Breakpoints

Drs. Amy Crockett (@amyhcrockett), Ben Ereshefsky (@brainofbpharm), and Pamela Bailey (@pamipenem) join Dr. Julie Ann Justo (@julie_justo) to discuss new treatment strategies for management of intraamniotic infections, also known as chorioamnionitis. They discuss whether it is time to move away from the combination of ampicillin, gentamicin, and/or clindamycin, alternative antibiotic regimens to consider, and stewardship strategies to approach this practice change at a local level. References: Basic stats/epi on chorioamnionitis: Romero R, et al. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques. J Perinat Med. 2015 Jan;43(1):19-36. doi: 10.1515/jpm-2014-0249. PMID: 25720095. ACOG 2017 Guideline for IAI: Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. Obstet Gynecol. 2017 Aug;130(2):e95-e101. doi: 10.1097/AOG.0000000000002236. PMID: 28742677. ACOG 2024 Update on clinical criteria for IAI: ACOG Clinical Practice Update: Update on Criteria for Suspected Diagnosis of Intraamniotic Infection. Obstetrics & Gynecology 144(1):p e17-e19, July 2024. doi: 10.1097/AOG.0000000000005593 Helpful review with more recent microorganisms : Jung E, et al. Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment. Am J Obstet Gynecol. 2024 Mar;230(3S):S807-S840. doi: 10.1016/j.ajog.2023.02.002. PMID: 38233317. Cochrane Review: Chapman E, et al. Antibiotic regimens for management of intra-amniotic infection. Cochrane Database Syst Rev. 2014 Dec 19;2014(12):CD010976. doi: 10.1002/14651858.CD010976.pub2. PMID: 25526426. Helpful recent review on intrapartum infections: Bailey, P, et al_._ Out with the Old, In with the New: A Review of the Treatment of Intrapartum Infections. Curr Infect Dis Rep. 2024;26:107–113 doi: 10.1007/s11908-024-00838-8. Role of genital mycoplasmas in IAI: Romero R, et al. Evidence that intra-amniotic infections are often the result of an ascending invasion - a molecular microbiological study. J Perinat Med. 2019 Nov 26;47(9):915-931. doi: 10.1515/jpm-2019-0297. PMID: 31693497. Regimens without enterococcal coverage with similar clinical outcomes: Blanco JD, et al. Randomized comparison of ceftazidime versus clindamycin-tobramycin in the treatment of obstetrical and gynecological infections. Antimicrob Agents Chemother. 1983 Oct;24(4):500-4. doi: 10.1128/AAC.24.4.500. PMID: 6360038. Bookstaver PB, et al. A review of antibiotic use in pregnancy. Pharmacotherapy. 2015 Nov;35(11):1052-62. doi: 10.1002/phar.1649. PMID: 26598097. Updated review in pregnancy, includes data on frequency of antibiotic use in pregnancy: Nguyen J, et al. A review of antibiotic safety in pregnancy-2025 update. Pharmacotherapy. 2025 Apr;45(4):227-237. doi: 10.1002/phar.70010. Epub 2025 Mar 19. PMID: 40105039. Locksmith GJ, et al. High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels. Obstet Gynecol. 2005 Mar;105(3):473-9. doi: 10.1097/01.AOG.0000151106.87930.1a. PMID: 15738010. Clindamycin CDI Risk: Miller AC, et al. Comparison of Different Antibiotics and the Risk for Community-Associated Clostridioides difficile Infection: A Case-Control Study. Open Forum Infect Dis. 2023 Aug 5;10(8):ofad413. doi: 10.1093/ofid/ofad413. PMID: 37622034. Impact of penicillin allergy on clindamycin use & cites 47% clindamycin resistance per CDC among GBS: Snider JB, et al. Antibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes. BMC Pregnancy Childbirth. 2023 May 30;23(1):400. doi: 10.1186/s12884-023-05697-0. PMID: 37254067. Clindamycin anaerobic coverage data: Hastey CJ, et al. Changes in the antibiotic susceptibility of anaerobic bacteria from 2007-2009 to 2010-2012 based on the CLSI methodology. Anaerobe. 2016 Dec;42:27-30. doi: 10.1016/j.anaerobe.2016.07.003. PMID: 27427465. Older PK study of ampicillin & gentamicin for chorioamnionitis: Gilstrap LC 3rd, Bawdon RE, Burris J. Antibiotic concentration in maternal blood, cord blood, and placental membranes in chorioamnionitis. Obstet Gynecol. 1988 Jul;72(1):124-5. PMID: 3380500. Paper putting out the call for modernization of OB/Gyn antibiotic regimens: Pek Z, Heil E, Wilson E. Getting With the Times: A Review of Peripartum Infections and Proposed Modernized Treatment Regimens. Open Forum Infect Dis. 2022 Sep 5;9(9):ofac460. doi: 10.1093/ofid/ofac460. PMID: 36168554. Vanderbilt University Medical Center experience with modernizing OB/Gyn infection regimens: Smiley C, et al. Implementing Updated Intraamniotic Infection Guidelines at a Large Academic Medical Center. Open Forum Infect Dis. 2024 Sep 5;11(9):ofae475. doi: 10.1093/ofid/ofae475. PMID: 39252868. Prisma Health/University of South Carolina experience with modernizing OB/Gyn infection regimens: Bailey P, et al. Cefoxitin for Intra-amniotic Infections and Endometritis: A Retrospective Comparison to Traditional Antimicrobial Therapy Regimens Within a Healthcare System. Clin Infect Dis. 2024 Jul 19;79(1):247-254. doi: 10.1093/cid/ciae042. PMID: 38297884.

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/

Drs. Amy Mathers and Julie Ann Justo join Dr. Erin McCreary to talk all things Stenotrophomonas maltophilia, a water-loving organism and frequent colonizer. Hear from the experts on why this organism is so difficult to treat, which agents have in vitro activity, and how to optimize antimicrobial regimens, including the use of combination therapy, in the setting of true infections. This medical education was provided by an unrestricted grant from Shionogi. References: Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections. Clin Infect Dis. 2024 Aug 7:ciae403. doi: 10.1093/cid/ciae403. PMID: 39108079. Clinical challenges treating Stenotrophomonas maltophilia infections: an update. JAC Antimicrob Resist. 2022 May 5;4(3):dlac040. doi: 10.1093/jacamr/dlac040. PMID: 35529051. Alterations of the Oral Microbiome and Cumulative Carbapenem Exposure Are Associated With Stenotrophomonas maltophilia Infection in Patients With Acute Myeloid Leukemia Receiving Chemotherapy. Clin Infect Dis. 2021 May 4;72(9):1507-1513. doi: 10.1093/cid/ciaa778. PMID: 32544947. An Overview of the Treatment of Less Common Non–Lactose-Fermenting Gram-Negative Bacteria. Pharmacotherapy. 2020 Sep;40(9):936-951. doi: 10.1002/phar.2447. PMID: 32687670.

