Podcasts about antibiotic stewardship

In this episode of Communicable, Emily McDonald and Josh Davis are joined by Roger Lewis (USA) and Ian Marschner (Australia) to compare and contrast Bayesian and frequentist statistical approaches. The panel discusses the fundamental principles of both methods, common misconceptions, and the extent to which they are often more similar than many realise. Together, they explore their use in clinical trial design, analysis, and reporting, including adaptive trials and sequential learning. Additional topics include sample size misconceptions, regulatory versus clinical thresholds, and the challenges of interpreting post hoc reanalyses of negative trials.This episode was edited by Kathryn Hostettler and the executive producer of Communicable is Angela Huttner.  Further reading:Berry SM, et al. Bayesian Adaptive Methods for Clinical Trials (Chapman & Hall/CRC Biostatistics Series). Boca Raton (FL): CRC Press; 2010. FDA Guidance Document: Use of Bayesian Methodology in Clinical Trials of Drug and Biological Products FDA, 2026, https://www.fda.gov/regulatory-information/search-fda-guidance-documents/use-bayesian-methodology-clinical-trials-drug-and-biological-productsLee TC, et al. Contextualizing the use of corticosteroids in severe Pneumocystis jirovecii pneumonia through a Bayesian lens. CMI Comms 2025, https://www.cmi-comms.org/article/S2950-5909(25)00082-4/fulltextLivingston EH and Lewis RJ. JAMA Guide to Statistics and Methods, https://jamaevidence.mhmedical.com/Book.aspx?bookId=2742Marschner I. Confidence distributions for treatment effects in clinical trials: Posteriors without priors. Stat Med 2024, doi: 10.1002/sim.10000.Whitehead J. The design and analysis of sequential clinical trials. Revised 2nd ed. Chichester: John Wiley & Sons; 1997.

Our editors – Marc Bonten, Erin McCreary, Anne-Grete Märtson, Angela Huttner, and Josh Davis – are back for part two of the ESCMID Global Late Breakers series, summarising five more late-breaking trials presented at ESCMID Global 2026. They discuss the trials' strengths and weaknesses, and whether their results should change practice. The five trials presented in this half of the series are listed below, and links to their respective sessions can be watched and rewatched on the ESCMID Global Virtual Platform. Links to corresponding abstracts and publications where available are provided as well.Conflict of interest/involvement in the trials:Marc Bonten was the chair of the E.mbrace trial's steering committeeJosh Davis is global co-lead of the SNAP trialJosh Davis was a site investigator on the E.mbrace trialAngela Huttner was an independent/unpaid member of the E.mbrace trial's steering committee and an investigator on the precursor phase 1 trial testing the E. coli vaccinePROCALBAN trial (Late-breaking clinical trials in sepsis management)Chowdhury F, et al. Use of Procalcitonin Point-Of-Care Testing to Guide De-Escalation of Antibiotic Therapy in Adult Sepsis Patients in a Tertiary Hospital in Bangladesh: A Randomised Controlled Open-Label Trial, Preprints with The Lancet, doi: 10.2139/ssrn.6541698BENEFICIAL trial (Late-breaking clinical trials in sepsis management) De Cock PA, et al. Bedside model-informed precision dosing of vancomycin in severely ill neonates and children in Belgium (the BENEFICIAL trial): a multicentre, randomised controlled trial. Lancet Child Adolesc Health, doi: 10.1016/S2352-4642(25)00385-2  SNAP trial (Late-breaking clinical trials in sepsis management) Bowen A. Adjunctive clindamycin for treatment of Staphylococcus aureus bacteraemia: a randomised controlled trial within the S. aureus Network Adaptive Platform (SNAP), abstractAdjunctive betamethasone treatment of hypoxemic adults hospitalised with Mycoplasma pneumoniae community-acquired pneumonia: an open-label, multicentre, randomised, controlled trial (Late-breaking research from The Lancet)Hagman K, et al. Adjunctive betamethasone treatment of hypoxaemic adults hospitalised with Mycoplasma pneumoniae community-acquired pneumonia: an open-label, multicentre, randomised, controlled trial. Lancet 2026, doi: 10.1016/j.lanepe.2026.101610E.mbrace trial (Vaccines: landmark trials and preventive immunisation)Cohen CA, et al. Randomised phase III trial of a 9-valent vaccine (ExPEC9V) for prevention of invasive Escherichia coli disease (IED) in older adults (E.mbrace), abstractThe Swiss multicentre phase 1, first-in-human trial testing the conjugate E. coli vaccine:Huttner A et al. Safety, immunogenicity, and preliminary clinical efficacy of a vaccine against extraintestinal pathogenic Escherichia coli in women with a history of recurrent urinary tract infection: a randomised, single-blind, placebo-controlled phase 1b trial. Lancet Infect Dis 2017: May;17(5):528-537

Small hospitals bring unique stewardship challenges, but also unique opportunities. Dr. Tina Khadem and Dr. Ashley Cubillos join host Dr. Whitney Buckel to discuss the realities of antimicrobial stewardship in small and critical access hospitals. From navigating competing priorities and limited resources, to building strong provider relationships in close-knit communities, we have you covered! Join us as we unpack real-world strategies, challenge common perceptions, and highlight the practical pearls you can apply in your own setting. References: Implementation of Core Elements at Small and Critical Access Hospitals: https://www.cdc.gov/antibiotic-use/media/pdfs/core-elements-small-critical-508.pdf Stenehjem E, Hyun DY, Septimus E, Yu KC, Meyer M, Raj D, Srinivasan A. Antibiotic Stewardship in Small Hospitals: Barriers and Potential Solutions. Clin Infect Dis. 2017 Aug 15;65(4):691-696. Veillette JJ, May SS, Gabrellas AD, Gelman SS, Albritton J, Lyons MD, Stenehjem EA, Webb BJ, Dalto JD, Throneberry SK, Stanfield V, Grisel NA, Vento TJ. A Fully Integrated Infectious Diseases and Antimicrobial Stewardship Telehealth Service Improves Staphylococcus aureus Bacteremia Bundle Adherence and Outcomes in 16 Small Community Hospitals. Open Forum Infect Dis. 2022 Oct 14;9(11):ofac549. Cubillos AL, Fortier K, Hoang A. P-920. Impact of Positive Blood Culture Antimicrobial Stewardship on Staphylococcus aureus Bloodstream Infection Management across Critical Access, Small, and Medium Community Hospitals. Open Forum Infect Dis. 2026 Jan 11;13(Suppl 1):ofaf695.1126. Smith LM, Ahern JW. Establishing Antibiotic Stewardship Programs in Rural Hospitals to Decrease Fluoroquinolone Prescribing: The Vermont Experience. Infect Prev Pract. 2021 Jan 21;3(1):100121. Kassamali-Escobar Z, et al. Antimicrob Steward Healthc Epidemiol 2024. doi: 10.1017/ash.2024.458. Imlay H, Ciarkowski CE, Bryson-Cahn C, et al Infect Control Hosp Epidemiol 2025. 46: 150–155, doi: 10.1017/ice.2024.206 Ciarkowski CE, Imlay HN, Bryson-Cahn C, et al. Infect Control Hosp Epidemiol 2025. 46: 143–149, doi: 10.1017/ice.2024.171 Stenehjem E, et al. JAMA Netw Open. 2023;6(5):e2313011. doi:10.1001/jamanetworkopen.2023.13011 Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) or @breakpointspodcast_sidp (https://www.instagram.com/breakpointspodcast_sidp/)https://www.instagram.com/breakpointspodcast_sidp/?hl=en 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/

The ESCMID Global Late Breakers series returns to Communicable! Five CMI Communications editors – Marc Bonten, Josh Davis, Angela Huttner, Anne-Grete Märtson, and Erin McCreary – handpicked five late-breaking trials presented at ESCMID Global 2026 to summarise their  findings and discuss whether the results will change their practice. This is part one of the two-part series. Trials presented are listed below and links to their respective sessions can be watched and rewatched on the ESCMID Global Virtual Platform. Links to corresponding publications, if available, and mentioned related articles are provided as well. The FAST trial (Late-breaking research from JAMA)Banerjee R, et al. Fast Antimicrobial Susceptibility Testing for Gram-Negative Bacteremia. The FAST Randomized Clinical Trial, doi: 10.1001/jama.2026.5487 Srinivasan A. A Multinational Trial of Rapid Antimicrobial Susceptibility Testing. Is FASTer Better?, doi: 10.1001/jama.2026.5504The CEFMEC trial (Poster session)Hayakawa K, et al. Effectiveness of cefmetazole versus meropenem for invasive urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli, Antimicrob Agents Chemother 2023, doi: 10.1128/aac.00510-23The COBRA trial (Late-breaking trials in surgical infection prevention)Overdevest AG, et al. Antibiotic treatment for 1 day versus 4-7 days in patients with acute cholangitis after adequate endoscopic biliary drainage (COBRA): study protocol for a randomized controlled trial. Trials, doi: 10.1186/s13063-026-09524-7The DOTS trial, a secondary analysis (Late-breaking research from JAMA)Lodise, TP, et al. Pharmacokinetics of Dalbavancin in Complicated Staphylococcus aureus Bacteremia: A Secondary Analysis of the DOTS Randomized Clinical Trial, JAMA 2026, doi: 10.1001/jamanetworkopen.2026.11652 Walls G, et al. Patient-reported Perceptions, Experiences, and Preferences Around Intravenous and Oral Antibiotics for the Treatment of Staphylococcus aureus Bacteremia: A Descriptive Qualitative Study, Clin Infect Dis 2026, doi: 10.1093/cid/ciaf522Turner  NA , et al.  Dalbavancin for treatment of Staphylococcus aureus bacteremia: the DOTS randomized clinical trial. JAMA 2025, doi: 10.1001/jama.2025.12543 Maribavir for clinically significant cytomegalovirus infection in hematopoietic cell transplantation: a real-world retrospective international study of the Infectious Disease Working Party of EBMT (Late-breaking research from The Lancet)Paviglianiti A, et al. Maribavir for clinically significant cytomegalovirus infection in haematopoietic cell transplant recipients in Europe: a real-world multicentre retrospective registry study. Lancet 2026. doi: 10.1016/S1473-3099(26)00144-1

In this collaborative episode of Breakpoints and Communicable, the hosts revisit the “trial run” session from ESCMID Global, a format designed to facilitate critical discussion of major infectious diseases trials. This episode focuses on two studies addressing bloodstream infections caused by third‑generation cephalosporin-resistant Enterobacterales [1].Mical Paul (Rambam Health Care Campus, Israel) joins the podcast to discuss the PETER PEN trial [1,2], comparing piperacillin/tazobactam with meropenem, including its design, interim analyses, and interpretation alongside prior data such as MERINO. The episode also features Jesús Rodríguez‑Baño (University of Seville, Spain), who presents a post hoc analysis of the ASTARTE trial [1,3], comparing temocillin and carbapenems.This episode was edited by Lacy Worden and was peer reviewed by Jeanette Bouchard (Duke Antimicrobial Stewardship Outreach Network (DASON) Durham, NC, USA). ReferencesPaul, M., & Rodríguez-Baño, J. (2026, April 20). The trial run: treatment of ESBL bacteraemia - off to never-never land. [Presentation]. ESCMID Global 2026, Munich, Germany. ESCMID Global Virtual Platform.Bitterman R, Koppel F, Mussini C, et al. Piperacillin-tazobactam versus meropenem for treatment of bloodstream infections caused by third-generation cephalosporin-resistant Enterobacteriaceae: a study protocol for a non-inferiority open-label randomised controlled trial (PeterPen). BMJ Open. 2021;11(2):e040210. Published 2021 Feb 8. doi: 10.1136/bmjopen-2020-040210 Marín-Candón A, Rosso-Fernández CM, Bustos de Godoy N, et al. Temocillin versus meropenem for the targeted treatment of bacteraemia due to third-generation cephalosporin-resistant Enterobacterales (ASTARTÉ): protocol for a randomised, pragmatic trial [Internet]. BMJ Open. 2021 Sep 27;11(9):e049481. doi: 10.1136/bmjopen-2021-049481 Further readingHarris PNA, et al. Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance: A Randomized Clinical Trial. JAMA. 2018;320(10):984–994. doi: 10.1001/jama.2018.12163.

