Health
**Breakpoints**

The SIDP Podcast

Latest Episodes:

#104 – Dosing Consult: Rifampin Part 1 Oct 04, 2024

Show notes

In this episode of Breakpoints’ Dosing Consult series, Drs. Chuck Peloquin and Gerry Davies join Dr. Megan Klatt to discuss rifampin dosing for mycobacterial infections. Hear from the experts on if higher doses are really better, toxicity thresholds, and the role of alternative rifamycins for patients with MTB and NTMs.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About X: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp

References:

Efficacy and Safety of High-Dose Rifampin in Pulmonary Tuberculosis. A Randomized Controlled Trial. Am J Respir Crit Care Med. 2018 Sep 1;198(5):657-666. doi: 10.1164/rccm.201712-2524OC.
Rifampin vs. rifapentine: what is the preferred rifamycin for tuberculosis? Expert Rev Clin Pharmacol. 2017 Oct;10(10):1027-1036. doi: 10.1080/17512433.2017.1366311.
Rifabutin for treating pulmonary tuberculosis. Cochrane Database Syst Rev. 2007 Oct; 2007(4): CD005159. doi: 10.1002/14651858.CD005159.pub2.
Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease. Clin Infect Dis. 2023 Oct 5;77(7):1053-1062. doi: 10.1093/cid/ciad312.

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#103 – Dosing Consult: Daptomycin Sep 06, 2024

Show notes

Drs. Jim Rhodes and Molly Steed join host Jeannette Bouchard to discuss all things related to optimal dosing of daptomycin. This podcast episode provides insight on why dosing matters with this antibiotic, especially with certain organisms (looking at you, E. faecium), why weight matters with dosing, and what that pesky CPK means.

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

References:

Fixed-dose daptomycin in Staphylococcus aureus: doi 10.1002/phar.4602
High dose daptomycin for VRE: doi 10.1093/cid/ciw815

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#102 – Oh, the Places Stewardship Will Go! Best Practices for Outpatient Antibiotic Stewardship and Transitions of Care Aug 23, 2024

Show notes

In this episode, Drs. Erica Stohs, Ryan Stevens, and Jame McCrae join Dr. Megan Klatt to discuss antimicrobial stewardship practices at transitions of care and in the outpatient setting. Hear from the experts on how to establish programs in this space, best practices for data/reporting, and other tips for stewardship intervention.

References:

Pharmacist-Driven Transitions of Care Practice Model for Prescribing Oral Antimicrobials at Hospital Discharge. 10.1001/jamanetworkopen.2022.11331
From concept to reality: Building an ambulatory antimicrobial stewardship program. 10.1002/jac5.1528
Cracking the code(s): Optimization of encounter-level diagnosis coding to inform outpatient antimicrobial stewardship data modeling. 10.1017/ice.2023.296
Antibiotic Prescribing Variability in a Large Urgent Care Network: A New Target for Outpatient Stewardship. 10.1093/cid/ciz910
DART communication for respiratory illness treatment resources: Dialogue Around Respiratory Illness Treatment (DART) – iMTR (uwimtr.org)

#101 – BLING III: Does Continuous Infusion Make the Whole Place Shimmer Aug 02, 2024

Show notes

Join Prof Jason Roberts and Dr. Erin McCreary for this episode dedicated to discussing the results of the BLING III trial, which explored the use of continuous versus intermittent infusion of a beta-lactam antibiotic in critically ill patients.

Reference: Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis: The BLING III Randomized Clinical Trial. 10.1001/jama.2024.9779

#100 – Tackling Tetracyclines: Breakpoints 100th Episode! Jul 26, 2024

Show notes

Drs. Jeffrey Pearson and Jason Pogue join Dr. Jeannette Bouchard as they take on all things tetracyclines. Starting with tetracycline, they walk through differences between each generation and drug in this class, from dosing all the way to pertinent resistance mechanisms. You will not want to miss out on this one! This podcast was supported by an unrestricted grant from Paratek Pharmaceuticals Inc.