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.

Drs. Nico Cortes-Penfield (@Cortes-Penfield), Kerry LaPlante (@Kerry_LaPlante), Jessica Seidelman (@JessieLSeidel) join Dr. Julie Ann Justo (@julie_justo) to discuss the pesky slime that is biofilm in periprosthetic joint infections. They review biofilm composition & development, have an honest discussion about whether antibiotics can ever really eradicate it, and provide updates on the promising non-pharmacologic strategies on the horizon (bacteriophages, electromagnetism, & more). 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 Nixing the Nidus: Managing Retained Sources in Prosthetic Joint Infections. Breakpoints Podcast Episode #67. Society of Infectious Diseases Pharmacists. Dosing Consult: Rifampin Part 1. Breakpoints Podcast Episode #104. Society of Infectious Diseases Pharmacists. Review on Staphylococcal biofilm development: Schilcher K, Horswill AR. 2020 Aug 12;84(3):e00026-19. doi: 10.1128/MMBR.00026-19. PMID: 32792334. Antibiotics can fail to kill biofilm cells even if they penetrate the biofilm: Singh R, et al. Pathog Dis. 2016 Aug;74(6):ftw056. doi: 10.1093/femspd/ftw056. Epub 2016 Jul 7. PMID: 27402781. Subinhibitory antibiotic concentrations can promote biofilm formation: Schilcher K, et al. Antimicrob Agents Chemother. 2016 Sep 23;60(10):5957-67. doi: 10.1128/AAC.00463-16. PMID: 27458233. Clinical and genetic risk factors for biofilm-forming Staphylococcus aureus: Luther MK, et al. Antimicrob Agents Chemother. 2018 Apr 26;62(5):e02252-17. doi: 10.1128/AAC.02252-17. PMID: 29530854. Meta-analysis showing poor clinical outcomes with debridement, antibiotics, and implant retention (DAIR): Kunutsor SK, et al. J Infect. 2018 Dec;77(6):479-488. doi: 10.1016/j.jinf.2018.08.017. PMID: 30205122. Thieme L, et al. MBEC versus MBIC: the lack of differentiation between biofilm reducing and inhibitory effects as a current problem in biofilm methodology. Biol Proced Online 21, 18 (2019). https://doi.org/10.1186/s12575-019-0106-0. Ongoing trial investigating use of MBEC in the treatment of PJIs: Tillander JAN, et al. BMJ Open. 2022 Sep 15;12(9):e058168. doi: 10.1136/bmjopen-2021-058168. PMID: 36109038. Maale, G. Complete eradication of biofilm using low frequency electromagnetic force (EMF) and antibiotics at MIC. 34th Annual Meeting Musculoskeletal Infection Society. 2024 Aug. Abstract 1232 (see full program). Meta-analysis on bacteriophages for biofilm: Kovacs CJ, et al. Mil Med. 2024 May 18;189(5-6):e1294-e1302. doi: 10.1093/milmed/usad385. PMID: 37847552. Berking BB, et al. Biofilm disruption from within: light-activated molecular drill-functionalized polymersomes bridge the gap between membrane damage and quorum sensing-mediated cell death. ACS Biomater Sci Eng. 2024 Sep 9;10(9):5881-5891. doi: 10.1021/acsbiomaterials.4c01177. PMID: 39176452. Aboelnaga N, et al. Deciphering the dynamics of methicillin-resistant Staphylococcus aureus biofilm formation: from molecular signaling to nanotherapeutic advances. Cell Commun Signal. 2024 Mar 22;22(1):188. doi: 10.1186/s12964-024-01511-2. PMID: 38519959. Conway J, et al. Phase 1 study of the pharmacokinetics and clinical proof-of-concept activity of a biofilm-disrupting human monoclonal antibody in patients with chronic prosthetic joint infection of the knee or hip. Antimicrob Agents Chemother. 2024 Aug 7;68(8):e0065524. doi: 10.1128/aac.00655-24. PMID: 39012102. Mulpur P, et al. Efficacy of intrawound vancomycin in prevention of periprosthetic joint infection after primary total knee arthroplasty: a prospective double-blinded randomized control trial. J Arthroplasty. 2024 Jun;39(6):1569-1576. doi: 10.1016/j.arth.2024.01.003. PMID: 38749600. Dong Y, et al. Synergy of ultrasound microbubbles and vancomycin against Staphylococcus epidermidis biofilm. J Antimicrob Chemother. 2013 Apr;68(4):816-26. doi: 10.1093/jac/dks490. PMID: 23248238. Miltenberg B, et al. Intraosseous Regional Administration of Antibiotic Prophylaxis for Total Knee Arthroplasty: A Systematic Review. J Arthroplasty. 2023 Apr;38(4):769-774. doi: 10.1016/j.arth.2022.10.023. PMID: 36280158. Viswanathan VK, et al. Intraosseous regional antibiotic prophylaxis in total joint arthroplasty (TJA): Systematic review and meta-analysis. J Clin Orthop Trauma. 2024 Oct 3;57:102553. doi: 10.1016/j.jcot.2024.102553. PMID: 39435324. SOLARIO trial: Dudareva M, et al. The European Bone and Joint Infection Society Meeting, 2024 Sept. SOLARIO trial press release from BoneSupportTM. 2024 Oct 3. Fehring TK, et al. Does treatment at a specialized prosthetic joint infection center improve the rate of reimplantation. J Arthroplasty. 2023 Jun;38(6S):S314-7. PMID 37004968. ROADMAP trial website. 2024.

