Cameron Forbes

Antimicrobial Stewardship and Infectious Diseases Pharmacist. BCIDP. PK/PD geek wannabe. Also I play the banjo. Opinions expressed are my own.

[Queensway Carleton Hospital & Foundation @QCHOttawa]

It's #WorldAntimicrobialAwareness Week and this year's theme is “Act Now: Protect Our Present, Secure Our Future." We want to spotlight on our “Gold Star Physicians," for their appropriate antibiotic use, patient safety, and collaboration with QCH teams! #QCHOttawa #OttawaHealth

[Cameron Forbes @camoxicillin]

@DrToddLee @ABsteward I think in the paper the issue is that the PCN MIC 4-8 corresponded to much higher pip/tazo MICs (ie PCN MIC=8 was all piptazo MIC >=16)

[Cameron Forbes @camoxicillin]

@Zaydovudine @ABsteward @infeccHRUmalaga @DrToddLee @BradSpellberg @JAMANetwork @syctong @JAMA_current https://t.co/hz8eXR48Il
There is an osteo RCT for this dose

[Cameron Forbes @camoxicillin]

@DrToddLee @infeccHRUmalaga @BradSpellberg @ABsteward @JAMANetwork @syctong @JAMA_current DOTS trial uses 1500mg repeat in 1 week I believe

[Cameron Forbes @camoxicillin]

@JLimHospMD @ABsteward Technically the CLSI breakpoint (cefazolin surrogate) for oral cephs in UTI does not include cefadroxil. Realistically it probably works just fine but cephalexin BID avoids the issue

[Queensway Carleton Hospital & Foundation @QCHOttawa]

This week, our Antimicrobial Stewardship (ASP) team passed out “StewardCHIPS” to raise awareness and highlight their impactful interventions being implementing to combat Antimicrobial Resistance.

Learn more about Antimicrobial Resistance: https://t.co/TfGKAq7xRb

[Cameron Forbes @camoxicillin]

"Conclusion: A high degree of discordance between vancomycin Cmin and AUC was present in patients considered to be at high risk of nephrotoxicity. Monitoring vancomycin AUC in these patients may reduce the risk of nephrotoxicity." Important!

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

🆕️⚡️⚡️Small observational
A Comparison of Vancomycin AUC & Trough Concentration in Specific Populations*
The majority (79%) of the 43 Cmin levels <15 mg/L had an associated AUC >400 mgh/L & 57% of 21 Cmin levels within the 15 to 20 range had an AUC >600
https://t.co/2rNNxi0SS7

[Neil Stone @DrNeilStone]

Pharmacist correcting doctor's prescription

[Cameron Forbes @camoxicillin]

@ABsteward Really enjoying the shift from the misleading "low vs high oral bioavailability drugs" to "oral beta-lactams vs oral alternatives." I am going to start referring to quinolones as "alternative agents"!

[Brad Spellberg @BradSpellberg]

I agree with what you've said. It is exhausting to be constantly nudging others to modify their treatment plans. It's exhausting to be the abx police. Some in our field have become apologists for being abx police. Not me. I wanna work with ya--but there is a higher calling.

[ACCP INFD PRN @accpinfdprn]

#IDPharmacistDay is this Wed (5/22)! Get involved and recognize ID pharmacists in your life! #IDtwitter 👨‍⚕️👩‍⚕️

[SIDP @SIDPharm]

So much work has been done to fight AMR 🦠, but this is just the beginning…the rest is still unwritten. 💊 Share your story & celebrate ID Pharmacists Day! Join the Twitter/X storm! #JointheAMRFight #IDPharmacistsDay @IDSAInfo @SHEA_Epi @ACCPInfdPRN @MAD_ID_ASP @ASMicrobiology

[Cameron Forbes @camoxicillin]

Happy #IDPharmacistsDay! I'd have written something longer, but I'm busy fighting to get post-op antibiotics removed from an order set. 💩

[SIDP @SIDPharm]

Mark your calendars for the 4th Annual #IDPharmacistsDay on Wednesday, May 22nd, and prepare to share a photo of yourself with the Infectious Diseases Pharmacist in your life. #SIDPAdvocacy #JointheAMSFight 🦠 👩‍⚕️ 💊

Find out how to celebrate & learn more: https://t.co/3AF4RXCG6L

[Matthew Girgis @GirgisMatthew]

@DrToddLee @tonybai16 @camoxicillin @IDPharmacometrx @legg_wamy Troughs of 10-15 can be achieved with various different exposures/AUCs and AKI risks. We may find that 400-600 isn’t the ideal range, but troughs certainly can’t be the answer. This is old news. We’ve already switched :)

[Cameron Forbes @camoxicillin]

@tonybai16 @IDPharmacometrx @DrToddLee @legg_wamy Seems like we need to answer AUC 200-400 vs AUC 400-600 question before deciding an acceptable trough surrogate range

[Cameron Forbes @camoxicillin]

@tonybai16 @IDPharmacometrx @DrToddLee @legg_wamy It's a fair rant, but I don't know anyone who is currently targeting AUCs of 200 for severe MRSA infections. PROVIDE trial suggested we may not need > 400, but it didn't establish a lower bound that I could tell.

[Cameron Forbes @camoxicillin]

@tonybai16 @IDPharmacometrx @DrToddLee @legg_wamy I feel like if I'm comfortable with lower AUC efficacy target, I'd still rather target AUC directly than allow for AUCs of 500+ knowing AKI risks go up with exposure. Esp as troughs are so dependent on chosen dosing intervals and proper admin/draw timings.

[Cameron Forbes @camoxicillin]

@tonybai16 @IDPharmacometrx @DrToddLee @legg_wamy Practically speaking I feel it would take more effort and level draws to hit and stay at a perfect trough of 10 than doing 2 post-dose levels and a bit of math to target AUC directly?

[SIDP @SIDPharm]

#Cdifficile can be devastating side effect of treating infections, but did you know that the specific antibiotic used can impact #Cdiff risk? Check out this infographic to C the diff-erence you can have when selecting antibiotics! #IDxPosts #IDTwitter #Antibiotics #TwitteRx