This is a short message to Communicable listeners to inform them that the next episode will be released on Friday, 8 May, as it is a collaboration episode with Breakpoints, the podcast of the Society of Infectious Diseases Pharmacists. It will cover the two trials presented in Munich during ESCMID Global's late-breaker Trial Run session.

Communicable is launching a new series on everything related to pharmacokinetics (PK) and pharmacodynamics (PD). Kicking off this series are hosts Thomas Tängdén, Erin McCreary and Angela Huttner, and invited guests Amy Legg and Rekha Pai Mangalore. They walk us through key parameters and terms of PK/PD, such as volume of distribution, minimum inhibitory concentration (MIC), epidemiological cut-off value (ECOFF), and PK/PD indices, laying the foundation to better comprehend clinical applications such as setting a clinical breakpoint and how it guides therapeutic drug monitoring (TDM). This first episode encompasses a broad scope across PK/PD theory, preparing the listener for subsequent episodes that will explore these topics with greater depth and make you love PK/PD. This episode was peer-reviewed by Ummu Afeera Zainulabid of the International Islamic University, Kuantan, Malaysia.   Terms and definitions ADME, a drug's journey through the body: absorption, distribution, metabolism, excretionVolume of distribution, a parameter describing the theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration that it is observed in the blood plasmaClearance, the volume of blood cleared of drug per unit timeHalf-life, the time required for the concentration of a drug to decrease to half of its initial amount in the bodyLoading dose, a larger initial dose designed to rapidly bring drug levels into the therapeutic rangeSteady state, an equilibrial condition in which the rate of input of a drug is equal to the rate of its outputMIC, minimum inhibitory concentrationECOFF, epidemiological cut-off value: the highest MIC value of isolates that are not known to have resistance and are therefore considered representative of wild-type bacterial isolatesClinical breakpoint setting, takes into account drug dosing, PK/PD, site of infection, clinical data; what we think is the breakpoint for the lab to call a bacterial organism susceptible to a drugPK/PD index, a parameter that describes the observed antimicrobial activity of an antimicrobial; there are three different indices: T>MIC (bacterial killing depends on the drug concentration's remaining higher than the MIC over time)Cmax/MIC (bacterial killing depends on the drug's peak concentration)AUC/MIC (bacterial killing depends on the area under the curve over the MIC)TDM, therapeutic drug monitoringFurther readingMouton JW, et al. MIC-based dose adjustment: facts and fables. J Antimicrob Chemother 2018. doi:10.1093/jac/dkx427Märtson A, et al. The pharmacokinetics of antibiotics in patients with obesity: a systematic review and consensus guidelines for dose adjustments. Lancet Infect Dis 2025. doi: 10.1016/S1473-3099(25)00155-0Eagle H and Musselman AD. The rate of bactericidal action of penicillin in vitro as a function of its concentration, and its paradoxically reduced activity at high concentrations against certain organisms. J Exp Med 1948. doi: 10.1084/jem.88.1.99

In this episode, made possible through an educational grant from Sandoz Canada, Dr. George Zhanel discusses the latest developments in antimicrobial stewardship, focusing on IV Amox Clav, its clinical applications, safety profile, and the Canadian Leadership on Antimicrobial Real-Life Usage Registry (CLEAR). Gain insights into optimizing antibiotic use and future prospects in antimicrobial development.Key Topics:IV Amox Clav clinical applicationsCanadian Leadership on Antimicrobial Usage Registry (CLEAR)Antibiotic stewardship strategiesFuture developments in antimicrobial agentsChapters: 00:00 Introduction and Guest Credibility01:47 Introduction of Dr. George Zhanel and his background02:41 The journey into IV Amox Clav and its significance03:21 Overview of the CLEAR registry and its purpose06:18 Findings from the CLEAR study on IV Amox Clav usage07:57 Clinical indications and safety profile of IV Amox Clav10:58 De-escalation and appropriate use of IV Amox Clav12:34 Use in bacteremia and various infections13:35 Side effects and safety data of IV Amox Clav15:02 Dosing strategies and renal adjustments17:29 Beta-lactamase inhibitors and future antimicrobial development20:16 Future prospects for new antibiotics in Canada23:13 Canadian Antimicrobial Resistance Alliance (CARA) and involvement25:53 Case examples and clinical decision-making in pneumonia and skin infections31:09 Closing remarks and appreciation for the audienceResources: Canadian Leadership on Antimicrobial Real-Life Usage Registry (CLEAR) - https://www.clearregistry.caCanadian Antimicrobial Resistance Alliance (CARA) - https://www.cara.caMeropenem Vaborbactam - https://www.meropenem.comCeftazidime-Avibactam - https://www.ceftazidime-avibactam.comGuest Links: LinkedIn - https://www.linkedin.com/in/george-zhanelTwitter - https://twitter.com/GeorgeZhanel

This is the first episode of the 'Quarterly catchup' series, in which CMI Communications editors discuss important and useful articles that have come out in the last 3 months to understand their results and potential clinical impact. In this inaugural episode of 'Quarterly catchup', Emily McDonald (Canada), Thomas Tängdén (Sweden) and Navaneeth Narayanan (USA) convene to discuss clinical microbiology and infectious diseases studies published in the first quarter of 2026 [1-6]. From Wolbachia-infected mosquitoes reducing dengue infection to exploration of antibiotic combination therapies against multidrug-resistant organisms, our hosts summarize six articles they found the most interesting, and discuss whether they can and should change clinical practice.   This episode was peer reviewed by Connor Prosty of McGill University, Montréal, Canada.  ReferencesLim JT, et al. Dengue suppression by Male Wolbachia-Infected mosquitoes. NEJM 2026. doi: https://doi.org/10.1056/NEJMoa2503304 Escrihuela-Vida F, et al. Adjunctive Fosfomycin for the Treatment of Staphylococcus aureus Bacteremia: A Pooled Post Hoc Analysis of Individual Participant Data From 2 Randomized Trial. Clin Infect Dis 2026. doi: https://doi.org/10.1093/cid/ciaf387 Baldanzi G, et al. Antibiotic use and gut microbiome composition links from individual-level prescription data of 14,979 individuals. Nat Med 2026. doi: https://doi.org/10.1038/s41591-026-04284-y.Quentin Vallé, et al. Evaluating the antibacterial activity of ceftazidime/avibactam and aztreonam combinations against multidrug-resistant Stenotrophomonas maltophilia complex isolates in a hollow fibre infection model.  Clin Microbiol Infect 2026. doi: https://doi.org/10.1016/j.cmi.2026.02.010 Rana AI, et al. Cabotegravir plus Rilpivirine for Persons with HIV and Adherence Challenges. NEJM 2026. doi: https://doi.org/10.1056/NEJMoa2508228 Donovan J, et al. Genotype-stratified adjunctive dexamethasone for tuberculous meningitis in HIV-negative adults: a randomized controlled phase 3 trial. Nat Med 2026. doi: https://doi.org/10.1038/s41591-025-04138-z Further readingThwaite GE, et al. Dexamethasone for the Treatment of Tuberculous Meningitis in Adolescents and Adults. NEJM 2004. doi: https://doi.org/10.1056/NEJMoa040573 Behrmann LV. “The specimen is never wrong”: the pathologist behind Wolbachia. CMI Communications, 2026. doi: https://doi.org/10.1016/j.cmicom.2026.105185                

Antibiotic stewardship and infection prevention are critical in nursing homes, where residents are especially vulnerable and antibiotic overuse remains a persistent challenge. In this episode of The SHEA Podcast, host Kristy Weinshel is joined by Dr. Suzanne Bradley and Dr. Morgan Katz to discuss what nursing homes need to know to improve stewardship practices and resident safety. Together, they explore SHEA's “You Can Help! Improving Antibiotic Stewardship & Infection Prevention in Nursing Homes” program, including its practical, micro-learning approach designed for brief daily huddles. The conversation highlights how frontline staff—especially nurses and CNAs—can play a vital role in influencing antibiotic decisions, recognizing early signs of infection, and improving communication across care teams. They also address common misconceptions around urinary tract and respiratory infections, and explain how unnecessary antibiotic use contributes to multidrug-resistant organisms in long-term care settings. From early detection strategies to empowering staff engagement, this episode offers actionable insights for strengthening stewardship efforts and enhancing the quality and safety of care for nursing home residents. Check out SHEA's “You Can Help! Improving Antibiotic Stewardship & Infection Prevention in Nursing Homes” course here: https://learningce.shea-online.org/content/you-can-help-improving-antibiotic-stewardship-infection-prevention-nursing-homes#group-tabs-node-course-default1

Yesterday was International Women's Day. In light of that, Communicable prepared a special episode in which hosts Erin McCreary and Annie Joseph are joined by Esmita Charani (South Africa) and Annette Westgeest (Netherlands) for a discussion on gender- and sex-dependent patient-care disparities in the infectious diseases space. Together they review recent research findings that identified gender and sex as important determinants influencing patient outcomes and even decision making by prescribers. They also explore how societal and cultural norms may introduce further nuance and complexities. The panel remains optimistic in reaching equal healthcare for all, reflecting also on progressive steps such as increasing recognition by international organisations like the WHO, which published guidance on gender inequalities in national plans on AMR in 2024.This episode was peer reviewed by Casandra Bulescu at the Dr. Victor Babes Clinical Hospital of Infectious and Tropical Diseases in Bucharest, Romania.ReferencesCharani E, et al. Wellcome Open Research, 2024. Charani E, et al. Lancet Global Health, 2023.WHO guidance on gender inequalities in national action plans on AMR, 2024.Westgeest AC's presentation at ESCMID Global 2023.Dellière S, et al. Clin Microbiol Infect, 2026.Westgeest AC, et al. Clin Microbiol Infect, 2023.Madsen TE, et al. DISPARITY-II study, 2014.Criado Perez, C. Invisible Women. Ausman SE, et al. CLASI study, 2023.Vaughn VM, et al. ICHE, 2022.Szymczak JE. Clin Infect Dis, 2019.