We are back with more exciting IDWeek 2024 content. In this episode, Breakpoints hostesses Drs. Erin McCreary, Julie Ann Justo, Jeannette Bouchard, and Megan Klatt highlight more of our favorite sessions and posters at IDWeek, this episode is a must listen if you are an IDWeek nerd like us! References: Perret et al. Application of OpenAI GPT-4 for the retrospective detection of catheter-associated urinary tract infections in a fictitious and curated patient data set. 10.1017/ice.2023.189 Wiemken et al. Assisting the infection preventionist: Use of artificial intelligence for health care–associated infection surveillance. 10.1016/j.ajic.2024.02.007 Leekha et al. Evaluation of hospital-onset bacteraemia and fungaemia in the USA as a potential healthcare quality measure: a cross-sectional study. 10.1136/bmjqs-2023-016831 Diekema et al. Are Contact Precautions "Essential" for the Prevention of Healthcare-associated Methicillin-Resistant Staphylococcus aureus? 10.1093/cid/ciad571 Martin et al. Contact precautions for MRSA and VRE: where are we now? A survey of the Society for Healthcare Epidemiology of America Research Network. 10.1017/ash.2024.350 Browne et al. Investigating the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections in Australia (CLEEN): a stepped-wedge, cluster randomised, controlled trial. 10.1016/S1473-3099(24)00399-2 Protect trial: Decolonization in Nursing Homes to Prevent Infection and Hospitalization. 10.1056/NEJMoa2215254 Aldardeer et al. Early Versus Late Antipseudomonal β-Lactam Antibiotic Dose Adjustment in Critically Ill Sepsis Patients With Acute Kidney Injury: A Prospective Observational Cohort Study. 10.1093/ofid/ofae059 Schmiemann et al. Effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women: parallel, cluster randomised, controlled trial. 10.1136/bmj-2023-076305 Vernacchio et al. Improving Short Course Treatment of Pediatric Infections: A Randomized Quality Improvement Trial. 10.1542/peds.2023-063691 Advani et al. Bacteremia From a Presumed Urinary Source in Hospitalized Adults With Asymptomatic Bacteriuria. 10.1001/jamanetworkopen.2024.2283 Saif et al. Clinical decision support for gastrointestinal panel testing. 10.1017/ash.2024.15 Bekker et al. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women. 10.1056/NEJMoa2407001 Montini et al. Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections: A Randomized Trial. 10.1542/peds.2023-062598 Nielsen et al. Oral versus intravenous empirical antibiotics in children and adolescents with uncomplicated bone and joint infections: a nationwide, randomised, controlled, non-inferiority trial in Denmark. 10.1016/S2352-4642(24)00133-0 Kaasch et al. Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial. 10.1016/S1473-3099(23)00756-9 AMIKINHAL: Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia. 10.1056/NEJMoa2310307 PROPHY-VAP: Ceftriaxone to prevent early ventilator-associated pneumonia in patients with acute brain injury: a multicentre, randomised, double-blind, placebo-controlled, assessor-masked superiority trial. 10.1016/S2213-2600(23)00471-X AVENIR: Azithromycin to Reduce Mortality — An Adaptive Cluster-Randomized Trial. 10.1056/NEJMoa2312093 Thomas et al. Comparison of Two High-Dose Versus Two Standard-Dose Influenza Vaccines in Adult Allogeneic Hematopoietic Cell Transplant Recipients. 10.1093/cid/ciad458 Schuster et al. The Durability of Antibody Responses of Two Doses of High-Dose Relative to Two Doses of Standard-Dose Inactivated Influenza Vaccine in Pediatric Hematopoietic Cell Transplant Recipients: A Multi-Center Randomized Controlled Trial. 10.1093/cid/ciad534 Mahadeo et al. Tabelecleucel for allogeneic haematopoietic stem-cell or solid organ transplant recipients with Epstein-Barr virus-positive post-transplant lymphoproliferative disease after failure of rituximab or rituximab and chemotherapy (ALLELE): a phase 3, multicentre, open-label trial. 10.1016/S1470-2045(23)00649-6 Khoury et al. Third-party virus-specific T cells for the treatment of double-stranded DNA viral reactivation and posttransplant lymphoproliferative disease after solid organ transplant. 10.1016/j.ajt.2024.04.009 Spec et al. MSG-15: Super-Bioavailability Itraconazole Versus Conventional Itraconazole in the Treatment of Endemic Mycoses—A Multicenter, Open-Label, Randomized Comparative Trial. 10.1093/ofid/ofae010

Did you miss IDWeek this year and trying to catch up on the hot topics? Or was there just too many good sessions and you want to catch up on the ones you missed? Let the Breakpoints Hostesses help you out! In the first of two IDWeek 2024 recap episodes, join Drs. Erin McCreary, Julie Ann Justo, Jeannette Bouchard, and Megan Klatt as they cover top late breaking abstracts and stewardship data that you won't want to miss! References: BALANCE Trial: Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. 10.1056/NEJMoa2404991 White et al. Antibiotic stewardship targets in the outpatient setting. 10.1016/j.ajic.2019.01.027 Wattengel et al. Outpatient antimicrobial stewardship: Optimizing patient care via pharmacist led microbiology review. 10.1016/j.ajic.2019.07.018 Augostini et al. An evaluation of antimicrobial prophylaxis for transrectal prostate biopsies: A potential stewardship target. 10.1016/j.ajic.2024.05.012 Cotter et al. Antibiotic use and outcomes among children hospitalized with suspected pneumonia. 10.1002/jhm.13002

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.

Drs. Ed Septimus and Whitney Buckel join Dr. Jeannette Bouchard for our second episode in the series “Stewie Struggles.” In this episode, we focus on interventions within the EHR and what we can do on the end-user side of antimicrobials. We discuss how to use unique tools within the EHR and get a VIP look at the efforts to pull off the amazing INSPIRE trials! You don't want to miss this! 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: INSPIRE PNA: doi:10.1001/jama.2024.6248 INSPIRE UTI: doi:10.1001/jama.2024.6259 Order set study by Kufel et al: doi:10/1017/ice.2023.293 This podcast is powered by Pinecast.

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 episode of Breakpoints' Dosing Consult series, Drs. Chuck Peloquin and Gerry Davies join Dr. Megan Klatt to discuss rifampin dosing for mycobacterial infections. Hear from the experts on if higher doses are really better, toxicity thresholds, and the role of alternative rifamycins for patients with MTB and NTMs. 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: Efficacy and Safety of High-Dose Rifampin in Pulmonary Tuberculosis. A Randomized Controlled Trial. Am J Respir Crit Care Med. 2018 Sep 1;198(5):657-666. doi: 10.1164/rccm.201712-2524OC. Rifampin vs. rifapentine: what is the preferred rifamycin for tuberculosis? Expert Rev Clin Pharmacol. 2017 Oct;10(10):1027-1036. doi: 10.1080/17512433.2017.1366311. Rifabutin for treating pulmonary tuberculosis. Cochrane Database Syst Rev. 2007 Oct; 2007(4): CD005159. doi: 10.1002/14651858.CD005159.pub2. Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease. Clin Infect Dis. 2023 Oct 5;77(7):1053-1062. doi: 10.1093/cid/ciad312. This podcast is powered by Pinecast.

