#ASPChat Transcript
Healthcare social media transcript of the #ASPChat hashtag.
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See #ASPChat Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Rxtepen π @Rxtepen RT @richdavisphd: If you're in the fields of infectious disease, pharmacy or clinical antibiotic testing, this looks like VERY worthwhile chat event, happening tonight #ASPchat #IDMedEd #ASMClinMicro |
 | Brad Langford @BRxAD @ASP_Chat @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Community acquired pneumonia is so frequent and often responds quickly to antibiotic therapy, we could reduce a lot of antibiotic exposure for our patients focusing on this condition #ASPChat |
 | Brad Crane @ASP_PharmD HAP/VAP of 7d per guidelines (assuming clinical improvement). ICU great place to have core group to start with this and can prolong when slow improvement. #ASPChat |
 | Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_PharmD: HAP/VAP of 7d per guidelines (assuming clinical improvement). ICU great place to have core group to start with this and can prolong when slow improvement. #ASPChat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @BRxAD: @ASP_Chat @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Community acquired pneumonia is so frequent and often responds quickly to antibiotic therapy, we could reduce a lot of antibiotic exposure for our patients focusing on this condition #ASPChat |
 | Krutika Mediwala Hornback @krutu8 RT @ASP_Chat: π Welcome to the #ASPchat on antimicrobial stewardship and duration of therapy!!! We are staring in just a few minutes. ********** REMEMBER: Use the hashtag #ASPchat in your tweets and replies so everyone can follow along. ********** https://t.co/8EIQBxNeF8 |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_Chat @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Community acquired pneumonia is so frequent and often responds quickly to antibiotic therapy, we could reduce a lot of antibiotic exposure for our patients focusing on this condition #ASPChat |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: HAP/VAP of 7d per guidelines (assuming clinical improvement). ICU great place to have core group to start with this and can prolong when slow improvement. #ASPChat |
| Krutika Mediwala Hornback @krutu8 @ASP_PharmD @ASP_Chat and MRSA nasal swabs! #ASPChat #nomorevanc #thatrhymes |
 | HutchIDSciences @HutchIDScience RT @ASP_Chat: π Welcome to the #ASPchat on antimicrobial stewardship and duration of therapy!!! We are staring in just a few minutes. ********** REMEMBER: Use the hashtag #ASPchat in your tweets and replies so everyone can follow along. ********** https://t.co/8EIQBxNeF8 |
| Brad Crane @ASP_PharmD Can incorporate Procalcitonin (PCT) as well to help with duration of therapy with pneumonia (90% reduction from peak value suggests antimicrobial duration complete given ~24h half-life). #ASPChat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF A1. How about we go from a 5-days to a zero-days course of azithromycin for viral infections in the outpatient setting, can we count that? #ASPchat |
| Brad Langford @BRxAD @ASP_Chat @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Have had some experience using duration as short as 3 days for rapidly resolving CAP, as seen in this study by el Moussaoui and colleagues: https://t.co/DoyMI0YwKL #ASPchat |
| Krutika Mediwala Hornback @krutu8 @ASP_PharmD @ASP_Chat yes! lots of variability between ordering of and interpreting on the physician side! Need for universal protocols #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF A1. How about we go from a 5-days to a zero-days course of azithromycin for viral infections in the outpatient setting, can we count that? #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @BRxAD: @ASP_Chat @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Have had some experience using duration as short as 3 days for rapidly resolving CAP, as seen in this study by el Moussaoui and colleagues: https://t.co/DoyMI0YwKL #ASPchat |
| Krutika Mediwala Hornback @krutu8 @IDstewardship @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Or stop using it indefinitely in culture proven PNA for "anti-inflammatory" properties #ASPchat https://t.co/1M7dWXfjFf |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_Chat @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Have had some experience using duration as short as 3 days for rapidly resolving CAP, as seen in this study by el Moussaoui and colleagues: https://t.co/DoyMI0YwKL #ASPchat |