What if the most expensive healthcare decisions aren't made in the boardroom — but in the exam room, when the wrong infection gets treated with the wrong antibiotic? In this episode of the Your Health University, Podcast, Jamie sits down with Madison Browning, a registered nurse in urology at Your Health, to talk about what proper urological care actually looks like, why it matters far beyond the individual patient, and how a strong, collaborative provider team is the difference between a patient thriving and a patient stuck in a revolving door of emergency room visits. What you'll hear in this episode: Why getting a UTI diagnosis right the first time has massive implications for patient health and system costs The role nurse practitioners play in specialized urology care — and why their expertise is often underestimated How the team-based model at Your Health empowers every provider to collaborate and deliver better outcomes The direct connection between outpatient urology care and reduced hospital stays, ER visits, and downstream Medicare and tax costs Madison's genuine gratitude for the team around her — and what it looks like when a healthcare culture actually works If you've ever wondered whether the healthcare system could do better — this episode is proof that it already is, one patient at a time. www.YourHealth.Org

Show notes at pharmacyjoe.com/episode1109 In this episode, I'll discuss a novel metric for antibiotic stewardship.

In this third collaboration between SIDP's Breakpoints and ESCMID's Communicable podcasts, hosts Erin McCreary and Angela Huttner invite two veteran authors of guidelines and guidances, Pranita Tamma (Philadelphia, USA) and Benedikt Huttner (WHO, Geneva, Switzerland) [1-3]. Together, they deconstruct the complex landscape of developing and implementing guidelines into digestible components: they discuss why different organizations develop guidelines and what need they hope to fulfil, the framework including the GRADE methodology under which guidelines are written, and major barriers in the uptake of guidelines. The conversation also details the distinction between guideline and guidance as well as the art and science behind formulating recommendations or suggestions, with a few anecdotal cases sprinkled in from the panel. This episode was edited by Kathryn Hostettler and Lacy Worden. It was peer reviewed for Breakpoints by Lacy Worden and for Communicable by Ljiljana Lukić of University Hospital for Infectious Diseases in Zagreb, Croatia.  References WHO handbook for guideline development, 2nd Edition The WHO AWaRe (Access, Watch, Reserve) antibiotic book IDSA 2024 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative InfectionsFurther readingESCMID AMR Guidelines, https://clinicalmicrobiologyandinfection.com/retrieve/pii/S1198743X21006790 GRADE working group, https://www.gradeworkinggroup.org/GRADE Book, https://book.gradepro.org/ IDSA's intraabdominal guidelines, https://www.idsociety.org/practice-guideline/intra-abdominal-infections/ ESCMID Manual for Clinical Practice Guidelines and Other Guidance Documents, https://www.escmid.org/guidelines-journals/guidelines/ International Consensus Guidelines for the Optimal Use of the Polymyxins https://accpjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/phar.2209 American Thoracic Society guidelines on community-acquired pneumonia, https://www.atsjournals.org/doi/abs/10.1164/rccm.202507-1692ST 

At what point does a “routine” sinus or ear infection become a warning sign of immunodeficiency? In this episode of the BackTable ENT Podcast, board-certified allergist-immunologist Dr. Basil Kahwash explores the intersection of immunodeficiency and otolaryngology with Dr. Lauren Gunderman, a pediatric immunologist at Seattle Children's Hospital. Learn why ENTs should remain vigilant for underlying immune disorders, and how to manage suspected immunodeficiency. --- SYNPOSIS The conversation reviews common signs and symptoms of immunodeficiency, key elements of the diagnostic workup, and when ENT physicians should consider referral to immunology. Dr. Kahwash and Dr. Gunderman discuss the role of family history and genetics, as well as current management strategies, including antibiotic use, immunoglobulin replacement therapy, and lifestyle modifications. Throughout the episode, Dr. Gunderman emphasizes the importance of multidisciplinary collaboration between otolaryngologists and immunologists to improve outcomes for patients with recurrent or severe infections. --- TIMESTAMPS 00:00 - Introduction 02:45 - Understanding Immunodeficiency in ENT08:20 - Common Immunodeficiencies and Indicators11:02 - Basic Immunology Refresher22:13 - Initial Diagnostic Workup25:05 - Challenges in Allergy and Immunology Testing27:57 - When to Refer to an Immunologist34:01 - Antibiotic Stewardship in Immunodeficient Patients46:07 - Advances in Diagnosing Immunodeficiency50:31 - Final Thoughts and Takeaways --- RESOURCES Lauren Michelle Gunderman, MDhttps://www.seattlechildrens.org/directory/lauren-michelle-gunderman/

In this episode of Communicable, Navaneeth Narayanan and Josh Nosanchuk invite Virginie Lemiale and Elie Azoulay (Paris, France) as well as fellow editor Emily McDonald (Montreal, Canada)—this time as guest—to discuss adjunctive steroid therapy for pneumocystis pneumonia (PCP) in HIV-negative individuals. In 2025, Lemiale and Azoulay published results from their double-blind, randomised controlled trial investigating steroid treatment for severe Pneumocystis jirovecii pneumonia (PIC trial) in the Lancet Respiratory Medicine [1]. At first glance, one might dismiss the study's clinical impact due the ‘negative' result of  the primary outcome, mortality at 28 days, which just missed a statistically significant difference between groups. There was a clinical difference, however, and all other outcomes, including 90-day mortality, were significantly different between groups. Understanding how pivotal these results were to clinical practice, McDonald and colleagues sought to contextualise the results of the PIC trial through a Bayesian analysis in a follow-up publication [2]. While the discussion provides useful clinical commentary, it also helps both to demystify Bayesian analysis and to call attention to what might be lost with strict or overly concrete interpretations of traditional frequentist analyses. This episode was peer reviewed by Arjana Zerja from the Mother Theresa University Hospital Center, Tirana, Albania.ReferencesLemiale V, et al. Adjunctive corticosteroids in non-AIDS patients with severe Pneumocystis jirovecii pneumonia (PIC): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med. 2025;13(9):800-808. doi:10.1016/S2213-2600(25)00125-0.Lee TC, Albuquerque AM, McDonald EG. Contextualizing the use of corticosteroids in severe Pneumocystis jirovecii pneumonia through a Bayesian lens. CMI Commun. 2025;2(4):105141. doi:10.1016/j.cmicom.2025.105141.

Nurses are the backbone of patient care, but their role in antibiotic and diagnostic stewardship is still underrecognized. In this episode of The SHEA Podcast, host Dr. Marisa Holubar is joined by Dr. Eileen Carter and Dr. David Ha to explore why nurses are essential to stewardship success. Together, they discuss the evidence behind nursing engagement, persistent barriers to involvement, and real-world examples where nurse-led initiatives have reduced antibiotic use, infections, and waste. From IV-to-PO transitions to penicillin allergy assessment and diagnostic stewardship, this conversation offers practical strategies for engaging nurses, leveraging shared governance, and building stronger, more effective stewardship programs across care settings. References: Thurman Johnson C, Ridge LJ, Hessels AJ. Nurse Engagement in Antibiotic Stewardship Programs: A Scoping Review of the Literature. J Healthc Qual. 2023 Mar-Apr 01;45(2):69-82. doi: 10.1097/JHQ.0000000000000372. Epub 2022 Dec 12. PMID: 36729679; PMCID: PMC9991980. Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and Management of Penicillin Allergy: A Review. JAMA. 2019 Jan 15;321(2):188-199. doi: 10.1001/jama.2018.19283. PMID: 30644987. Carter EJ, Schramm C, Baron K, Zolla MM, Zavez K, Banach DB. Perceived usefulness of a mnemonic to improve nurses' evaluation of reported penicillin allergies. Antimicrob Steward Healthc Epidemiol. 2023 Jul 11;3(1):e124. doi: 10.1017/ash.2023.177. PMID: 37502243; PMCID: PMC10369439. Carter EJ, Zavez K, Schramm C, Zolla MM, Baron K, Banach DB. Multifaceted implementation strategy to improve the evaluation of penicillin allergies in perioperative patients: a pre-post feasibility implementation study. Infect Control Hosp Epidemiol. 2024 Oct 30;45(12):1-7. doi: 10.1017/ice.2024.119. Epub ahead of print. PMID: 39473231; PMCID: PMC11663472. Resources: ANCC Magnet Recognition Program: https://www.nursingworld.org/organizational-programs/magnet/ Breakpoints, The SIDP Podcast: https://breakpoints-sidp.org/18-waking-the-sleeping-giant-engaging-nurses-in-antimicrobial-stewardship/

In reconstructive urology, preventing infection often means prolonged antibiotic exposure, raising important questions about stewardship and long-term harm. In this episode of BackTable Urology, Joshua Sterling of Yale University joins host George Koch to examine how antibiotic stewardship and emerging insights into the urinary microbiome are reshaping infection management in reconstructive practice. --- SYNPOSIS The discussion centers on real-world clinical challenges, particularly in high-risk populations such as patients with neurogenic bladder, chronic catheterization, or prior reconstruction - groups in whom antibiotics are frequently used prophylactically or indefinitely. Drs. Sterling and Koch explore how well-intentioned prescribing patterns can contribute to resistance, dysbiosis, and recurrent infection, while often failing to address the underlying drivers of disease. Rather than framing infection control solely around eradication, the conversation considers a shift toward modulation of the urinary microbiome, drawing on lessons from gastroenterology, infectious disease, and transplant medicine. The episode concludes by outlining how a more nuanced, multidisciplinary approach may better serve reconstructive urology patients in the long term. --- TIMESTAMPS 00:00 - Introduction02:22 - Antibiotic Stewardship in Urology06:34 - Current Landscape of Antibiotic Use13:44 - Protocols and Practices in Reconstruction18:24 - Antibiotic Overuse and Misuse21:02 - Shifting the Microbiome25:12 - Chlorhexidine Irrigations32:38 - Future Directions38:27 - Implementing Antibiotic Protocols40:48 - Conclusions --- RESOURCES STOP-IT Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa1411162