References:

Omadacycline for Mycobacterium abscessus full case series data set: 10.1128/aac.00824-23
Long term safety of omadacycline in Mycobacterium abscessus: 10.1093/ofid/ofad335
USCAST Acinetobacter baumannii Recommendations for Susceptibility Test Interpretive Criteria: https://www.uscast.org/uploads/1/1/9/0/119044870/uscast_alepak_acbc_stic_08feb23.pdf

#99 – Don’t be CRABby: Acinetobacter baumannii review Jun 28, 2024

Show notes

Drs. Yohei Doi and Emily Heil join Dr. Erin McCreary to dive into one of the most requested topics from our listeners and something that is consistently confusing in clinical practice: Acinetobacter baumannii! Hear from experts on their experience with treating this tricky organism and their thoughts on best approaches when you are presented with CRAB. Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

References:

SNAP doi:10.1128/mbio.02759-2
ATTACK doi:10.1016/S1473-3099(23)00184-6
CRAB among COVID patients: doi:10.1093/jac/dkad042

#98 – Uncomplicated UTIs: Getting Uncomfortable with Uncertainty May 24, 2024

Show notes

Drs. Chris Crnich, Angela Huttner, and Jeannette Bouchard join Dr. Erin McCreary to discuss all things uncomplicated UTIs! Gain insight into where our new guidelines may be headed and pearls from experts in a variety of clinical settings, including a clinic specifically devoted to UTIs! Funding for this podcast was supported by an independent medical education grant from GSK.

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

References:

Proposing the "Continuum of UTI" doi: 10.1097/JU.0000000000003874
UTIs exciting new frontier doi: 10.1016/j.cmi.2022.07.016
Fosfo vs Nitro doi: 10.1001/jama.2018.3627

#97 – Hot Topics: What Did You Miss in Infectious Diseases in 2023-2024 (LIVE from MAD-ID) May 17, 2024

Show notes

In this special LIVE podcast episode, Drs. Emily Heil (@emilyheil) and Mandee Noval (@MandeeNoval) present the latest and greatest in ID literature from MAD-ID 2024 (@MAD_ID_ASP) in Orlando, FL. They cover everything from ECCMID late breakers to stewardship to the best things to come out of a good old shortage! You won’t want to miss this one!

Google Drive to Slides from Live Session: https://drive.google.com/file/d/1L4zq0ZC5LW9cCySE0AiJL7m8qDxS9MGM/view?usp=sharing

Submit your 100th Episode videos at: sidp@affinity-strategies.com

Check out more information on ID Pharmacists Day on May 22nd, 2024 at SIDP.org/IDPharmacistsDay

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

#96 – The Tortured Stewards & Surgeons Department Apr 19, 2024

Show notes

Episode Notes

The Society of Infectious Diseases Pharmacists is excited to invite you to the first ever meeting (via Breakpoints) of The Tortured Stewards & Surgeons Department. Today’s agenda items: optimal management of perioperative antibiotics and prevention of surgical site infections.

Drs. Trisha Peel (@DrTrishaPeel), Michael Calderwood (@CalderwoodMD) and Patch Dellinger join Dr. Jillian Hayes (@thejillianhayes) to discuss some of the controversies we encounter while managing antibiotics in the perioperative space. Does anyone really need post-op antimicrobial prophylaxis longer than 24 hours? Where should vancomycin be fitting into surgical prophylaxis regimens? Can we truly give pre-operative cefazolin to patients with a penicillin allergy? Tune in for the answers to these questions and more!

