachel Britt (@RachelBPharmD) gets a behind-the-scenes interview with Adam Stewart (@adm_stewart), lead investigator of MERINO-2, and Jason Pogue (@jpogue1), lead investigator of OVERCOME. They discuss original intentions and evolving expectations to investigate optimal antibiotic therapy for multidrug resistant bacteria. Listen in for the insider analysis! 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/

Jacinda Abdul-Mutakabbir (@jayCdoesID) and Jeannette Bouchard (@jlbouchard001) join Erin McCreary (@ErinMcCreary) to discuss COVID vaccines, including access to, confidence in, and hesitancy around them.    This episode was sponsored by an unrestricted educational grant from Janssen Therapeutics, Division of Janssen Products, LP References: 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. 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. 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 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. 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 ACIP Website: https://www.cdc.gov/vaccines/acip/index.html 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 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. 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/

Erin McCreary (@erinmccreary) reviews clinical data and implementation strategies for therapeutic drug monitoring of beta-lactam antibiotics with Veena Venugopalan (@Veena_PharmD), Joseph Kuti, Jason Roberts (@jasonroberts_pk), and Marc Scheetz (@IDPharmacometrx). 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/