Jeff Freiberg, MD, PhD

ID physician scientist studying S. aureus and antibiotic failure. Here mostly for the ID. Views my own.

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@InternSupp @PulmCrit Definitely agree MRSA being rare drives the NPV for many infections where people tout the high NPV of nasal swabs, but in STOP-Vanc the MRSA incidence was > 1/15 in intervention arm & still the test had a 99% NPV. How knowing those odds informs ones practice is the question.

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@DrToddLee @ABsteward @arthur_alb1 Based on that, presumably the PCR NEG group would likely have had a notably shorter vanc duration, but clearly still lots of room for improvement even in the NEG group, PCR POS test results weren’t driving the duration all by themselves

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@DrToddLee @ABsteward @arthur_alb1 Study was only designed to look at the avg as we felt potential for a + MRSA PCR to ⬆️ vanc use was important in evaluating overall usefulness of intervention. Figure S8:⏱️from result to order d/c is different measure, but gets to your point-vanc use likely different for + vs -

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@Ackley_PharmD @ABsteward @VUMC_ID I definitely would not start vanc solely based on a + PCR since it has a low PPV. An important part of this study and the reason for an RCT is to ensure that testing doesn’t lead to an inadvertent increase in vanc in this low MRSA risk, high acuity population.

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@DilipMysore @ABsteward @VUMC_ID Not necessarily, it can definitely vary from hospital to hospital when and how it is used. The timing of a MRSA nasal swab relative to the start of nasal decolonization can also vary, something we are attempting to control in this study, as well.

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@Ackley_PharmD @ABsteward @VUMC_ID It is low (although arguably significantly above zero in many places), which is part of the reason for choosing this population. Despite the low MRSA rates vancomycin use is often very high in this population, hence the big opportunity for stewardship.

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

🆕💫(STOP-Vanc) RCT protocol
@VUMC_ID @JeffFreiberg
Swab Testing to Optimize Pneumonia treatment with empiric Vancomycin
The study will provide the 1st RCT data regarding the use of MRSA nasal swab PCR testing to guide antibiotic de-escalation #idxposts
https://t.co/HZu0M5RzhF

[Jeff Freiberg, MD, PhD @JeffFreiberg]

The study protocol for STOP-Vanc, our RCT looking at the use of MRSA nares PCR testing in an ICU, is finally published!

We are hoping to be done with enrollment soon and excited to see what we learn from this study! @VUMCLHS

https://t.co/gcxO5ncaI6

[Rafeeque @rafeequemavoor]

Free scientific illustrations for biologists! 😍

@NIH has released a library of 500+ free scientific illustrations to create figures, presentations, and illustrations!

all freely available in the public domain.

Retweet and spread the message!
https://t.co/p1bD1kxO7H

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@EricSkaar @NIAIDNews @VUMC_ID @VUMC_MedPSTP @EFSInsideScoop Thanks Eric, I couldn’t have done it without you!

[Jeff Freiberg, MD, PhD @JeffFreiberg]

I am excited to announce that my work on antibiotic treatment failure in Staph is now funded through a K08 from @NIAIDNews!

A big thank you to @VUMC_ID @VUMC_MedPSTP @EFSInsideScoop and especially my mentor @EricSkaar to help get me to this point!

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@ValeriaMReyes @NIAIDNews @VUMC_ID @VUMC_MedPSTP @EFSInsideScoop @EricSkaar Thank you!

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@erin_r_green @NIAIDNews @VUMC_ID @VUMC_MedPSTP @EFSInsideScoop @EricSkaar Thanks!

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@HSerezani @NIAIDNews @VUMC_ID @VUMC_MedPSTP @EFSInsideScoop @EricSkaar Yes!

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@joeyzacks @NIAIDNews @VUMC_ID @VUMC_MedPSTP @EFSInsideScoop @EricSkaar Thanks!

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@DWeissLab @NIAIDNews @VUMC_ID @VUMC_MedPSTP @EFSInsideScoop @EricSkaar Thank you!

[Jeff Freiberg, MD, PhD @JeffFreiberg]

@laurenpalmerphd @NIAIDNews @VUMC_ID @VUMC_MedPSTP @EFSInsideScoop @EricSkaar Thanks!

[maricar malinis @maricar_malinis]

We have an open #TID fellowship position @VUMC_IDFellows. @VUMCTransplant is a high-volume transplant center ( lung, heart, kidney, pancreas, liver) with a diverse patient population and pathology. The program has expanded to 6 faculty members and APRN.

[Michael Baym @baym]

I appreciate the work that went into this study, but if your prediction, absent a new mechanism or major change, looks like this, I’m worried your conclusions follow from assumptions and not evidence

[Mariana Byndloss @Mari_Byndloss]

🚨My favorite event of the year is here 🚨 - the @VI4Research DEI Symposium is highlighting Immigrant scientists (so timely, huh?)!! Talks from @mraffatellu , Sophie Helaine and Yi-Wei Chang. Open to VU/VUMC community! Link to register: https://t.co/uA155Y4OId - Please, RT!