In this episode of Communicable, Josh Davis (Newcastle, Australia) and Emily McDonald (Montreal, Canada), plus invited guest, Steven Tong (Melbourne, Australia)—all practicing physicians and clinical trialists—assemble to discuss some of their ‘top infectious diseases papers published in 2025'. Bassam Ghanem (Jeddah Lol, Saudi Arabia), whom one might know better as Antibiotic Steward on social media, was also invited to share his favourite publications of 2025.Six papers that were most consistently picked by the panel are presented, explaining why they were picked and how they have shifted paradigms or changed their practice. This episode complements the previous episode, which presented ‘top clinical microbiology papers in 2025', and was peer reviewed by Akshatha Ravindra of Kasturba Medical College, Manipal, India.   ResourcesCLARITY initiative websitePapers presented (in order of presentation) Turner NA, et al. Dalbavancin for Treatment of Staphylococcus aureus Bacteremia. JAMAMeya DB, et al. Trial of High-Dose Oral Rifampin in Adults with Tuberculous Meningitis. NEJMVodstrcil LA, et al. Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis. NEJMKreimer A, et al. Noninferiority of One HPV Vaccine Dose to Two Doses. NEJMGuglielmetti L, et al. Oral Regimens for Rifampin-Resistant, Fluoroquinolone-Susceptible Tuberculosis. NEJMRoss JDC et al, Oral gepotidacin for the treatment of uncomplicated urogenital gonorrhoea (EAGLE-1). Lancet  ‘One liners' (in order of presentation)Burdet C et al. Cloxacillin versus cefazolin for meticillin-susceptible Staphylococcus aureus bacteraemia (CloCeBa). LancetLemiale V et al, Adjunctive corticosteroids in non-AIDS patients with severe Pneumocystis jirovecii pneumonia (PIC). Lancet Respir MedLuetkemeyer AF et al, Doxycycline to prevent bacterial sexually transmitted infections in the USA. Lancet Inf DisEyting M, et al. A natural experiment on the effect of herpes zoster vaccination on dementia. NatureXie M, et al. The effect of shingles vaccination at different stages of the dementia disease course. CellPomirchy M, et al. Herpes Zoster Vaccination and Dementia Occurrence. JAMADurbin AP et al, Daily Mosnodenvir as Dengue Prophylaxis in a Controlled Human Infection Model. NEJMHook EW et al, One Dose versus Three Doses of Benzathine Penicillin G in Early Syphilis. NEJMOpdam MAA et al, Continuation versus temporary interruption of immunomodulatory agents during infections in patients with inflammatory rheumatic diseases. Clin Infect DisArundel C et al, Negative pressure wound therapy versus usual care in patients with surgical wound healing by secondary intention in the UK (SWHSI-2). LancetHonourable mentionsChaccour C, et al. Ivermectin to Control Malaria. NEJMLucinde RK, et al. A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia. NEJMMorel J, et al. Effect of a 1-month methotrexate delay on pneumococcal vaccine immunogenicity and disease control in patients with early rheumatoid arthritis (VACIMRA). Lancet RheumatolHaukoos J, et al. Hepatitis C Screening in Emergency Departments. JAMAMajor Extremity Trauma Research Consortium (METRC). Oral vs Intravenous Antibiotics for Fracture-Related Infections: The POvIV Randomized Clinical Trial, JAMA SurgAnderson CS, et al. Influenza vaccination to improve outcomes for patients with acute heart failure (PANDA II). LancetSt Peter SD, et al. Appendicectomy versus antibiotics for acute uncomplicated appendicitis in children. LancetPan CQ, et al. Tenofovir and Hepatitis B Virus Transmission During Pregnancy. JAMAGohil SK, et al. Improving Empiric Antibiotic Selection for Patients Hospitalized With Abdominal Infection. JAMA SurgRelated podcast episodesCommunicable E44: Top clinical microbiology papers in 2025 https://share.transistor.fm/s/6e5c26aeCommunicable E29: Bacterial vaginosis & male partners, https://share.transistor.fm/s/3de4f5c3 Communicable E28: Late-breaker trials at ESCMID Global: Should they change your practice? - part 2, https://share.transistor.fm/s/4f044e8c Communicable E20: Tuberculosis today https://share.transistor.fm/s/9858900e 

In the first Communicable episode of 2026, Annie Joseph and Josh Nosanchuk invite Robin Patel (Rochester, USA) and Fidelma Fitzpatrick (Dublin, Ireland) to discuss some of their favourite clinical microbiology papers published in 2025. These six papers highlight everything from technological advances of genomics and molecular diagnostic testing to the importance of patient and public involvement in research as well as effective communication [1-6]. The panel also discusses whether or not any of these papers have changed their practice.This episode was edited by Kathryn Hostettler and peer reviewed by Sinéad Kilgarriff of the National Virus Reference Laboratory University College, Dublin in Ireland. Robin's papersOyeniran SJ, et al. J Clin Microbiol 2025. DOI: https://doi.org/10.1128/jcm.00986-25 Xie O, et al. Lancet Microbe 2025. DOI: 10.1016/j.lanmic.2025.101182Lopopolo M et al., Science 2025. DOI: 10.1126/science.adu7144Fidelma's papersTurner NA, et al. JAMA 2025. DOI: 10.1001/jama.2025.12543  Paterson DL, et al. Lancet Infectious Diseases 2025. DOI: 10.1016/S1473-3099(25)00469-4Langford BJ, et al. Antimicrobial Stewardship & Healthcare Epidemiology 2025. DOI: 10.1017/ash.2025.10210Related podcast episodesCommunicable episode 1: Late breaker trials at ESCMID Global 2024, https://share.transistor.fm/s/9c598f68ReferencesOyeniran SJ, et al. J Clin Microbiol 2025. DOI: https://doi.org/10.1128/jcm.00986-25 Xie O, et al. Lancet Microbe 2025. DOI: 10.1016/j.lanmic.2025.101182Turner NA, et al. JAMA 2025. DOI: 10.1001/jama.2025.12543  Paterson DL, et al. Lancet Infectious Diseases 2025. DOI: 10.1016/S1473-3099(25)00469-4Lopopolo M et al., Science 2025. DOI: 10.1126/science.adu7144Langford BJ, et al. Antimicrobial Stewardship & Healthcare Epidemiology 2025. DOI: 10.1017/ash.2025.10210Further readingMohammed HT, et al. IJSEM 2025. DOI: 10.1099/ijsem.0.006986  Skally M, et al. BMJ Open 2025. DOI: 10.1136/bmjopen-2025-103431Ong SWX and Tverring J. CMI Communications 2025. DOI: 10.1016/j.cmicom.2025.105154Tverring J and Ong SWX. CMI Communications 2025. DOI: 10.1016/j.cmicom.2025.105169 

This special episode of the RCVS Knowledge podcast features Fiona Lovatt of RCVS Knowledge and the Sheep Antibiotic Guardian Group, David Black - President of the BCVA, and Mark Jelley of the Cattle Antibiotic Guardian Group. The panel discuss the UK ruminant antibiotic stewardship roadmap, a project that aims to drive more responsible antibiotic usage in the ruminant sector. Read the transcript.   Take the survey.

During the COVID-19 pandemic with lockdown mandates and social distancing, doctors, researchers, and the public were able to find refuge and community online; for the infectious disease community, it was on the social media platform Twitter, and more specifically under the widely used hashtag, #IDTwitter. Under new ownership from 2022, however, Twitter's name and brand changed to what we now know as X, and “the heyday of #IDTwitter is long since gone”. In this special episode of Communicable, Angela Huttner and Marc Bonten invite doctors and science communicators, Neil Stone (London, UK), Ilan Schwartz (Durham, USA), and Tara Smith (Kent, USA) to debate whether we should stay on X or leave it for alternatives.This episode is a follow-up from Stone and Schwartz's commentary [1] and Smith's response letter [2] addressing the same topic published in CMI Communications. The views expressed by the panelists are their own and do not represent the positions of their affiliated institutions or ESCMID. This episode was not peer reviewed.ResourcesYou can follow all participants of this episode on Bluesky: @drneilstone.bsky.social, @germhuntermd.bsky.social, @aetiology.bsky.social, @marcbonten.bsky.social, @angelahuttner.bsky.social, and Stone on X: @DrNeilStone.ReferencesStone NRH and Schwartz IS. Joining the X-odus: Contrasting perspectives on whether infection specialists should leave X (formerly Twitter). CMI Comms 2025. DOI: 10.1016/j.cmicom.2025.105140Smith TC. Twitter remains a haven of harassment. CMI Comms 2025. DOI: 10.1016/j.cmicom.2025.105144Further readingBiever, C. Bluesky's science takeover: 70% of Nature poll respondents use platform. Nature News 2025. PEW Research Center. How Do Americans View Childhood Vaccines, Vaccine Research and Policy? https://www.pewresearch.org/science/2025/11/18/how-do-americans-view-childhood-vaccines-vaccine-research-and-policy/   NBC News. X's new location labels unmask users. Insiders say the idea was rejected for years. https://www.nbcnews.com/tech/elon-musk/x-user-location-feature-country-elon-musk-new-rcna245620

Molecular point-of-care testing has the potential to substantially mitigate the impact of sexually transmitted infections (STIs) on personal and public health. Listen in to learn how it may even limit the development of antimicrobial resistance. Topics covered include:CDC and US Preventive Services Task Force STI screening recommendationsWhether or not laboratory-based STI tests contribute to increasing antibiotic resistanceRole of point-of-care testing and strategies for implementationPresenter:Jeffrey D. Klausner, MD, MPHClinical Professor of MedicinePopulation and Public Health Sciences LeadInfectious Diseases Epidemiology and Applies Studies (I.D.E.A.S.) InitiativeKeck School of Medicine of the University of Southern CaliforniaLos Angeles, CaliforniaLink to full program:https://bit.ly/4nS7rYEGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, YouTube Music, or Spotify.  Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In the last ten years, 'diagnostic stewardship' has emerged as a core principle of good clinical practice whose implementation impacts both the individual patient and public health at large. In this episode of Communicable, hosts Angela Huttner and Annie Joseph invite two experts in the field, Daniel Morgan (Maryland, USA) and Valerie Vaughn (Utah, USA), to discuss diagnostic stewardship in the context of infectious diseases, hospital medicine, and healthcare in general. Other topics covered include practical interventions for better testing practices and the role of artificial intelligence in the future of diagnostics. The episode highlights how thoughtful, intentional diagnostic practices can enhance clinician workflows and improve patient outcomes.This episode is a follow-up from Morgan's recently published commentary in CMI Communications on diagnostic testing, and the need for evaluating its clinical impact [1]. The episode was peer reviewed by Özlem Türkmen Recen of Çınarcık State Hospital, Yalova, Türkiye. ReferencesBaghdadi JD & Morgan DJ. Diagnostic tests should be assessed for clinical impact. CMI Comms 2024. DOI: 10.1016/j.cmicom.2024.105010Further readingAdvani S and Vaughn VM. Quality Improvement Interventions and Implementation Strategies for Urine Culture Stewardship in the Acute Care Setting: Advances and Challenges. Curr Infect Dis Rep 2021. DOI: 10.1007/s11908-021-00760-3 Core Elements of Hospital Antibiotic Stewardship Programs, https://www.cdc.gov/antibiotic-use/hcp/core-elements/hospital.html Core Elements of Hospital Diagnostic Excellence (DxEx), https://www.cdc.gov/patient-safety/hcp/hospital-dx-excellence/index.htmlCosgrove SE & Srinivasan A. Antibiotic Stewardship: A Decade of Progress. Infect Dis Clin North Am 2023. DOI: 10.1016/j.idc.2023.06.003 Dik JH, et al. Integrated Stewardship Model Comprising Antimicrobial, Infection Prevention, and Diagnostic Stewardship (AID Stewardship). J Clin Microbiol 2017. DOI: 10.1128/jcm.01283-17Fabre V, et al. Principles of diagnostic stewardship: A practical guide from the Society for Healthcare Epidemiology of America Diagnostic Stewardship Task Force. Infect Control Hosp Epidemiol 2023. DOI: 10.1017/ice.2023.5 Huttner A, et al. Re: ‘ESR and CRP: it's time to stop the zombie tests' by Spellberg et al. CMI 2025. DOI: 10.1016/j.cmi.2024.09.016 Morgan DJ, et al. Diagnostic Stewardship—Leveraging the Laboratory to Improve Antimicrobial Use. JAMA 2017. DOI:  10.1001/jama.2017.8531 Messacar K, et al. Implementation of rapid molecular infectious disease diagnostics: the role of diagnostic and antimicrobial stewardship. J Clin Microbiol 2017. DOI: 10.1128/jcm.02264-16Messacar K, et al. Clinical and Financial Impact of a Diagnostic Stewardship Program for Children with Suspected Central Nervous System Infection. J Pediatr. 2022. DOI: 10.1016/j.jpeds.2022.02.002  Qian ET, et al. Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection: The ACORN Randomized Clinical Trial. JAMA 2023. DOI: 10.1001/jama.2023.20583 Siontis KC et al. Diagnostic tests often fail to lead to changes in patient outcomes. J Clin Epidemiol 2014. DOI: 10.1016/j.jclinepi.2013.12.008Vaughn VM, et al. Antibiotic Stewardship Strategies and Their Association With Antibiotic Overuse After Hospital Discharge. Clin Infect Dis 2022. DOI: 10.1093/cid/ciac104Vaughn VM, et al. A Statewide Quality Initiative to Reduce Unnecessary Antibiotic Treatment of Asymptomatic Bacteriuria. JAMA Intern Med 2023. DOI: 10.1001/jamainternmed.2023.2749  

