Mark Downing

Infectious Diseases and Antimicrobial Stewardship Physician in Toronto

[Kevin Schwartz @DrKevinSchwartz]

Masks, gloves, goggles at home? Please donate
⁦@MarkADowning⁩ ⁦@TorontoIDDoc⁩ ⁦@BogochIsaac⁩ https://t.co/N2zQd5cw9R

[Nathan Stall @NathanStall]

This is a big step. I wonder how IPAC in Toronto and elsewhere will react.

@picardonhealth @theresaboyle @HotaSusy @MarkADowning @AlonVaisman @DFisman @ASPphysician @janinemccready @TorontoIDDoc @FralickMike @JonZipursky @LapointeShaw @kieranlquinn

[Maureen Taylor @maureentaylor31]

I want to highlight this from the incredible thread by the Italian ICU MD: "the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists." 1/3

[Janine McCready @janinemccready]

THREAD:
In Canada to date we have only seen travel-related #COVID19 cases. This will soon change.

China's containment attempts gave us time. We cannot squander this by being complacent. The time to increase funding, improve communication and prepare is now. 1/

[Maureen Taylor @maureentaylor31]

@janinemccready @jpowi @HotaSusy @Abx_ID_Doc @MarkADowning @carlyweeks @picardonhealth @BogochIsaac @AlonVaisman @DFisman @PHAC_GC @TOPublicHealth @PublicHealthON @CBCHealth @CDCofBC Canada could be perfect country to see whether #COVID19 can be contained at this point. Universal healthcare, many have paid sick leave, all cases to date can be traced to travel, testing has been rapid. Let's not screw this up @ONThealth! Be proactive. @janinemccready @jpowi

[Brad Langford @BRxAD]

Procalcitonin -guided antibiotic duration combined with #antimicrobialstewardship was associated with 27% adjusted decrease in overall antibiotic use in our community hospital ICU @UnityHealthTO
https://t.co/40RvRcoPEk

[Mark Downing @MarkADowning]

A very important analysis for those trying to understand how 2019-nCoV is spreading https://t.co/rn55CI7m2m

[Laurie Garrett @Laurie_Garrett]

Any health care worker staying on the front lines of this #nCoV2019 is a hero, given how easily the virus can spread to doctors and nurses that are performing pulmonary procedures or screening panicked people in ER facilities.
Rest in peace, Dr. Liang.

[Isaac Bogoch @BogochIsaac]

1. HIV PEP-in-Pocket ("PIP"), an HIV prevention strategy for those with a low frequency of high-risk exposures.

Here is longer term follow-up of 79 patients using PIP, with ~100 PIP-years of follow-up. No HIV seroconversions.

https://t.co/HbCoLirAWH

#HIVPIP #PrEP @CATIEinfo

[Janine McCready @janinemccready]

Anyone seen these antibiotic characters lurking around? @MGHToronto #AAW2019 #AntibioticAwarenessWeek #AntibioticResistance

[Choosing Wisely Canada @ChooseWiselyCA]

The more we use antibiotics unnecessarily, the less effective they become. One of the ways we can fight #AntibioticResistance is to use antibiotics wisely.

https://t.co/OxwlAUbKDO

[Mark Downing @MarkADowning]

@TheIDApprentice @BRxAD @ASP_Mark Or Cipro, take it out of your urine culture reports👍

[Brad Langford @BRxAD]

🆕How can we nudge clinicians to choose more appropriate
#antibiotic therapy? Our scoping review just published in @ICHEJournal maps the literature on nudging strategies in microbiology reports. Read the full text here: https://t.co/R8S1x5r8Br

#VisualAbstract

[Steve Russell @SteveRussell]

One of the most clever Halloween yard displays I've seen in Toronto is also a great public service announcement, pumpkins and carrots make up measles virus with a "Vaccinate your Kids" headstone underneath in the City's East End. #halloween2019

[Brad Langford @BRxAD]

Inter-disciplinary, rounds-based prospective audit and feedback is associated with lower antibiotic use in general medicine.
🆕 Our latest paper in @ICHEJournal

https://t.co/ayAWtrDG1y #visualabstract #antimicrobialstewardship

[Isaac Bogoch @BogochIsaac]

There appears to be an autochthonous, mosquito-transmitted case of Zika virus in southern France.

This would have been acquired in August when southern France has the appropriate climate and competent mosquito vectors.

https://t.co/VKF0tYCWNy

[Brad Langford @BRxAD]

Our latest publication in @JAMMI_Journal: a pilot study of a province-wide #antibiotic use tracking and reporting system
#VisualAbstract
https://t.co/4YKZisityB

[Brad Langford @BRxAD]

Procalcitonin monitoring in a community ICU was associated with a non-significant decrease in antibiotic use and wide variability in inter-prescriber protocol adherence #IDWeek2019 https://t.co/aIKk2h2SAU (poster #1995)

[Michael Calderwood, MD, MPH @CalderwoodMD]

With a map like this, it seems like it is time to say goodbye to the Z-pack everywhere in the U.S. for CAP.

[Mark Downing @MarkADowning]

@DrKevinSchwartz @TorontoIDDoc @stjoestoronto Will be interesting to compare the two studies. Different populations (more stable in this study I think), different bugs (some gram positives, polymicrobial in BALANCE) and different endpoints (composite vs mortality).