YY HAM

Infectious diseases/ABX allergy pharmacist at OHSU | ID PGY2 @ OHSU | PGY1 @ LegacyHealth

[YY HAM @YYHamophilus]

@BrentFooter Oooh, thanks!

[ACCP INFD PRN @accpinfdprn]

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@SaratoninSyndrm @GageD28 @YYHamophilus @TheApotheKeri

[YY HAM @YYHamophilus]

@MRaoRx @mmPharmD My apologies, it should obviously be “see da solution” I now hang my head in shame

[YY HAM @YYHamophilus]

@MRaoRx @mmPharmD Scedosporium? See tha solution!

[YY HAM @YYHamophilus]

@DrCatherineB Same thing happened to me, except the bill I received was for 154k even though it was for an outpatient procedure for which my son was awake the whole time and took about 30 minutes. Call to insurance cleared up but I can only imagine how often people just give up in shock.

[YY HAM @YYHamophilus]

@InYourFAECIUM @Julietavancin We run about 5 percent penicillin susceptible. Something about Portland. Our acinetobacter is also fairly polite. Probably the ipa and unicycles, somehow.

[YY HAM @YYHamophilus]

@SmeagsIDPharmD @EricMacyMD We’re actually retooling our surgical prophylaxis allergy algorithm now. Goal being cefazolin for all where it’s first line. Biggest change being not avoiding the cefazolin even if penicillin allergy is severe as long as it’s ige mediated (so give cefaz for pen anaphylaxis)

[YY HAM @YYHamophilus]

@SmeagsIDPharmD @EricMacyMD We have quite a lot in that category. We have different protocols for cross reactivity, how to deal with allergies for surgical prophylaxis, various protocols for skin testing and direct oral challenge, and when all else fails, desensitization protocols.

[YY HAM @YYHamophilus]

@Weavofloxacin Works pretty well overall.

[YY HAM @YYHamophilus]

@Weavofloxacin I write a note for the challenge, make sure the patient is aware so that they don’t add it back themselves, and then added a note in the allergy listing under clarification needed with a dot phrase that this patient isn’t allergic and to not add back unless additional reaction.

[YY HAM @YYHamophilus]

@KimberlyBlumen1 @drtimothyli @EricMacyMD @PharmerMeg @TrubianoJason When someone is specifically reacting to pip tazo but no other penicillins, would you assume tazobactam is the culprit? Or the piperacillin side chain? Sometimes in those cases I’ll enter the allergy as tazobactam so that other penicillins are spared the alerts.

[YY HAM @YYHamophilus]

@ThoPham27 @accpinfdprn Is there a cefepime arm? The graph seems to compare to mero only?

[YY HAM @YYHamophilus]

@accpinfdprn I do this at my institution. We’ve expanded beyond just penicillin, but penicillin is still the majority of the testing we do. Mostly oral challenge, very little skin testing. Our pen algorithm is in our publication: https://t.co/GErEU6gOEG

[YY HAM @YYHamophilus]

@BillJonez1 @EricTopol @JAMAInternalMed Lower dose is to match the level of nirmatrelvir in the blood with those with normal kidneys (nirmatrelvir is cleared by the kidneys). If she’d ingested the std dose she would’ve gotten a higher than normal level in her blood. I hope she’s doing better.

[YY HAM @YYHamophilus]

@BriFrescas @ABsteward I’ll read in full on Monday, but was just wondering if there’s a sub analysis for cefepime mic 1 and under?

[YY HAM @YYHamophilus]

@PhlawlessPharm How do you feel about the bigger kiddos? Do you max out at adult dose? Or go higher?

[YY HAM @YYHamophilus]

@BriFrescas @ABsteward Ooh, was just thinking about this yesterday… can’t wait to see what you found.

[YY HAM @YYHamophilus]

@saltylungs Can you get 3 day remdesivir? Given anti rejection drugs, your best bet for staying out of hospital. Get better soon!

[YY HAM @YYHamophilus]

@madison_salam @jlbouchard001 Ndm? Aztreonam with ceftaz avi for the avibactam?