Sepsis and bloodstream infections (BSIs) are common and cause millions of deaths each year, with a disproportionate burden in low-income and middle-income countries. Tune in to learn from Jasmine R. Marcelin, MD, FACP, FIDSA, how inadequate antibiotic coverage can be linked to increased mortality and length of stay and how unnecessary broad-spectrum antibiotics can drive antimicrobial resistance. Topics covered include:The worldwide burden of sepsis and BSIsThe ongoing threat of antimicrobial resistanceUS and global health disparities in sepsis, BSI, and antimicrobial resistanceBarriers toward optimizing antibiotic use in BSIsPresenter:Jasmine R. Marcelin, MD, FACP, FIDSAAssociate Professor, Infectious DiseaseAssociate Medical Director, Antimicrobial Stewardship ProgramVice Chair for Belonging and Community Engagement, Department of Internal MedicineCo-Director, Digital Innovation & Social Media Strategy, Division of Infectious DiseasesUniversity of Nebraska Medical CenterOmaha, NebraskaLink to full program and downloadable slides:https://bit.ly/4inoXCxGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.  Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Unnecessary broad-spectrum antibiotics can drive antimicrobial resistance and cause adverse events, whereas inadequate antibiotic coverage is linked to increased mortality and length of stay for patients with bloodstream infections (BSIs). Listen now to learn from Jose Alexander, MD, D(ABMM), CIC, FCCM, SM/MB(ASCP), how to use rapid genotypic and phenotypic antimicrobial susceptibility testing results to inform antibiotic selection for patients with gram-negative BSIs. Topics covered include:Typical patterns of intrinsic antibiotic susceptibility and resistance in EnterobacteralesMechanisms of resistance in gram-negative bacteriaGenotypic rapid diagnostic tests for BSIsResistance markers for earlier targeted therapyRapid phenotypic antimicrobial susceptibility test platforms for blood culturesPresenter:Jose Alexander, MD, D(ABMM), CIC, FCCM, SM/MB(ASCP)Medical and Public Health MicrobiologistMedical and Technical Director of MicrobiologyAdventHealthOrlando, FloridaLink to full program and downloadable slides:https://bit.ly/4inoXCxGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Rapid phenotypic antimicrobial susceptibility testing (AST) significantly reduces time to actionable results and can improve antibiotic decision-making for patients with bloodstream infections. Listen in to learn from Michael P. Veve, PharmD, MPH, how to optimally integrate rapid phenotypic AST into clinical practice, including incorporation into your existing antimicrobial stewardship workflow. Topics covered include:Considerations for implementationDecision-making steps for implementationThe role of antimicrobial stewardship programs in AST workflowPresenter:Michael P. Veve, PharmD, MPHClinical Associate ProfessorDepartment of Pharmacy PracticeEugene Applebaum College of Pharmacy and Health SciencesWayne State UniversityClinical Pharmacy Specialist, Infectious DiseaseHenry Ford HospitalDetroit, MichiganLink to full program and downloadable slides:https://bit.ly/4inoXCxGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

It's World AMR Awareness Week (WAAW) and we have prepared a special episode in light of that. In this week's Communicable, Navaneeth Narayanan and Thomas Tängdén host Aula Abbara (London, UK), Guido Granata (Rome, Italy) and Tuomas Aro (Helsinki, Finland) to discuss the phenomenon of AMR in conflict and crisis zones. They elaborate on how difficult conditions and austere environments amplify the spread of AMR, drawing on findings from the ongoing conflicts in Ukraine, Gaza, Syria and other regions. Other topics covered include adapting antimicrobial stewardship and infection prevention and control (IPC) practices as well as the need for genuine political will and international collaboration to end conflicts and their exacerbation on AMR.This episode follows the webinar “Beyond the frontlines” organised by ESCMID's AMR Action Subcommittee for WAAW 2025, featuring the same guests, and is available on ESCMID Media. This Communicable episode was peer reviewed by Arjana Zerja of Mother Theresa University Hospital Centre, Tirana, Albania.  Related ESCMID and Communicable mediaESCMID Media, Part 1: Beyond the frontlines - tackling AMR in conflict and crisis zones, webinar Communicable episode 11: Nightmare series, part 2 – how to deal with carbapenemase producers Communicable episode 16: Climate change and infections – effects on clinical practice & sustainabilityResourcesTrainee Association of ESCIMD (TAE) Doctors without Borders (Médecins sans Frontières), Antibiogo, https://www.antibiogo.org/Doctors without Borders (Médecins sans Frontières), Mini-lab, https://fondation.msf.fr/en/projects/mini-lab Further ReadingAbbara A, et al. Unravelling the linkages between conflict and antimicrobial resistance. NPJ Antimicrob Resist. 2025. DOI: 10.1038/s44259-025-00099-yAbbara A, et al. A summary and appraisal of existing evidence of antimicrobial resistance in the Syrian conflict. Int J Infect Dis. 2018. DOI: 10.1016/j.ijid.2018.06.010Abu-Shomar R, et al. Multidrug-resistant Pseudomonas isolated from water at primary health care centers in Gaza, Palestine: a cross-sectional study. IJID Reg. 2025. DOI: 10.1016/j.ijregi.2025.100671Aldbis A, et al. The lived experience of patients with conflict associated injuries whose wounds are affected by antimicrobial resistant organisms: a qualitative study from northwest Syria. Confl Health. 2023. DOI: 10.1186/s13031-023-00501-4Aro T, et al. War on antimicrobial resistance: high carriage rates of multidrug-resistant bacteria among war-injured Ukrainian refugees. Clin Microbiol Infect. 2025. DOI: 10.1016/j.cmi.2025.07.010  Bazzi W, et al. Heavy Metal Toxicity in Armed Conflicts Potentiates AMR in A. baumannii by Selecting for Antibiotic and Heavy Metal Co-resistance Mechanisms. Front Microbiol. 2020. DOI: 10.3389/fmicb.2020.00068 Dewachi O. War Biology and Antimicrobial Resistance: The Case of Gaza, AMR Insights, 2024.Granata G, et al. The impact of armed conflict on the development and global spread of antibiotic resistance: a systematic review. Clin Microbiol Infect. 2024. DOI: 10.1016/j.cmi.2024.03.029 Huang XZ, et al. Molecular analysis of imipenem-resistant Acinetobacter baumannii isolated from US service members wounded in Iraq, 2003-2008. Epidemiol Infect. 2012. DOI: 10.1017/S0950268811002871Hujer KM, et al. Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center. Antimicrob Agents Chemother. 2006. DOI: 10.1128/AAC.00778-06Karah N, et al. Teleclinical Microbiology: An Innovative Approach to Providing Web-Enabled Diagnostic Laboratory Services in Syria. Am J Clin Pathol. 2022. DOI: 10.1093/ajcp/aqab160Keen EF 3rd, et al. Evaluation of potential environmental contamination sources for the presence of multidrug-resistant bacteria linked to wound infections in combat casualties. Infect Control Hosp Epidemiol. 2012. DOI: 10.1086/667382Murray CK, et al. Recovery of multidrug-resistant bacteria from combat personnel evacuated from Iraq and Afghanistan at a single military treatment facility. Mil Med. 2009. DOI: 10.7205/milmed-d-03-8008Petersen K, et al. Diversity and clinical impact of Acinetobacter baumannii colonization and infection at a military medical center. J Clin Microbiol. 2011. DOI: 10.1128/JCM.00766-10Scott P, et al. An outbreak of multidrug-resistant Acinetobacter baumannii-calcoaceticus complex infection in the US military health care system associated with military operations in Iraq. Clin Infect Dis. 2007. DOI: 10.1086/518170Sensenig RA, et al. Longitudinal characterization of Acinetobacter baumannii-calcoaceticus complex, Klebsiella pneumoniae, and methicillin-resistant Staphylococcus aureus colonizing and infecting combat casualties. Am J Infect Control. 2012. DOI: 10.1016/j.ajic.2011.03.025World Health Organization. Fourth WHO Global Evidence Review on Health and Migration stresses that equitable access to and appropriate use of antibiotics for refugees and migrants is essential to tackling Antimicrobial Resistance, News, 2022.

A Rutgers-led trial found that ibuprofen plus acetaminophen provided better pain relief and fewer side effects than opioids following dental surgery, challenging traditional prescribing habits. A Swiss national cohort showed that non–beta-lactam antibiotics nearly doubled surgical-site infection risk compared to beta-lactams, reinforcing their role in prophylaxis. Finally, a meta-analysis confirmed that acetaminophen remains safe during pregnancy when used appropriately, with no proven link to neurodevelopmental disorders.