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 episode, Drs. Erica Stohs, Ryan Stevens, and Jame McCrae join Dr. Megan Klatt to discuss antimicrobial stewardship practices at transitions of care and in the outpatient setting. Hear from the experts on how to establish programs in this space, best practices for data/reporting, and other tips for stewardship intervention. Follow us on Instagram! @breakpointspodcast_sidp References: Pharmacist-Driven Transitions of Care Practice Model for Prescribing Oral Antimicrobials at Hospital Discharge. 10.1001/jamanetworkopen.2022.11331 From concept to reality: Building an ambulatory antimicrobial stewardship program. 10.1002/jac5.1528 Cracking the code(s): Optimization of encounter-level diagnosis coding to inform outpatient antimicrobial stewardship data modeling. 10.1017/ice.2023.296 Antibiotic Prescribing Variability in a Large Urgent Care Network: A New Target for Outpatient Stewardship. 10.1093/cid/ciz910 DART communication for respiratory illness treatment resources: Dialogue Around Respiratory Illness Treatment (DART) – iMTR (uwimtr.org)

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 smaller case series: 10.1093/ofid/ofaa415 Omadacycline for Mycobacterium abscessus larger case series: 10.1093/ofid/ofab002 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

Drs. Yohei Doi and Emily Heil join Dr. Erin McCreary to dive into one of the most requested topics from our listeners and something that is consistently confusing in clinical practice: Acinetobacter baumannii! Hear from experts on their experience with treating this tricky organism and their thoughts on best approaches when you are presented with CRAB.   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: SNAP doi:10.1128/mbio.02759-2 ATTACK doi:10.1016/S1473-3099(23)00184-6 CRAB among COVID patients: doi:10.1093/jac/dkad042

Drs. Chris Crnich, Angela Huttner, and Jeannette Bouchard join Dr. Erin McCreary to discuss all things uncomplicated UTIs! Gain insight into where our new guidelines may be headed and pearls from experts in a variety of clinical settings, including a clinic specifically devoted to UTIs! Funding for this podcast was supported by an unrestricted grant from GSK. 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: Proposing the "Continuum of UTI" doi: 10.1097/JU.0000000000003874 UTIs exciting new frontier doi: 10.1016/j.cmi.2022.07.016 Fosfo vs Nitro doi: 10.1001/jama.2018.3627

In this special LIVE podcast episode, Drs. Emily Heil (@emilyheil) and Mandee Noval (@MandeeNoval) present the latest and greatest in ID literature from MAD-ID 2024 (@MAD_ID_ASP) in Orlando, FL. They cover everything from ECCMID late breakers to stewardship to the best things to come out of a good old shortage! You won't want to miss this one! Google Drive to Slides from Live Session: https://drive.google.com/file/d/1L4zq0ZC5LW9cCySE0AiJL7m8qDxS9MGM/view?usp=sharing Submit your 100th Episode videos at: sidp@affinity-strategies.com Check out more information on ID Pharmacists Day on May 22nd, 2024 at SIDP.org/IDPharmacistsDay 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/

Episode Notes The Society of Infectious Diseases Pharmacists is excited to invite you to the first ever meeting (via Breakpoints) of The Tortured Stewards & Surgeons Department. Today's agenda items: optimal management of perioperative antibiotics and prevention of surgical site infections. Drs. Trisha Peel (@DrTrishaPeel), Michael Calderwood (@CalderwoodMD) and Patch Dellinger join Dr. Jillian Hayes (@thejillianhayes) to discuss some of the controversies we encounter while managing antibiotics in the perioperative space. Does anyone really need post-op antimicrobial prophylaxis longer than 24 hours? Where should vancomycin be fitting into surgical prophylaxis regimens? Can we truly give pre-operative cefazolin to patients with a penicillin allergy? Tune in for the answers to these questions and more! 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 If you'd like more information about the CALIPSO trial, please visit this link: https://www.anzca.edu.au/profiles/ctn-trials/underway/calipso Bibliography SSI Infection Prevention Review: https://jamanetwork.com/journals/jama/article-abstract/2800424#:~:text=Six%20are%20supported%20by%20randomized,use%20a%20chlorhexidine%20gluconate%2Dalcoho Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/strategies-to-prevent-surgical-site-infections-in-acutecare-hospitals-2022-update/2F824B9ADD6066B29F89C8A2A127A9D American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update: https://journals.lww.com/journalacs/citation/2017/01000/american_college_of_surgeons_and_surgical.8.aspx  2017 CDC Guidelines: https://jamanetwork.com/journals/jamasurgery/fullarticle/2623725  2018 WHO Guidelines: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y  ASHP Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery: https://www.ashp.org/surgical-guidelines  Surgeons as Stewards: https://journals.lww.com/journalacs/citation/2020/12000/perioperative_antibiotic_prophylaxis__surgeons_as.23.aspx  Li et al, Arthroplasty 2022: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y  Dutch Arthroplasty Register Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023957/  de Jonge Meta-Analysis on duration and incidence of SSI: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30084-0/abstract  Prolonged Antibiotic Prophylaxis After Cardiovascular Surgery and Its Effect on Surgical Site Infections and Antimicrobial Resistance: https://www.ahajournals.org/doi/10.1161/01.cir.101.25.2916?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed RCT - Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs: https://jamanetwork.com/journals/jama/article-abstract/2810510  NYU Langone Study - Preventing Surgical Site Infections: A Randomized, Open-Label Trial of Nasal Mupirocin Ointment and Nasal Povidone-Iodine Solution: https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=91dee3e1445adb80d533f2c210816a3285254e3a  Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty: https://www.nejm.org/doi/full/10.1056/NEJMoa2301401 What Is the Primary Driver of Preoperative Vancomycin Use? It's Not Methicillin-resistant Staphylococcus aureus—or Allergy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744972/  Drug allergy: a 2022 practice parameter update: https://www.jacionline.org/article/S0091-6749(22)01186-1/fulltext  Perioperative use of cefazolin without preliminary skin testing in patients with reported penicillin allergy: https://www.surgjournal.com/article/S0039-6060(18)30307-6/abstract#%20  Timing of Surgical Prophylaxis RCT: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30176-7/abstract  Propensity Score-Weighted Analysis of Postoperative Infection in Patients With and Without Preoperative Urine Culture: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815528

In this episode, Drs. Helen Boucher (@hboucher3), Ramy Elshaboury, and Mike Dudley (@MikeMNDudley) join host, Megan Klatt (@MeganKlatt3), to discuss barriers to antimicrobial drug development, potential incentives and legislation to promote market growth, and what we can do to ensure the antimicrobial pipeline doesn't run dry. 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 An analysis of antibacterial drug development trends in the United States, 1980-2019: Dheman N, et al. Clin Infect Dis. 2021 Dec 6;73(11):e4444-e4450. doi:10.1093/cid/ciaa859. PMID: 32584952. Antibacterial R&D at a crossroads: we've pushed as hard as we can…now we need to start pulling!: Rex JH, Outterson K. Clin Infect Dis. 2021 Dec 6;73(11):e4451-4453. doi:10.1093/cid/ciaa852. PMID: 32584949. No Patient Left Behind (website): https://www.nopatientleftbehind.org/ (many useful explainers of how the investment, innovation cycle, and drug pricing work) ISPOR special task force report on defining elements of value in health care – a health economics approach: Lakdawalla DN, et al. Value Health. 2018 2018 Feb;21(2):131-139. doi: 10.1016/j.jval.2017.12.007. PMID: 29477390. Generalized cost-effectiveness analysis to assess treatment value in hepatitis C: Chou JW, et al. Am J Manag Care. 2023 Dec;29(12):696-703. doi: 10.37765/ajmc.2023.89468. PMID: 38170486.