If you’d like more information about the CALIPSO trial, please visit this link: https://www.anzca.edu.au/profiles/ctn-trials/underway/calipso

Bibliography

SSI Infection Prevention Review: https://jamanetwork.com/journals/jama/article-abstract/2800424#:~:text=Six%20are%20supported%20by%20randomized,use%20a%20chlorhexidine%20gluconate%2Dalcoho
Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/strategies-to-prevent-surgical-site-infections-in-acutecare-hospitals-2022-update/2F824B9ADD6066B29F89C8A2A127A9D
American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update: https://journals.lww.com/journalacs/citation/2017/01000/american_college_of_surgeons_and_surgical.8.aspx
2017 CDC Guidelines: https://jamanetwork.com/journals/jamasurgery/fullarticle/2623725
2018 WHO Guidelines: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y
ASHP Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery: https://www.ashp.org/surgical-guidelines
Surgeons as Stewards: https://journals.lww.com/journalacs/citation/2020/12000/perioperative_antibiotic_prophylaxis__surgeons_as.23.aspx
Li et al, Arthroplasty 2022: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y
Dutch Arthroplasty Register Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023957/
de Jonge Meta-Analysis on duration and incidence of SSI: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30084-0/abstract
Prolonged Antibiotic Prophylaxis After Cardiovascular Surgery and Its Effect on Surgical Site Infections and Antimicrobial Resistance: https://www.ahajournals.org/doi/10.1161/01.cir.101.25.2916?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
RCT - Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs: https://jamanetwork.com/journals/jama/article-abstract/2810510
NYU Langone Study - Preventing Surgical Site Infections: A Randomized, Open-Label Trial of Nasal Mupirocin Ointment and Nasal Povidone-Iodine Solution: https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=91dee3e1445adb80d533f2c210816a3285254e3a
Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty: https://www.nejm.org/doi/full/10.1056/NEJMoa2301401
What Is the Primary Driver of Preoperative Vancomycin Use? It’s Not Methicillin-resistant Staphylococcus aureus—or Allergy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744972/
Drug allergy: a 2022 practice parameter update: https://www.jacionline.org/article/S0091-6749(22)01186-1/fulltext
Perioperative use of cefazolin without preliminary skin testing in patients with reported penicillin allergy: https://www.surgjournal.com/article/S0039-6060(18)30307-6/abstract#%20
Timing of Surgical Prophylaxis RCT: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30176-7/abstract
Propensity Score-Weighted Analysis of Postoperative Infection in Patients With and Without Preoperative Urine Culture: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815528

#95 – A to Z on R&D: Challenges and Solutions for Sustained Antimicrobial Drug Development Mar 29, 2024

Show notes

In this episode, Drs. Helen Boucher (@hboucher3), Ramy Elshaboury, and Mike Dudley (@MikeMNDudley) join host, Megan Klatt (@MeganKlatt3), to discuss barriers to antimicrobial drug development, potential incentives and legislation to promote market growth, and what we can do to ensure the antimicrobial pipeline doesn’t run dry.

References

An analysis of antibacterial drug development trends in the United States, 1980-2019: Dheman N, et al. Clin Infect Dis. 2021 Dec 6;73(11):e4444-e4450. doi:10.1093/cid/ciaa859. PMID: 32584952.
Antibacterial R&D at a crossroads: we’ve pushed as hard as we can…now we need to start pulling!: Rex JH, Outterson K. Clin Infect Dis. 2021 Dec 6;73(11):e4451-4453. doi:10.1093/cid/ciaa852. PMID: 32584949.
No Patient Left Behind (website): https://www.nopatientleftbehind.org/ (many useful explainers of how the investment, innovation cycle, and drug pricing work)
ISPOR special task force report on defining elements of value in health care – a health economics approach: Lakdawalla DN, et al. Value Health. 2018 2018 Feb;21(2):131-139. doi: 10.1016/j.jval.2017.12.007. PMID: 29477390.
Generalized cost-effectiveness analysis to assess treatment value in hepatitis C: Chou JW, et al. Am J Manag Care. 2023 Dec;29(12):696-703. doi: 10.37765/ajmc.2023.89468. PMID: 38170486.

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