Once confined to the tropics, dengue is spreading via its vector, the Aedes mosquito, to more temperate regions, causing increases in global morbidity, mortality and cost. In 2019, the WHO recognised dengue as one of the top ten global health threats alongside climate change and antimicrobial resistance [1]. In this episode of Communicable, Annie Joseph and Nav Narayanan welcome two dengue experts, André Siqueira of the non-profit Drugs for Neglected Diseases Initiative based in Geneva, Switzerland (Rio de Janeiro, Brazil), and Steven Lim of the Raja Permaisuri Bainun Hospital (Ipoh, Malaysia). Together, they discuss the epidemiology, clinical presentation and management of dengue including comparisons to other arboviral infections like zika and chikungunya, and the heightened risk of disease for vulnerable populations such as pregnant women and those with comorbidities. The conversation also highlights innovative vector-control strategies and candidate therapeutics currently under investigation. This episode was edited by Kathryn Hostettler and peer reviewed by Loora Grünvald of the University of Tartu, Estonia. Resources:Drug for Neglected Diseases (DNDi), https://dndi.org/ Dengue Alliance, https://dndi.org/global-networks/dengue-alliance/ Qdenga vaccine information: https://travelhealthpro.org.uk/news/763/qdenga-dengue-vaccine-guidanceDengavaxia vaccine information: https://www.cdc.gov/dengue/hcp/vaccine/index.html References: World Health Organization, Ten threats to global health in 2019.Further reading: Treating a feverish planet: The Dengue Alliance, a video

This episode is sponsored by Lightstone Direct LLC. Lightstone DIRECT invites you to partner with a $12B AUM real estate institution as you grow your portfolio. Access the same single-asset multifamily and industrial deals Lightstone pursues with its own capital – Lightstone co-invests a minimum of 20% in each deal alongside individual investors like you. You're an institution. Time to invest like one.____________________________________________________________________Struggling to differentiate sinus symptoms? You're not alone—medical training often falls short.In this solo episode of Succeed in Medicine, Dr. Bradley Block shares how to distinguish between colds, bacterial sinusitis, allergies, and sinus migraines. With insights from years of clinical experience, on sinusitis as a secondary bacterial infection following viruses, not allergies or blockages. He covers "second sickness" patterns, why 10-day watchful waiting beats early antibiotics, migraine misdiagnoses, and treatments like nasal steroids for allergies versus surgery for fungal balls. Debunking myths like balloon sinuplasty for migraines. This episode equips physicians with practical tools to avoid overtreatment and improve patient outcomes, learn why facial pressure often points to migraines, when antibiotics are truly needed, and how to spot the “second sickness” pattern of sinus infections. Packed with practical tips and myth-busting, this episode is a must-listen for anyone navigating sinus issues or curious about ENT care.Three Actionable Takeaway:Sinusitis Starts with a Virus: Dr. Block explains bacterial sinusitis as a secondary infection after a cold disrupts sinus mucosa—watch for "second sickness" where symptoms worsen after initial improvement. Hold antibiotics for at least 10 days unless complications like orbital cellulitis arise.Facial Pressure Isn't Always Sinus: Often misdiagnosed as sinusitis, facial pressure (especially weather-related) signals migraines—Dr. Block advises checking for tenderness over sinuses and avoiding unnecessary CT scans or surgery like balloon sinuplasty, which treats mucosa issues poorly.Allergies vs. Sinusitis: Separate Issues: Allergies swell nasal mucosa but don't cause sinus infections due to insufficient allergen entry—treat with nasal steroids or immunotherapy. Fungal balls require surgery, not meds, as they're not true infections. About the Show:Succeed In Medicine  covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the Host:Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physiciansWant to be a guest?Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more!Socials:@physiciansguidetodoctoring on Facebook@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode of Communicable, Erin McCreary and Angela Huttner are joined by Barbara Trautner (St. Louis, USA) and Valéry Lavergne (Vancouver, Canada), the co-chairs and leading authors of the first IDSA guideline on complicated urinary tract infection (cUTI), which was published a few months ago [1]. Together, they discuss the process of developing the guideline from its conception in 2018, the new definition of cUTI, their stepwise approach to clinical decision-making, and some case-by-case scenarios for common antibiotics. They also elaborate on how this guideline compares (and contrasts) to other existing UTI guidelines—including the previous IDSA guideline for UTI [2] —and the clinical need to supply frontline clinicians to identify and distinguish complicated cases from the uncomplicated ones. The episode closes with what essential clinical questions the guests hope to tackle next.  This episode was edited by Kathryn Hostettler and peer reviewed by Maria Ana Flores of Santa Maria Local Health Unit, Lisbon, Portugal.Other resources:European Urologic Association guidelinesUpToDateFDA guidance on complicated UTI ReferencesTrautner BW, et al. Clinical Practice Guideline by Infectious Diseases Society of America (IDSA): 2025 Guideline on Management and Treatment of Complicated Urinary Tract Infections Gupta, K, et al. Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: 2010 Update by IDSA

Join Dr. Ryan Dare as he dives into the critical role of antibiotic stewardship in healthcare. Learn how proper management of antibiotic prescriptions can help combat resistance, ensure effective treatments, and protect future generations from infections. Discover why this topic is vital for both healthcare providers and patients. Learn more about Ryan Dare, M.D.

Contrary to popular belief, peer review has only recently become an integral step in scientific publishing. Currently seen by many as a badge of honour ensuring valid, innovative and honest research, peer review seems in reality to be increasingly thankless, exploitative, and sometimes invisible. How did we get here? In this episode of Communicable, Annie Joseph and Angela Huttner are joined by two experts, Melinda Baldwin (University of Maryland, USA) and Serge Horbach (Radboud University, Netherlands), to unpack and examine the role of peer review, why it is still essential, and how it fits within the greater editorial process. The conversation covers the history of peer review, contemporary formats including open review and the use of artificial intelligence, and thoughtful discussion on how to fix and rethink peer review. This episode was edited by Kathryn Hostettler and peer reviewed by Barbora Píšová from the Czech Republic.Related podcast episodes Communicable episode 13: The Wild West of publishing today—predatory journals and how to deal with them https://share.transistor.fm/s/e3abe9af ResourcesEASE, the European Association of Science Editors https://ease.org.uk/ Peer review week https://peerreviewweek.net/ Further readingCsiszar, A. The Scientific Journal: Authorship and the Politics of Knowledge in the Nineteenth Century. The University of Chicago Press, 2018. DOI: 10.7208/chicago/9780226553375.001.0001 Entradas, Sousa, Yan, et al. (2023) Public Deliberative Workshops – Findings. POIESIS project deliverable D2.2. https://poiesis-project.eu/deliverables/.Ross-Hellauer T and Horbach SPJM. Additional experiments required: A scoping review of recent evidence on key aspects of Open Peer Review, Research Evaluation, 2024. DOI: 10.1093/reseval/rvae004Horbach SPJM and Halffman W. The changing forms and expectation of peer review. Res Integr Peer Rev 2018. DOI: 10.1186/s41073-018-0051-5Danziger S, et al. Extraneous factors in judicial decisions. Proc Natl Acad Sci USA, 2011. DOI: 10.1073/pnas.1018033108Fyfe, A., Moxham, N., McDougall-Waters, J., & Røstvik, C. M. (2022). A History of Scientific Journals: Royal Society publishing, 1665-2015. London: UCL Press.“Misconduct in Science,” 9 February 1983, NN3-443-UD-12D-1 box 78, file “RES 12 Misconduct in Science, 1983-1987,” Papers of the NIH Director, National Archives and Records Administration, College Park, MD.Baldwin M. In Referees We Trust? How Peer Review Became a Mark of Scientific Legitimacy. MIT Press (Open Access). Work in Progress.

This episode of the Intelligent Medicine podcast is a deep dive into the complexities of Lyme disease and other tick-borne illnesses. Nicole Bell, the CEO of Galaxy Diagnostics and author of “What Lurks in the Woods,” details the challenges of diagnosing tick-borne diseases, the limitations of current diagnostic tests, and the controversy around treatment methodologies. Nicole shares her personal journey that led her to this field after her husband was misdiagnosed with early-onset Alzheimer's, which was later revealed to be caused by advanced Lyme disease. They also discuss new diagnostic techniques, the importance of personalized treatment plans, and ongoing advocacy efforts to improve awareness and research funding for Lyme disease.

Dr. Hoffman continues his conversation with Nicole Bell, the CEO of Galaxy Diagnostics and author of “What Lurks in the Woods.” 

Ed Goluch is the founder and CEO of QSM Diagnostics, makers of the Otter eQ laboratory instrument platform and FetchDx mail-in testing kits. Prior to QSM, Ed was a tenured professor in the Department of Chemical Engineering at Northeastern University. Ed earned his PhD in Bioengineering from the University of Illinois at Urbana-Champaign, and he has over 60 publications and several patents in the areas of sensors, microfluidics, and biophysics. He lives in Somerville, MA, with his wife, Liz, two Alaskan Klee Kai dogs, Odin and Gunnar, and two Balinese cats, Loki and Bandit. Topics covered in this episode:  Ed Goluch's journey into the veterinary space with QSM Diagnostics Understanding Quorum-Sensing Molecules The applications and benefits of QSM Technology for veterinarians Antibiotic stewardship Antibiogram and antibiotic resistance Streamlined mobile diagnostics FetchDx mail-in testing kits The House Call Vet Academy experience Links & Resources:  Visit the QSM Diagnostics website to learn more Find QSM Diagnostics on Instagram Find QSM Diagnostics on Facebook The House Call Vet Academy Resources:  Download Dr. Eve's FREE House Call & Mobile Vet Biz Plan Find out about the House Call Vet Academy online CE course Learn more about Dr. Eve Harrison Learn more about the Concierge Vet Mastermind Get your FREE Concierge Vet Starter Kit mini course Learn more about SoulShine Space For Vets. Use discount code SHINE15 for 15% OFF SoulShine Space For Vets! (Available for a limited time only! Rules and restrictions apply.) Learn more about 1-to-1 coaching for current & prospective house call & mobile vets Get House Call Vet swag Learn more about the House Call & Mobile Vet Virtual Conference Register TODAY for the House Call & Mobile Vet Virtual Conference, February 7th-8th, 2026!!!!!! Here's a special gift from me as a huge thank you for being a part of our wonderful House Call Vet Cafe podcast community! ☕️ GET 20% OFF your Four Sigmatic Mushroom Coffee when you order through this link! 4Sig truly is my favorite!!! Enjoy it in good health, my friends! Music:  In loving memory of Dr. Steve Weinberg.  Intro and outro guitar music was written, performed, and recorded by house call veterinarian Dr. Steve Weinberg.  Thank you to our sponsors!  Chronos  O3 Vets  This podcast is also available in video on our House Call Vet Cafe YouTube channel 