 | Jamie Kisgen @KisgenUF RT @BRxAD: @ASP_Chat @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Have had some experience using duration as short as 3 days for rapidly resolving CAP, as seen in this study by el Moussaoui and colleagues: https://t.co/DoyMI0YwKL #ASPchat |
| Krutika Mediwala Hornback @krutu8 @jlo921 @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Plug: @idsa guidelines on ASB!! #ASPchat |
| Brad Crane @ASP_PharmD @jlo921 @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Abx duration for UTI seems to be a challenge as it appears the duration of therapy often changes depending on which antimicrobial is being used and severity/type of UTI (uncomplicated cystitis different than pyelo). Not many other disease states differentiate like this. #ASPChat |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: @jlo921 @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Abx duration for UTI seems to be a challenge as it appears the duration of therapy often changes depending on which antimicrobial is being used and severity/type of UTI (uncomplicated cystitis different than pyelo). Not many other disease states differentiate like this. #ASPChat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF This @DASON_duke @tmjones6 image does a nice job of identifying where we can look from 5π7 based one literature... #ASPchat cc: @BradSpellberg https://t.co/W6Cu4TknDx |
 | #ASPchat @ASP_Chat Q2. What π published or anticipated publication is on the top of your list for great data on antimicrobial duration of therapy and using shorter courses? #ASPchat #ThePowerOfData https://t.co/qeupBmOd9Y |
 | Deepali Dixit @deepalipharmd 5 days to zero for aspiration pneumonitis #ASPChat |
| Brad Langford @BRxAD @ASP_PharmD In our ICU we use PCT for guidance of antibiotic duration, beside a huge number of negative PCT at day 1 (perhaps antibiotics not needed) most patients meet relative threshold for stopping at day 5. #5isthenew7 #ASPchat |
 | David Ha @DHpharmd @ASP_Chat C'mon, @BradSpellberg's paper of course #ASPchat |
 | Monica Mahoney @mmPharmD A1. UTI. CAP. HAP. I feel like these studies have been beaten into our house staff recently. So little prompting from AST. Now if we can have built in stop dates ... #ASPchat |
| Jamie Kisgen @KisgenUF How about zero? - Asymptomatic bacteruria - Asthma exacerbation - Sinusitis - Bronchitis #ASPChat |
| Jamie Kisgen @KisgenUF RT @mmPharmD: A1. UTI. CAP. HAP. I feel like these studies have been beaten into our house staff recently. So little prompting from AST. Now if we can have built in stop dates ... #ASPchat |
 | Antimicrobial SP @SHUHNASP RT @ASP_Chat: Q1. What disease states are the lowest hanging π fruit for reducing unnecessarily long durations of antimicrobial therapy? Dont be afraid to get specific with your scenarios! #ASPchat https://t.co/muQOl8Ggfs |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_Chat: Q2. What π published or anticipated publication is on the top of your list for great data on antimicrobial duration of therapy and using shorter courses? #ASPchat #ThePowerOfData https://t.co/qeupBmOd9Y |
| Krutika Mediwala Hornback @krutu8 RT @KisgenUF: How about zero? - Asymptomatic bacteruria - Asthma exacerbation - Sinusitis - Bronchitis #ASPChat |
| Krutika Mediwala Hornback @krutu8 RT @mmPharmD: A1. UTI. CAP. HAP. I feel like these studies have been beaten into our house staff recently. So little prompting from AST. Now if we can have built in stop dates ... #ASPchat |
| Monica Mahoney @mmPharmD @ASP_PharmD @jlo921 @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF While this is true, I find when I make a DOT rec on a UTI, since its viewed as a "less severe" infection, more pt to take the rec. #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_PharmD In our ICU we use PCT for guidance of antibiotic duration, beside a huge number of negative PCT at day 1 (perhaps antibiotics not needed) most patients meet relative threshold for stopping at day 5. #5isthenew7 #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @deepalipharmd: 5 days to zero for aspiration pneumonitis #ASPChat |
| Krutika Mediwala Hornback @krutu8 @deepalipharmd you mean PMEUMONITIS π @ASP_Chat #aspchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @ASP_Chat A2. I know it's not the latest and greatest, but this @BradSpellberg editorial really has a special place in my β€οΈ https://t.co/a8gzcwztgj #ASPchat ...more recently I have been reaching to the @JGPharmD article in @PharmacoJournal https://t.co/lh8ttMPZoM #ASPchat https://t.co/DzT8oWnldu |