It's time to arm yourselves with all the resources on antimicrobial locks! Join our experts, Drs. Louise-Marie Oleksiuk (@CanRowPharm), Nasia Safdar (@NasiaSafdar), Joel Topf (@kidney_boy), and our wonderful host, Dr. Julie Justo (@julie_justo), to discuss the ins and outs of antimicrobial locks and how to implement them! Funding for this podcast was provided by CorMedix Inc 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 https://drive.google.com/file/d/1K0A4Bomhbcn7AZJ1JFOWW8EdEZq-aZcd/view?usp=sharing https://drive.google.com/file/d/1PRoQzEKJ1c0pa1XFc4yasxsMhx2A1DFU/view?usp=sharing Helpful antimicrobial lock review: Justo JA, Bookstaver PB. Infect Drug Resist. 2014 Dec 12;7:343-63. doi: 10.2147/IDR.S51388. PMID: 25548523. LOCK IT-100 Trial: Agarwal AK, et al. Clin J Am Soc Nephrol. 2023 Nov 1;18(11):1446-1455. doi: 10.2215/CJN.0000000000000278. PMID: 37678222. Cochrane review: Arechabala MC, et al. Cochrane Database Syst Rev. 2018 Apr 3;4(4):CD010597. doi: 10.1002/14651858.CD010597.pub2. PMID: 29611180. Cost-effectiveness of ethanol lock ppx with newer dehydrated alcohol product: Raghu VK, et al. JPEN J Parenter Enteral Nutr. 2022 Feb;46(2):324-329. doi: 10.1002/jpen.2130. PMID: 33908050. Antimicrobial lock development/implementation in a pediatric hospital: Zembles TN, et al. Am J Health Syst Pharm. 2018 Mar 1;75(5):299-303. doi: 10.2146/ajhp161056. PMID: 29472511. Dr. Topf's tweet surveying the prevalence of antimicrobial lock use in dialysis units CRBSIs in hemodialysis patients before and during the COVID-19 pandemic: Johansen KL, et al. Clin J Am Soc Nephrol. 2022 Mar;17(3):429-433. doi: 10.2215/CJN.11360821. PMID: 35110377. Antiseptic barrier caps review and meta-analysis: Gillis VELM, et al. Am J Infect Control. 2023 Jul;51(7):827-835. doi: 10.1016/j.ajic.2022.09.005. PMID: 36116679. 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. Thomas Holland and Vance Fowler (@VanceFowler5) join Drs. Steven Tong (@syctong) and Erin McCreary (@ErinMcCreary) to discuss the ERADICATE study and the role of ceftobiprole for the treatment of complicated Staphylococcus aureus bacteremia. This session was recorded live on Tuesday, February 6th, 2024 featuring an international audience. 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/ Article: https://www.nejm.org/doi/full/10.1056/NEJMoa2300220 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. Robert Bonomo, Ryan Shields (@ryankshields), and Erin McCreary (@ErinMcCreary) deep dive into the world of metallo-beta-lactamases. This riveting discussion is full of the nerdiest pub trivia nuggets and the “must know” details of novel beta lactams and beta-lactamase inhibitors, and their uses for MBLs. Funding for this podcast was provided by Shionogi Inc. 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: Urgent need for metallo B lactamase: DOI: 10.1016/S1473-3099(20)30868-9 NDM-9 Resistance to Taniborbactam: DOI 10.1016/S1473-3099(23)00069-5 AAC Taniborbactam inhibition of NDM-1: DOI 10.1128/aac.01332-23 OFID NDM E. coli with cefiderocol and aztreonam/avibactam resistance: DOI 10.1093/ofid/ofad276 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.

New accreditation standards making your head spin? Are you stressed and don't know where to start? Well, on this episode of Breakpoints Drs. Arjun Srinivasan and Jose Alexander (Alex) join Luis Plaza from Let's Talk Micro (@letstalkmicro1) and Dr. Jeannette Bouchard (@jlbouchard001) to breakdown what you need to know and where to start when it comes to the NHSN Antimicrobial Resistance (AR) module and the new College of American Pathologist's standards.   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: CDC AR Validation Guide: https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/aur/ar-validation-508.pdf CLSI Toolkit: https://clsi.org/meetings/ast/breakpoints-in-use-toolkit/ 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.

We are back with more exciting IDWeek 2023 content! If you listened to the last episode and want more? Than look no further. Join your Breakpoints hosts, Drs. Erin McCreary (@ErinMcCreary), Julie Ann Justo (@julie_justo), and Jeannette Bouchard (@jlbouchard001) for a review of key pipeline agents at IDWeek and highlights from everyone's favorite session “Clinical Trials That May Change Your Practice”. Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Google Podcasts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/ References: Oral Amphotericin for Cryptococcal Meningitis: doi 10.1093/cid/ciad440 PALACE: doi 10.1001/jamainternmed.2023.2986 DoxyPEP: doi 10.1056/NEJMoa2211934 RSV Vaccine in Pregnancy: doi 10.1056/NEJMoa2216480 RSV Vaccines in Older Adults: doi 10.1056/NEJMoa2209604 and doi 10.1056/NEJMoa2213836 AURORA: doi 10.1093/cid/ciad709 Mycoses Mapping: doi 10.1093/cid/ciac882 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.

Need help narrowing down your IDWeek re-watch content? Or maybe you were unable to make IDWeek so you want the pharmacy driven highlights? Well, look no further, Breakpoints has what you need!   Join your Breakpoints hosts, Drs. Erin McCreary (@ErinMcCreary), Julie Ann Justo (@julie_justo), and Jeannette Bouchard (@jlbouchard001) for a review of some of the late breaking clinical trials presented at IDWeek 2023.   Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Google Podcasts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/    References: 1. Oral Fosfomycin vs IV BL/BLI/Carbapenem in cUTI: doi:10.1093/ofid/ofad500.002 2. Oral Fosfomycin for male UTIs: doi:10.3390/antibiotics11020198 and prostatitis: doi:10.1093/jac/dkz015 3. ATM-AVI for cIAIA or HAP/VAP (REVISIT): doi:10.1093/ofid/ofad500.2476 4. CAZ-AVI for neonates: doi:10.1093/ofid/ofad500.2473 5. ACORN RCT: doi:10.1001/jama.2023.20583 HARMONIE RCT: doi:10.1093/ofid/ofad500.005 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. Nicholas Torney (@NPT_PharmD) and Sunish Shah join Dr. Jeannette Bouchard (@jlbouchard001) to discuss our next topic in our Dosing Consult series: BID vs TID dosing for metronidazole. Deep dive into the PK/PD and real-world application of this switch with experts in this dosing strategy. References: Addition of anaerobic coverage in biliary infections: Addition of anaerobic coverage for treatment of biliary tract infections: a propensity score-matched cohort study Eggerthella lenta and Pipercillin-tazobactam: Eggerthella lenta Bloodstream Infections Are Associated With Increased Mortality Following Empiric Piperacillin-Tazobactam (TZP) Monotherapy: A Population-based Cohort Study Q12H Dose Schedule in Surgery Prophylaxis: Twelve-hourly dosage schedule for oral and intravenous metronidazole 2018 Clinical Data on Q12H Dosing in Mixed Infections: Clinical efficacy of 12-h metronidazole dosing regimens in patients with anaerobic or mixed anaerobic infections 2021 Clinical Data on Q12H Dosing: Three is a crowd: Clinical outcomes of a twice daily versus a thrice daily metronidazole dosing strategy from a multicenter study 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.