In this second-ever collaboration between SIDP's Breakpoints and ESCMID's Communicable podcasts, hosts Erin McCreary and Angela Huttner invite the two principal investigators and visionaries who spearheaded the Bacteraemia Antibiotic Length Actually Needed for Clinical Effectiveness (BALANCE) trial, Nick Daneman and Rob Fowler (Sunnybrook Health Sciences Centre, Toronto), for a “deep dive into all things that went into this trial” (1). The BALANCE trial spanned over ten years investigating - as the acronym title suggests - whether a shorter treatment duration of seven days was non-inferior to the standard of care of fourteen days for bacteraemia. The conversation covers everything from the initial hallway discussions that sparked the trial to the trial itself that screened over 36,000 patients and enrolled +3,600, its key takeaways and its impact on clinical practice as well as what's next for Daneman and Fowler.This episode was edited by Kathryn Hostettler and Megan Klatt, and peer reviewed by Dr. Arjana Zerja of Mother Theresa University Hospital Centre, Tirana, Albania.Related podcast episodesCommunicable episode 36: Finding BALANCE in antibiotic durations—the BALANCE trial https://share.transistor.fm/s/b680895eCommunicable episode 26: SNAP out of it—rethinking anti-staphylococcal penicillins for S. aureus bacteremia, the SNAP trial PSSA/MSSA results https://share.transistor.fm/s/2a3c3bb4Breakpoints episode covering IDWeek (December 2024) https://breakpoints-sidp.org/108-idweek-2024-recap-late-breaker-abstracts-and-stewardship-talks/ ReferencesBALANCE Investigators, et al.  Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. N Engl J Med. 2025 March. DOI: 10.1056/NEJMoa2404991Further reading Fowler VG. Eight days a week – BALANCING duration and efficacy. N Engl J Med. 2025 March. DOI: 10.1056/NEJMe2414037   Dulhunty JM, et al. Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis: The BLING III Randomized Clinical Trial. JAMA 2024. DOI: 10.1001/jama.2024.9779  Yahav D, et al. Seven versus 14 days of antibiotic therapy for uncomplicated Gram-negative bactermia: A noninferiority randomized controlled trial. Clin Infect Dis 2018. DOI: 10.1093/cid/ciy1054 Von Dach E, et al. Effect of C-reactive protein-guided antibiotic treatment duration, 7-day treatment, or 14-day treatment on 30-day clinical failure rate in patients with uncomplicated Gram-negative bacteremia, a randomized clinical trial. JAMA 2020. DOI: 10.1001/jama.2020.6348 Ong SWX, et al. Identifying heterogeneity of treatment effect for antibiotic duration in bloodstream infection: an exploratory post-hoc analysis of the BALANCE randomised clinical trial. EClinicalMedicine 2025. DOI: 10.1016/j.eclinm.2025.103195Wallach JD, et al. Evaluation of evidence of statistical support and corroboration of subgroup claims in randomized clinical trials. JAMA Intern Med 2017. DOI: 10.1001/jamainternmed.20169125

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Listen in as Dr Trevor Van Schooneveld explores rapid syndromic testing for gastrointestinal and joint infections and discusses how to apply best practices for diagnostic and antimicrobial stewardship in syndromic testing. Topics covered include: Who should be tested for infectious diarrheaTypes of gastrointestinal syndromic panelsTypes of syndromic panels for joint infectionsReal-world applications for joint syndromic panelsPresenters: Trevor Van Schooneveld, MDProfessor, Division of Infectious DiseasesMedical Director, Antimicrobial Stewardship ProgramDepartment of Internal MedicineUniversity of Nebraska Medical CenterOmaha, NebraskaLink to full program: https://bit.ly/4mHOTtWGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify. 

Listen in as Michael Satlin, MD, MS, FIDSA,explores rapid syndromic testing for bloodstream infections and discusses how to apply best practices for diagnostic and antimicrobial stewardship in syndromic testing.Topics covered include:Types of upper and lower respiratory infection panelsConsiderations for when to use respiratory syndromic testingHow to use syndromic testing to guide both therapy escalation and de-escalationHow syndromic testing fits in with traditional testing methods, such as culture, antimicrobial susceptibility testing, Gram stain, and BAL cell count Presenter:Michael Satlin, MD, MS, FIDSAAssociate Professor of Medicine and Pathology and Laboratory MedicineWeill Cornell MedicineNew York, New YorkLink to full program: https://bit.ly/3UAB1oUGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

Listen in as Dr Emily Heil explores rapid syndromic testing for bloodstream infections and discusses how to apply best practices for diagnostic and antimicrobial stewardship in syndromic testing.Topics covered include:The importance of good blood culture practices and finding the balance between overuse and underuseBlood culture improvement programsThe utility of rapid diagnostic testsResistance markers for earlier targeted therapyPresenters:Emily Heil, PharmD, MS, BCIDP, AAHIVPProfessorDepartment of Practice, Sciences, and Health Outcomes ResearchUniversity of Maryland School of PharmacyBaltimore, MarylandLink to full program: https://bit.ly/45Ajz92Get access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

Ethics in the field of infectious disease can be a delicate interplay between treating the individual patient and protecting the collective health of a society. Sometimes these two mandates go hand in hand; at other times they can appear to be in conflict. In this episode of Communicable, Dr. Angela Huttner invites Drs. Zeb Jamrozik (Melbourne, Australia) and Beenish Syed (Karachi, Pakistan), two members of ESCMID's Ethics Advisory Committee, to unpack different scenarios encountered in the field of infectious disease from an ethics standpoint: how one ethically allocates scarce resources like antimicrobials; whether there is ethical justification for coercive public-health measures like lockdowns; and whether the need to collect evidence to advance patient care could include other models besides opt-in informed consent. This episode was edited by Dr. Kathryn Hostettler and peer reviewed by Dr. Goulia Ohan of Yerevan State Medical University, Yerevan, Armenia.Further reading:Barosa M, et al. The Ethical Obligation for Research During Public Health Emergencies: Insights From the COVID-19 Pandemic. Med Health Care Philos 2024. DOI: 10.1007/s11019-023-10184-6Symons X, et al. Why should HCWs receive priority access to vaccines in a pandemic? BMC Med Ethics 2021. DOI: 10.1186/s12910-021-00650-2Thorsteinsdottir B and Madsen BE. Prioritizing health care workers and first responders for access to the COVID19 vaccine is not unethical, but both fair and effective – an ethical analysis. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2021. DOI: 10.1186/s13049-021-00886-2Huttner A, Leibovici L, Theuretzbacher U, Huttner B, Paul M. Closing the evidence gap in infectious disease: point-of-care randomization and informed consent. Clin Microbiol Infect 2017;23(2):73-77. DOI: 10.1016/j.cmi.2016.07.029

A new report documents wide variations in antibiotic prescribing patterns by provider and setting. How can we get everyone on the same page to prevent antibiotic-resistant bacteria? David W. Johnson and Julie Murchinson break down the new report on, “What Ever Happened to Antibiotic Stewardship?” the new episode of the 4sight Health Roundup podcast, moderated by David Burda.

Fluoroquinolones (FQs) are valuable given their broad-spectrum activity against Gram-positive and Gram-negative bacteria and their high penetration into various tissues. Yet FQs have also caused concern, with some market withdrawals, important and sometimes long-lasting adverse drug events, and substantial collateral effects on the microbiota. In this episode of Communicable, hosts Emily McDonald and Thomas Tängdén invite Staffan Tevell (Karlstad, Sweden) and Bernadette Young (Oxford, UK) to weigh in on the pro-con debate of FQ use, especially for periprosthetic joint infections (PJIs), which can entail longer treatment durations. They review the standard of care for PJIs, including FQs in combination with rifampicin vs other antibiotic combinations, the impact of the OVIVA trial advocating for early oral switch strategies, the long list of rare but important side effects, and how best to preserve FQs for clinical indications that most need them.      This episode is a follow-up from Tevell and Young's recently published systematic review of the role of FQs in PJIs [1]. It was edited by Kathryn Hostettler and peer reviewed by Ljiljana Lukić of University Hospital for Infectious Diseases in Zagreb, Croatia. The executive producer of Communicable is Angela Huttner. ReferencesTevell S, et al. To heal or harm: A systematic review of the role of fluoroquinolones in periprosthetic joint infections. CMI Communications 2025. DOI: 10.1016/j.cmicom.2025.105103Further readingMandell LA, et al. Antimicrobial Safety and Tolerability: Differences and Dilemmas. Clin Infect Dis 2001. JSTOR http://www.jstor.org/stable/4461522.Pham TDM, et al. Quinolone antibiotics. Medchemcomm 2019. DOI: 10.1039/c9md00120d. Rodrigues CF and Silva F. The Rise, Fall, and Rethink of (Fluoro)quinolones: A Quick Rundown. Pathogens 2025. DOI: 10.3390/pathogens14060525Slimings C and Riley TV. Antibiotics and hospital-acquired Clostridium difficile infection: update of systematic review and meta-analysis. J Antimicrob Chemother 2014. DOI: 10.1093/jac/dkt477Davis JS, et al. Predictors of treatment success after periprosthetic joint infection: 24-month follow up from a multicenter prospective observational cohort study of 653 patients. Open Forum Infect Dis 2022. DOI: 10.1093/ofid/ofac048.Grossi O, et al. Gram- negative prosthetic joint infections managed according to a multidisciplinary standardized approach: risk factors for failure and outcome with and without fluoroquinolones. J Antimicrob Chemother 2016. DOI: 10.1093/jac/dkw202 Cortes-Penfield NW, et al. 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. DOI:  10.1093/ofid/ofac582Pushkin R, et al. A Randomized Study Evaluating Oral Fusidic Acid (CEM-102) in Combination With Oral Rifampin Compared With Standard-of-Care Antibiotics for Treatment of Prosthetic Joint Infections: A Newly Identified Drug-Drug Interaction. Clin Infect Dis 2016. DOI: 10.1093/cid/ciw665Bock M, et al. Rifampicin reduces plasma concentration of linezolid in patients with infective endocarditis. J Antimicrob Chemother 2023. DOI: 10.1093/jac/dkad316   Zeller V, et al. Influence of the clindamycin administration route on the magnitude of clindamycin-rifampicin interaction: a prospective pharmacokinetic study. Clin Microbiol Infect. 2021. DOI: https://doi.org/10.1016/j.cmi.2021.04.017 Bernard L, et al. Antibiotic Therapy for 6 or 12 Weeks for Prosthetic Joint Infection. N Engl J Med 2021. DOI: 10.1056/NEJMoa2020198Vollmer NJ, et al. Safety and Tolerability of Fluoroquinolones in Patients with Staphylococcal Periprosthetic Joint Infections, Clin Infect Dis 2021. DOI 10.1093/cid/ciab145Gopalakrishnan C, et al. Association of fluoroquinolones with the risk of aortic aneurysm or aortic dissection. JAMA Intern Med 2020. DOI 10.1001/jamainternmed.2020.4199Li HK, et al. Oral versus Intravenous Antibiotics for Bone and Joint Infection (OVIVA). N Engl J Med. 2019. DOI: 10.1056/NEJMoa1710926

Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from July 12-18, 2025.

