LDD

Antmicrobial Stewardship and ID Pharm D, at University of Toronto

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

POET II RCT:: In stabilized patients with left-sided endocarditis caused by Streptococcus spp, Entero-coccus faecalis, or Staphylococcus aureus, tailored treatment - guided by the clinical response (POET criteria*) - shortened treatment by app. 2 weeks i.e. by 1/3 compared to standard duration therapy, #IDXposts #IEWiki

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

🚫Very important 🚫
Recommendation 4.6
Cefazolin does not share any side chains with the currently available penicillins and can be used in cases of suspected or proven immediate type allergy to a penicillin*, irrespective of severity or time elapsed since the index reaction (Strong recommendation, moderate quality of evidence – GRADE)
*: With the exception of patients with severe anaphylaxis (e.g. anaphylactic shock), in which case the panel recommends seeking expert evaluation first)

[Isaac Bogoch @BogochIsaac]

A tablet to prevent COVID infections in close contacts:

Ensitrelvir reduced the risk of transmission among household contacts with covid in this Phase 3 study from Japan.

This could be extraordinarily helpful in Long Term Care among vulnerable people.

https://t.co/yS5o9lFFOG

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

🆕🔥Systematic Review and Noninferiority Meta-Analysis 🌟s @DrToddLee @DrEmilyMcD
Seven vs Fourteen Days of Antibiotics for Gram-Negative Bloodstream Infection
@BradSpellberg #IDXposts
https://t.co/2L26ylMSVa

[Dr. Lynora Saxinger MD FRCPC Infectious Diseases @AntibioticDoc]

So:
Measles can be a big deal, most recover but bad outcomes happen and it still kills people - mostly kids- every year.

People may be blasé about this because the vaccine, which is safe, HAS worked well.

For most, two doses and you are good (prior exposures matter)

10/10

[Brad Langford @BRxAD]

Hospital antibiotic stewardship programs with designated funding & resources use less fluoroquinolones, anti-pseudomonal agents, and clindamycin
🆕 in @ASHE_Journal
📰https://t.co/NqVqrglSiC
#antimicrobialstewardship

[Brad Langford @BRxAD]

Post-hoc bias: a marginal improvement in symptoms tends to encourage patients/HCPs to continue treatment even when the change is coincidental. This can lead to continuing dubious and costly treatments, including unnecessary antibiotics:
https://t.co/GH7MXLGqhC @JAMANetworkOpen

[Brad Langford @BRxAD]

Drug-related hospital re-admission is common in older adults and many events are preventable. #Antibiotics are one of the top 3 drug classes implicated
https://t.co/NN3J514I0l

[Eric Macy @EricMacyMD]

94% of patients with a penicillin allergy who were testing were negative.

Penicillin allergy testing should be a part of preoperative management.

Should Penicillin Allergy Testing Be Included as Part of Preoperative Testing? - PubMed https://t.co/YkL6oWOTW0

[Zain Chagla @zchagla]

Important for providers particularly in GTHA to understand most of this area falls into a lyme endemic zone (along with pockets in SW ON, around Kingston, and Up north). Very different than years past with small endemic zones.
https://t.co/SvG9wswL4W

[Nathan Stall @NathanStall]

During Canada's shortage of children’s fever and pain medications, parents were guided to use weight-based divided doses of adult formulations.

Our new @NEJM study reports this was associated with increased paediatric dosing errors for Tylenol and Advil: https://t.co/zAWP9ELV03

[Brad Langford @BRxAD]

An underrated reason to go from IV to Po antibiotics is nursing time required to prepare and administer them:

💊 PO 80 seconds
💉 IV 22 minutes

According to @jabicjenkins this time in motion data will help to convince non-stewards to support this important initiative
#ECCMID23

[Michael Calderwood, MD, MPH @CalderwoodMD]

Poster 625 at #SHEASpring2023: Do you have FOMO (fear of missing organisms)? If your patient with a diabetic foot infection has not had a culture with Pseudomonas in the past year, this has a negative predictive value of 94%. Hold on the pip-tazo!

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

Fantastic review I was waiting for
🆕️🔥🔥 @CMIJournal
@CLandersdorfer @GweeAmanda
Prof.Nation
Clinical pharmacological considerations in an early IV to oral antibiotic switch:are barriers real or simply perceived?
Rationale of switch in context of PKPD
https://t.co/H6B8sbPm5L

[Pharmacotherapy @PharmacoJournal]

The July issue of @PharmacoJournal is online at: https://t.co/1JZtxYQytA @ACCP @Stephan55924484 @GI_PharmD @AbrarThabit @canuckIDpharm @DrRaziKeb @ASPLDD @wsueacphs @IDpharmresearch @LusizzZZ

[Brad Langford @BRxAD]

Vaccination supports #antimicrobialstewardship
COVID-19 vaccination associated with reduced antibiotic prescribing in long-term care IRR 0.7 (95%CI 0.4-1) and community residents IRR 0.3 (95%CI 0.3-0.4)
@uOttawa @UofT_dlsph @ICESOntario @MPHMcMaster @PublicHealthON

[Steffanie Strathdee, PhD 🗡️ 🦠Superbug Slayer🗡️ @chngin_the_wrld]

My husband Tom survived a #superbug infection yrs ago but like many, has several comorbidities. After >3yrs of avoiding #COVID, it hit him hard despite being vaxxed & getting #Paxlovid. He was hospitalized this wknd but is finally on the mend. #COVIDisNotMild #COVIDAwarenessWeek

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

Vancomycin is the oldest and most frequently used drug in our arsenal against MRSA
Despite being used for almost 65 years, vancomycin resistance (MIC ≥ 16 μg/mL) is extraordinarily uncommon, with just 52 incidents of VRSA reported worldwide in the past two decades #IDTwitter