Dr. Ajit Limaye and Dr. Camille Kotton (@KottonNelson) join Dr. Erin McCreary (@ErinMcCreary) to discuss fascinating updates in the CMV space including new RCTs for prevention, vaccines, and more! Learn why a little "hair of the dog" might be a good thing, how great T cells are, and the trials we still need. References: CAPSIL study: Effect of Preemptive Therapy vs Antiviral Prophylaxis on Cytomegalovirus Disease in Seronegative Liver Transplant Recipients With Seropositive Donors: A Randomized Clinical Trial - PubMed (nih.gov) Extended CAPSIL data: Association of CMV DNAemia with Long-Term Mortality in a Randomized Trial of Preemptive Therapy (PET) and Antiviral Prophylaxis (AP) for Prevention of CMV Disease in High-Risk Donor Seropositive, Recipient Seronegative (D+R-) Liver Transplant Recipients - PubMed (nih.gov) Kidney transplant review: A Systematic Review and Meta-analysis of Optimized CMV Preemptive Therapy and Antiviral Prophylaxis for CMV Disease Prevention in CMV High-Risk (D+R-) Kidney Transplant Recipients - PubMed (nih.gov) Letermovir vs Valganciclovir for Prevention in Kidney Transplant: Letermovir vs Valganciclovir for Prophylaxis of Cytomegalovirus in High-Risk Kidney Transplant Recipients: A Randomized Clinical Trial - PubMed (nih.gov) 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.

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.

Episode Notes Drs. Jason Gallagher (@JGPharmD) and Melissa Johnson (@IDPharmacist) join Dr. Erin McCreary (@ErinMcCreary) to discuss one of the most talked about papers of the year: Antibiotic Myths for the Infectious Diseases Clinician. Tune in to hear these common myths debunked! Antibiotic Myths for the Infectious Diseases Clinician: https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciad357/7194976?redirectedFrom=fulltext 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.

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.

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.

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.

Episode Notes Drs. Zack Nelson (@zacroBID), Alison Dittmer, and Michael Pulia (@DrMichaelPulia) join Dr. Jillian Hayes (@thejillianhayes) to discuss the ins and outs of antimicrobial stewardship in one of the busiest parts of the hospital: the emergency department! Tune in for a discussion on communication considerations in the ED, the role of lipoglycopeptides for common gram-positive syndromes, and a rapid-fire round discussing common stewardship interventions. This podcast was supported by an educational grant from Melinta Therapeutics. References: Pulia M, et al. Antimicrobial Stewardship in the Emergency Department. Emerg Med Clin N Am 2018;36(4):853-872. doi: 10.1016/j.emc.2018.06.012. PMID: 30297009. Rech, Megan A et al. “PHarmacist Avoidance or Reductions in Medical Costs in Patients Presenting the EMergency Department: PHARM-EM Study.” Critical Care Explorations 2021;3(4):e0406. doi:10.1097/CCE.0000000000000406. PMID: 33912836. Sacdal JPA, Cheon E et al. Oritavancin versus oral antibiotics for treatment of skin and skin structure infections in the emergency department. Am J Emerg Med 2022;60:223-224. Jenkins TC, Jaukoos JS et al. Patterns of use and perceptions of an institution-specific antibiotic stewardship application among emergency department and urgent care clinicians. Infection Control and Hospital Epidemiology 2020;41:212-215. Dretske D, Schulz L, Werner E, Sharp B, Pulia M. Effectiveness of oritavancin for management of skin and soft tissue infections in the emergency department: A case series. The American Journal of Emergency Medicine 2021;43:77-80. doi: 10.1016/j.ajem.2021.01.050. PMID: 33545550. Paul M, Pulia M, Pulcini C. Antibiotic stewardship in the emergency department: not to be overlooked. Clin Microbiol Infect 2021;27(2):172-174. doi: 10.1016/j.cmi.2020.11.015. PMID: 33253938. Baxa J, McCreary E, Schulz L, Pulia M. Finding the niche: An interprofessional approach to defining oritavancin use criteria in the emergency department. Am J Emerg Med. 2020;38(2):321-324. doi:10.1016/j.ajem.2019.158442. Pulia MS, Hesse S, Schwei RJ, Schulz LT, Sethi A, Hamedani A. Inappropriate Antibiotic Prescribing for Respiratory Conditions Does Not Improve Press Ganey® Patient Satisfaction Scores in the Emergency Department. Open Forum Infect Dis 2020;7(6): ofaa214. doi:10.1093/ofid/ofaa214. Pulia MS, Lindenauer PK. Annals for Hospitalists Inpatient Notes - A Critical Look at Procalcitonin Testing in Pneumonia. Ann Intern Med. 2021;174(6):HO2-HO3. doi:10.7326/M21-1913. Redwood R, Knobloch MJ, Pellegrini DC, Ziegler MJ, Pulia M, Safdar N. Reducing unnecessary culturing: a systems approach to evaluating urine culture ordering and collection practices among nurses in two acute care settings. Antimicrob Resist Infect Control. 2018;7. doi:10.1186/s13756-017-0278-9. Pulia MS, Schwei RJ, Hesse SP, Werner NE. Characterizing barriers to antibiotic stewardship for skin and soft-tissue infections in the emergency department using a systems engineering framework. Antimicrob Steward Healthc Epidemiol. 2022;2(1):e180. doi:10.1017/ash.2022.316. May L, Gudger G, Armstrong P, et al. Multisite exploration of clinical decision making for antibiotic use by emergency medicine providers using quantitative and qualitative methods. Infect Control Hosp Epidemiol. 2014;35(9):1114-1125. doi:10.1086/677637. May L, Cosgrove S, L'archeveque M, et al. A Call to Action for Antimicrobial Stewardship in the Emergency Department: Approaches and Strategies. Ann Emerg Med 2013;62(1):69-77.e2. doi: 10.1016/j.annemergmed.2012.09.002. PMID: 23122955. Schoffelen T, Schouten JA, Hoogerwerf JJ, et al. Quality indicators for appropriate antimicrobial therapy in the emergency department: a pragmatic Delphi procedure. Clin Microbiol Infect 2021;27(2):210-214. doi: 10.1016/j.cmi.2020.10.027. PMID: 33144204. Yadav K, Stahmer A, Mistry RD, May L. An Implementation Science Approach to Antibiotic Stewardship in Emergency Departments and Urgent Care Centers. Academic Emergency Medicine 2020; 27(1):31-42. doi: 10.1111/acem.13873. PMID: 31625653. 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.