The adaptability of fungi to warmer temperatures is an obvious consequence of climate change. Perhaps less obvious is the role climate change has played on fungal pathogens emerging as a global health concern. While humans are mostly protected from fungal infections by our immune system and body temperature, a warming global climate could subvert the status quo. Some fungi are already adapted to warmer temperatures and causing invasive acute infections in humans: Candidozyma auris, Cryptococcus neoformans, and Aspergillus fumigatus, to name a few.  In this episode of Communicable, Angela Huttner and Josh Nosanchuk invite Arturo Casadevall, a Bloomberg Distinguished Professor at Johns Hopkins and this year's recipient of ESCMID's Excellence in Science Award, to discuss the world of fungi and their pathogenic potential in a warming world. Other topics include how to prepare for their emergence as a health threat, how fungi can be harnessed for applications that can benefit us, and ultimately answering the question Casadevall himself posed in the title of his recently published book, What if fungi win?This episode was edited by Kathryn Hostettler and peer reviewed by Robin Aerts of University Hospital Antwerp, Belgium.  References1.        Casadevall, A with Desmon S. What if fungi win? Johns Hopkins University Press, 2024.2.        Smith DFG, et al. Environmental fungi from cool and warm neighborhoods in the urban heat island of Baltimore City show differences in thermal susceptibility and pigmentation. BioRxiv 2025. DOI: 10.1101/2023.11.10.566554  3.        Casadevall A and Pirofski L. Benefits and Costs of Animal Virulence for Microbes. mBio 2019. DOI: 10.1128/mBio.00863-194.        Cordero RJB et al. Radiation protection and structural stability of fungal melanin polylactic acid biocomposites in low Earth orbit. PNAS 2025. DOI: 10.1073/pnas.24271181225.        Dadachova E, et al. The radioprotective properties of fungal melanin are a function of its chemical composition, stable radical presence and spatial arrangement. Pigment Cell Melanoma Res 2008. DOI: 10.1111/j.1755-148X.2007.00430.x6.        Cordero RJB et al. The hypothermic nature of fungi. PNAS 2022. DOI: 10.1073/pnas.2221996120

Want to elevate your infection prevention career? Dive into this inspiring episode with Gail Fraine and Dr. Mayar Al Mohajer as they explore the value, purpose, and impact of the Advanced Leadership Certification in Infection Prevention (AL-CIP). Learn how this credential empowers professionals to lead change, drive outcomes, and shape healthcare policy. Get tips for submission success and hear firsthand experiences from these certified leaders! Hosted by: Kelly Holmes, MS, CIC, FAPIC and Lerenza L. Howard, MHA, CIC, LSSGB About our Guests: Gail Fraine, CIC, LTC-CIP, AL-CIP Gail Fraine is the System Director of Infection Prevention at Ascension Saint Thomas in Nashville, TN, with over 30 years of experience reducing healthcare-associated infections through evidence-based practices and high-reliability principles. A long-standing APIC member, she has held national leadership roles including Board Director and Annual Conference Chair. Gail currently serves as President-Elect of the Certification Board of Infection Control and Epidemiology (CBIC) and contributed to developing both the long-term care and Advanced Leadership certifications. She holds nursing degrees from Arkansas State, Belmont, and Vanderbilt, and is certified in CIC, LTC-CIP, and AL-CIP. Mayar Al Mohajer, FIDSA, FSHEA, FAPIC, FACHE, AL-CIP Dr. Al Mohajer serves as Professor of Medicine in the Section of Infectious Diseases at Baylor College of Medicine in Houston, Texas, where he also directs the Infection Prevention, Antimicrobial Stewardship, Quality Improvement, and Leadership Track. He is the Chief of the Infectious Disease Section at Baylor St. Luke's Medical Center and the Medical Director of Infection Prevention, Occupational Health, Diagnostic Stewardship, and Antibiotic Stewardship for CommonSpirit Health's South Region and Baylor St. Luke's Medical Center. In addition to his clinical and academic roles, Dr. Al Mohajer sits on the CBIC Board and co-chairs the National Infection Prevention Council for CommonSpirit Health. He holds multiple fellowships and certifications recognizing his expertise and leadership, including FIDSA, FSHEA, FAPIC, FACHE, and AL-CIP.

Bacterial vaginosis (BV) was long considered not to be a sexually transmitted infection (STI), and treatment was only for women to bear. That was the convention at least until Catriona Bradshaw and her team at the Melbourne Sexual Health Centre published their groundbreaking clinical trial results earlier this year, demonstrating that treating male partners of women with BV prevented recurrence in those women. In this episode of Communicable, hosts Angela Huttner and Annie Joseph welcome back Bradshaw to discuss her trial's design, results, and clinical implications—with some guidelines already updated to include male partners in BV treatment regimens. The conversation also explores the complexities of BV diagnosis, the challenges of trial execution in general, and future research directions.This episode was edited by Kathryn Hostettler and peer reviewed by Arjana Zerja (Mother Theresa University Hospital Centre, Tirana, Albania)ReferencesVodstricil LA, et al. Male-partner treatment to prevent recurrence of bacterial vaginosis. N Engl J Med 2025. DOI: 10.1056/NEJMoa2405404Bacterial vaginosis in focus. Melbourne Sexual Health Centre (MSHC). https://www.mshc.org.au/sexual-health/bacterial-vaginosisFurther readingAuvert B, et al. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med 2005. DOI: 10.1371/journal.pmed.0020298Bailey RC, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet 2007. DOI: 10.1016/S0140-6736(07)60312-2Bukusi E, et al. Topical penile microbicide use by men to prevent recurrent bacterial vaginosis in sex partners: A randomized clinical trial, Sex Transmi Dis 2011. DOI: 10.1097/OLQ.0b013e318214b82dCohen CR, et al. Randomized trial of Lactin-V to prevent recurrence of bacterial vaginosis. N Engl J Med 2020. DOI: 10.1056/NEJMoa1915254Gray RH, et al. The effects of male circumcision on female partners' genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda, Am J Obstet Gynecol 2009. DOI: 10.1016/j.ajog.2008.07.069King AJ, et al. Getting Everyone on Board to Break the Cycle of Bacterial Vaginosis (BV) Recurrence: A Qualitative Study of Partner Treatment for BV. Patient 2025. DOI: 10.1007/s40271-025-00731-zMehta S, et al. The microbiome composition of a man's penis predicts incident bacterial vaginosis in his female sex partner with high accuracy, Front Cell Infect Microbiol 2020. DOI: 10.3389/fcimb.2020.00433Muzny CA, et al. An Updated Conceptual Model on the Pathogenesis of Bacterial Vaginosis. J Infect Dis 2019 DOI: 10.1093/infdis/jiz342Mitchell CM, et al. Screening and characterization of vaginal fluid donations for vaginal microbiota transplantation, Sci Rep 2022. DOI: 10.1038/s41598-022-22873-yPlummer EL, et al. A Prospective, Open-Label Pilot Study of Concurrent Male Partner Treatment for Bacterial Vaginosis. mBio 2021. DOI: 10.1128/mBio.02323-21Plummer EL, et al. Combined oral and topical antimicrobial therapy for male partners of women with bacterial vaginosis: Acceptability, tolerability and impact on the genital microbiota of couples - A pilot study. PLoS One 2018. DOI: 10.1371/journal.pone.0190199Vodstrcil LA, et al. Bacterial vaginosis: drivers of recurrence and challenges and opportunities in partner treatment. BMC Med 2021. DOI: 10.1186/s12916-021-02077-3Wawer MJ, et al. Wawer MJ, et al. Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda: A randomised controlled trial. Lancet 2009. DOI: 10.1016/S0140-6736(09)60998-3

In this episode of The Burleson Box, Dr. Dustin Burleson welcomes Dr. Erinne Kennedy, Assistant Dean for Curriculum and Integrated Learning at Kansas City University College of Dental Medicine. Dr. Kennedy shares her fascinating journey into dentistry, which was heavily influenced by her family of dental professionals and her passion for public health. She recounts the pivotal moment when a mentor encouraged her to apply for a dental public health specialty—at Harvard—within a two-week deadline, a decision that shaped the course of her career.Our discussion covers the pressing issue of burnout in the dental profession, with Dr. Kennedy offering valuable insights backed by research. She explains how excessive working hours, lack of adequate recovery time, and administrative burdens contribute to burnout among healthcare professionals. Using a compelling analogy comparing work schedules to endurance training, she illustrates the importance of balancing workload and rest. She also introduces the concept of "resilience confetti," small, joyful activities that help dental professionals maintain well-being and engagement during their workday.Dr. Kennedy and Dr. Burleson explore strategies that dental teams can implement to create healthier work environments, such as rethinking office hours, planning meaningful time off, and fostering a culture that prioritizes both patient care and team well-being. They discuss innovative scheduling models, including the effectiveness of three-day, 12-hour shifts, and how such models can improve job satisfaction and reduce burnout.A significant part of the conversation focuses on the future of preventive dentistry. Dr. Kennedy shares her excitement about advancements in salivary testing, peptides, and microbiome management, predicting that these innovations will reshape how dental professionals approach prevention. She explains how new materials and techniques, such as peptide-based remineralization and nanoparticle technology, could reduce the need for surgical interventions and lead to better long-term patient outcomes.As an educator, Dr. Kennedy highlights the importance of emotional intelligence and leadership training in dental schools. She describes the Thrive program at KCU, a two-day workshop designed to help students develop resilience, goal-setting skills, and emotional maturity. She stresses that fostering a mindset of adaptability and openness to unexpected opportunities is crucial for career growth.Wellness Resources:The Genius of Athletes by Noel Brick Ph. D. and Scott DouglasAtomic Habits by James ClearAntibiotic Stewardship Resources:Association for Dental Safety Antibiotic Stewardship ResourcesAmerican Dental Association Antibiotic Stewardship ResourcesCariology Resources:Carequest Managing Dental CariesCarequest Connect Caries Risk Assessments and Cultural AwarenessCarequest Utilizing Caries Management by Risk Assessment to Deliver Person-Centered Care ***The Burleson Box is brought to you by Stax Payments:Save Big on Transaction Fees: Boost Your Bottom Line with Stax Payments.Did you know that your practice can start saving thousands of dollars on your monthly processing costs with our preferred payments partner, Stax? Simplify your practice operations and provide a quality patient experience. Healthcare practices like yours need a way to accept payments simply and securely. That's where Stax comes in.Stax helps you manage your entire payments experience from within one platform. You can safely accept touch-free payments in-person, online, or over the phone, securely store and manage patient information with layered security and Level 1 PCI compliance.
Take advantage of a simpler, more transparent way to process your payments with competitive flat-rate pricing, provided exclusively through Stax. No additional fees or contracts required!Power your practice and get paid faster with simple, safe and secure payment solutions. Have questions? Schedule time to speak with a dedicated payment consultant to learn more.Click Below to Lear More Today:StaxPayments.com/burleson-seminars*** Go Premium: Members get early access, ad-free episodes, hand-edited transcripts, exclusive study guides, special edition books each quarter, powerpoint and keynote presentations and two tickets to Dustin Burleson's Annual Leadership Retreat.http://www.theburlesonbox.com/sign-up Stay Up to Date: Sign up for The Burleson Report, our weekly newsletter that is delivered each Sunday with timeless insight for life and private practice. Sign up here:http://www.theburlesonreport.com Follow Dustin Burleson, DDS, MBA at:http://www.burlesonseminars.com