Episode Notes Drs. Kate Kyler (@kedkyler) and Amit Pai (@DosingMatters) join Dr. Jeannette Bouchard (@jlbouchard001) for a discussion on dosing antibiotics in children and adults affected by obesity! Learn when practitioners should be concerned about drug dosing, what disease states and populations matter most, when we should explore TDM, 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/ 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.

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.

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.

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.

Episode Notes Drs. Jim Lewis, Mike Satlin (@MSatlin) and Jason Pogue (@jpogue1) are back with Dr. Erin McCreary (@ErinMcCreary) for episode four of a five-episode miniseries all about breakpoints! Join our panelists for a magically delicious episode all about breakpoint updates on fluoroquinolones. 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.

Episode Notes Drs. Jim Lewis, Mike Satlin (@MSatlin) and Jason Pogue (@jpogue1) are back with Dr. Erin McCreary (@ErinMcCreary) for episode three of a five-episode miniseries all about breakpoints! Join our panelists as they discuss breakpoint updates on aminoglycosides. 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.

Episode Notes Drs. Jim Lewis, Mike Satlin (@MSatlin) and Jason Pogue (@jpogue1) are back with Dr. Erin McCreary (@ErinMcCreary) for episode two of a five-episode miniseries all about breakpoints! Join our panelists as they discuss breakpoint updates on piperacillin/tazobactam. 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.

Episode Notes Drs. Jim Lewis, Mike Satlin (@MSatlin) and Jason Pogue (@jpogue1) join Dr. Erin McCreary (@ErinMcCreary) for episode one of a five-episode miniseries all about breakpoints! Over the next five weeks, our panelists will cover breakpoint updates on piperacillin/tazobactam, aminoglycosides, fluoroquinolones, and non-fermenters. You won't want to miss this series! Our first episode will tackle questions related to breakpoints themselves – a seemingly mystical art! How does a breakpoint become a breakpoint? How often are breakpoints updated? How do we implement all of these recent breakpoint changes into clinical practice? 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/ 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.

Episode Notes Drs. Saima Aslam (@DocSaimaAslam) and Daria Van Tyne (@DariaVanTyne) join Dr. Rachel Britt (@RachelBPharmD) for a discussion on bacteriophage therapy! Tune in for a review of their role in therapy, logistical considerations, the future of phage therapy, 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/ 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.

Episode Notes Episode Notes Inspired by lamentations on Twitter, Drs. Bobbi Jo Stoner (@BobbiJo_Stoner), Jonathan Ryder (@JonathanRyderMD) and Sami El-Dalati join Dr. Jillian Hayes (@thejillianhayes) to hash out some of the controversies we encounter while managing infective endocarditis. Do we really need gentamicin and rifampin for all cases of staphylococcal prosthetic valve endocarditis? Where do oral antimicrobials fit into this disease state? Who should have a seat at the table to provide the most comprehensive care to these patients? Tune in for the 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/ 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: IDSA/AHA Infective Endocarditis Guidelines: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000296 Deconstructing the Dogma: Systematic Literature Review and Meta-analysis of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve Endocarditis: https://pubmed.ncbi.nlm.nih.gov/36408468/ Twitter Poll – Gabe Vilchez (March 2021): https://twitter.com/IdVilchez/status/1372148761112240131?s=20&t=fYuyNWGmzZACWrpUb7Fp3g Survey of ID Physicians on Gent and Rifampin Use: https://pubmed.ncbi.nlm.nih.gov/32964063/ Bacteriological outcome of combination versus single-agent treatment for staphylococcal endocarditis: https://academic.oup.com/jac/article/52/5/820/760105 Treatment of experimental foreign body infection caused by methicillin-resistant Staphylococcus aureus: https://journals.asm.org/doi/abs/10.1128/AAC.34.12.2312 Successful therapy of experimental chronic foreign-body infection due to methicillin-resistant Staphylococcus aureus by antimicrobial combinations: https://journals.asm.org/doi/abs/10.1128/aac.35.12.2611 Rifampin Combination Therapy for Nonmycobacterial Infections: https://journals.asm.org/doi/10.1128/CMR.00034-09 ARREST Trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32456-X/fulltext Is Rifampin Use Associated With Better Outcome in Staphylococcal Prosthetic Valve Endocarditis? A Multicenter Retrospective Study: https://pubmed.ncbi.nlm.nih.gov/32706879/ Nephrotoxicity of vancomycin, alone and with an aminoglycoside: https://pubmed.ncbi.nlm.nih.gov/2351627/ Clinical Data on Daptomycin plus Ceftaroline versus Standard of Care Monotherapy in the Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia: https://journals.asm.org/doi/10.1128/AAC.02483-18 Multicenter Cohort of Patients With Methicillin-Resistant Staphylococcus aureus Bacteremia Receiving Daptomycin Plus Ceftaroline Compared With Other MRSA Treatments: https://academic.oup.com/ofid/article/7/1/ofz538/5691187 CERT Trial (in process): https://clinicaltrials.gov/ct2/show/NCT04886284 Rifampin for Surgically Treated Staphylococcal Infective Endocarditis: A Propensity Score-Adjusted Cohort Study: https://pubmed.ncbi.nlm.nih.gov/26872729/ A step-by-step guide to implementing a multidisciplinary endocarditis team: https://journals.sagepub.com/doi/10.1177/20499361211065596 Management of Infective Endocarditis in People Who Inject Drugs: A Scientific Statement from the American Heart Association: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001090?cookieSet=1 Infectious Complications of Addiction: A Call for a New Subspecialty Within Infectious Diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319263/ A Cross-sectional Analysis of Linezolid in Combination with Methadone or Buprenorphine as a Cause of Serotonin Toxicity: https://academic.oup.com/ofid/article/9/7/ofac331/6625822 POET Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1808312 Risk of New Bloodstream Infections and Mortality Among People Who Inject Drugs With Infective Endocarditis: https://pubmed.ncbi.nlm.nih.gov/32785635/ Comparing right- and left sided injection-drug related infective endocarditis: https://pubmed.ncbi.nlm.nih.gov/33441950/ Evaluation of Partial Oral Antibiotic Treatment for Persons Who Inject Drugs and Are Hospitalized With Invasive Infections: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745005/ Dalbavancin as Primary and Sequential Treatment for Gram-Positive Infective Endocarditis: 2-Year Experience at the General Hospital of Vienna: https://pubmed.ncbi.nlm.nih.gov/29659732/ Impact of the duration of antibiotic therapy on relapse and survival following surgery for active infective endocarditis: https://academic.oup.com/ejcts/article/55/4/760/5126415 Bacteriological Outcome after Valve Surgery for Active Infective Endocarditis: Implications for Duration of Treatment after Surgery: https://academic.oup.com/cid/article/41/2/187/529954 Long-term Risk of Hemorrhagic Stroke in Patients With Infective Endocarditis: A Danish Nationwide Cohort Study: https://academic.oup.com/cid/article/68/4/668/5039147 Sign of the Times: Updating Infective Endocarditis Diagnostic Criteria to Recognize Enterococcus faecalis as a Typical Endocarditis Bacterium: https://pubmed.ncbi.nlm.nih.gov/35262664/ Prevalence of colorectal disease in Enterococcus faecalis infective endocarditis: results of an observational multicenter study: https://pubmed.ncbi.nlm.nih.gov/31444092/ 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.

Episode Notes Drs. Valerie Vaughn (@ValerieVaughnMD), Jason Newland (@JasonGNewland) and Libby Dodds Ashley (@The_Real_LDA) join Dr. Erin McCreary (@ErinMcCreary) for a discussion on how to harness the power of data to move through those common stewie struggles. Tune in for a review of common barriers, the art of communication within stewardship, and more! This podcast is sponsored by bioMérieux. 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/

Episode Notes Your Breakpoints hosts, Drs. Erin McCreary (@ErinMcCreary), Julie Ann Justo (@julie_justo), Rachel Britt (@RachelBPharmD) and Jillian Hayes (@thejillianhayes) are back for a second week of IDWeek review. Tune in for publications that may change your practice, and a segment of I Feel Nerdy that is sure to Swiftly become one of your favorites! 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: Bacterial: _  GRACE-VAP: https://pubmed.ncbi.nlm.nih.gov/35394515/ Follow-up Blood Cultures: https://pubmed.ncbi.nlm.nih.gov/36136334/  SABATO: https://clinicaltrials.gov/ct2/show/NCT01792804  ZeNix: https://pubmed.ncbi.nlm.nih.gov/36053506/   SHINE: https://pubmed.ncbi.nlm.nih.gov/35263517/    _Viral:   MYR301: doi: 10.1016/j.dld.2022.01.047, https://www.natap.org/2021/EASL/EASL_14.htm   STOMP: https://clinicaltrials.gov/ct2/show/NCT05534984   MINMON: https://pubmed.ncbi.nlm.nih.gov/35026142/  ANCHOR: https://pubmed.ncbi.nlm.nih.gov/35704479/  HPTN083: https://pubmed.ncbi.nlm.nih.gov/34379922/  HPTN084: https://pubmed.ncbi.nlm.nih.gov/35378077/  ATLAS-2M: https://pubmed.ncbi.nlm.nih.gov/34648734/  LAI-ART in an Urban HIV Clinic: https://pubmed.ncbi.nlm.nih.gov/35913500/    Fungal:   CandiSep: https://pubmed.ncbi.nlm.nih.gov/35708758/  1,3 BDG and GM as Diagnostic Tools: https://pubmed.ncbi.nlm.nih.gov/34173659/  Single-Dose Ampho for Crypto: Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis - PubMed (nih.gov)  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.

Episode Notes Missing IDWeek already? Hoping for some new content to consume during your holiday travel plans? Have no fear – your IDWeek Breakpoints recap is here! Join your Breakpoints hosts, Drs. Erin McCreary (@ErinMcCreary), Julie Ann Justo (@julie_justo), Rachel Britt (@RachelBPharmD) and Jillian Hayes (@thejillianhayes) for a review of some new trials and pipeline agents presented at IDWeek 2022. Be sure to stay tuned for Part II, launching next Friday! 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.

Dr. Laura Certain (@laura_certain) and Dr. Nico Cortes-Penfield (@Cortes_Penfield) join Dr. Julie Ann Justo (@julie_justo) to discuss all things related to prosthetic joint infections. Tune in to learn about what comprises a bacterial biofilm, how it develops, and ways to combat it using the latest evidence-based antibiotic regimens. We also take a look at what's on the horizon for the field of orthopedic infectious diseases. 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: Cortés-Penfield NW, Kulkarni PA. The History of Antibiotic Treatment of Osteomyelitis. Open Forum Infect Dis. 2019 Apr 8;6(5):ofz181. doi: 10.1093/ofid/ofz181. PMID: 31123692. Bernard L, et al. Antibiotic Therapy for 6 or 12 Weeks for Prosthetic Joint Infection. N Engl J Med. 2021 May 27;384(21):1991-2001. doi: 10.1056/NEJMoa2020198. PMID: 34042388. (DATIPO trial) Gallagher C, et al. Impact of Implementing an IV to PO Antibiotic Treatment Protocol for Orthopedic Infections ion Prescribing Habits and Health Utilization Outcomes. IDWeek 2022. Poster 909. Febrile Podcast. Episode #31 – Truth or DAIR. 2022 Feb 28. https://febrilepodcast.com/episode-31-truth-or-dair/ Frank JM, et al. The Mark Coventry, MD, Award: Oral Antibiotics Reduce Reinfection After Two-Stage Exchange: A Multicenter, Randomized Controlled Trial. Clin Orthop Relat Res. 2017 Jan;475(1):56-61. doi: 10.1007/s11999-016-4890-4. PMID: 27387759. Kelly MP, et al. Extended Oral Antibiotics Increase Bacterial Resistance in Patients Who Fail 2-Stage Exchange for Periprosthetic Joint Infection. J Arthroplasty. 2022 Aug;37(8S):S989-S996. doi: 10.1016/j.arth.2022.01.027. PMID: 35074446. Payne J, et al. Inducing Antimicrobial Resistance with Long-term Antibiotics at Stage 2 Revision for Periprosthetic Joint Infection. IDWeek 2022. Poster 981. Frost P, et al. Phototoxic potential of minocycline and doxycycline. Arch Dermatol. 1972 May;105(5):681-3. PMID: 5026677. Lode H, et al. Comparative pharmacokinetics of cephalexin, cefaclor, cefadroxil, and CGP 9000. Antimicrob Agents Chemother. 1979 Jul;16(1):1-6. doi: 10.1128/AAC.16.1.1. PMID: 475366. Sader HS, et al. In vitro activity of cefpodoxime compared with other oral cephalosporins tested against 5556 recent clinical isolates from five medical centers. Diagn Microbiol Infect Dis. 1993 Aug-Sep;17(2):143-50. doi: 10.1016/0732-8893(93)90025-3. PMID: 8243035. Green S & Tsai YV. Precision Dosing of To-Marrow: Linezolid Therapeutic Drug Monitoring. ContagionLive: Bench to Bedside with SIDP. 2022 Nov 3. https://www.contagionlive.com/view/precision-dosing-of-to-marrow-linezolid-therapeutic-drug-monitoring 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. 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.