| Brad Crane @ASP_PharmD @BRxAD I am reluctant to recommend stopping (or not starting) atbx solely based on initial PCT based on its delayed onset/peak but when that repeat the next AM is also undetectable, then let's chat. Atypical organisms may not incr PCT though. Azith x5d only maybe. #ASPChat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF This @DASON_duke @tmjones6 image does a nice job of identifying where we can look from 5π7 based one literature... #ASPchat cc: @BradSpellberg https://t.co/W6Cu4TknDx |
| Krutika Mediwala Hornback @krutu8 RT @ASP_Chat: Q2. What π published or anticipated publication is on the top of your list for great data on antimicrobial duration of therapy and using shorter courses? #ASPchat #ThePowerOfData https://t.co/qeupBmOd9Y |
| Monica Mahoney @mmPharmD A2. All of the DOT BSI papers! I feel like this is the most nebulous "infection" . Looking forward to the #BALANCE study! @Guru_JoshD #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @ASP_Chat A2. I know it's not the latest and greatest, but this @BradSpellberg editorial really has a special place in my β€οΈ https://t.co/a8gzcwztgj #ASPchat ...more recently I have been reaching to the @JGPharmD article in @PharmacoJournal https://t.co/lh8ttMPZoM #ASPchat https://t.co/DzT8oWnldu |
| Krutika Mediwala Hornback @krutu8 RT @mmPharmD: @ASP_PharmD @jlo921 @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF While this is true, I find when I make a DOT rec on a UTI, since its viewed as a "less severe" infection, more pt to take the rec. #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @mmPharmD: A2. All of the DOT BSI papers! I feel like this is the most nebulous "infection" . Looking forward to the #BALANCE study! @Guru_JoshD #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: @BRxAD I am reluctant to recommend stopping (or not starting) atbx solely based on initial PCT based on its delayed onset/peak but when that repeat the next AM is also undetectable, then let's chat. Atypical organisms may not incr PCT though. Azith x5d only maybe. #ASPChat |
 | Kirsten @KirstenBrooks0 @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Treatment of UTIs in asymptomatic hospitalized patients. Just because an organism has been isolated doesn't mean it needs antimicrobial therapy. #ASPchat |
| Krutika Mediwala Hornback @krutu8 @mmPharmD @Guru_JoshD and those with resistance - longer, indefinite? what do we do?!?!? should it even matter? @ASP_Chat #aspchat |
| Brad Langford @BRxAD @ASP_Chat Looking forward to the results of the BALANCE trial: 7 vs 14 days for bacteremia, international RCT currently enrolling patients https://t.co/SRTSP5Z8Zn #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_Chat Looking forward to the results of the BALANCE trial: @ASP_Chat Looking forward to the results of the BALANCE trial: 7 vs 14 days for bacteremia, international RCT currently enrolling patients https://t.co/SRTSP5Z8Zn #ASPchat |
| Deepali Dixit @deepalipharmd 2016 HAP/VAP guidelines #ASPchat |
| Jamie Kisgen @KisgenUF RT @IDstewardship: @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF This @DASON_duke @tmjones6 image does a nice job of identifying where we can look from 5π7 based one literature... #ASPchat cc: @BradSpellberg https://t.co/W6Cu4TknDx |
| Krutika Mediwala Hornback @krutu8 @BRxAD @ASP_Chat how many Brads can we bring in?!? :) @ASP_PharmD @BradSpellberg #ASPchat |
| Brad Crane @ASP_PharmD @BRxAD @ASP_Chat Have to wonder how the source of the bacteremia will impact outcomes... #ASPChat |
| #ASPchat @ASP_Chat Q3. What is the most π‘π³ controversial issue you have encountered related to shortening antimicrobial durations of therapy? #ASPchat https://t.co/4ZwFWm1cTc |
| Brad Crane @ASP_PharmD RT @krutu8: @ASP_PharmD @ASP_Chat and MRSA nasal swabs! #ASPChat #nomorevanc #thatrhymes |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @KisgenUF #aspchat https://t.co/LBvqiF0UUl |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: @BRxAD @ASP_Chat Have to wonder how the source of the bacteremia will impact outcomes... #ASPChat |
| Monica Mahoney @mmPharmD @ASP_PharmD @BRxAD @ASP_Chat I can't wait to dive into the supplementary material! π€ #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_Chat: Q3. What is the most π‘π³ controversial issue you have encountered related to shortening antimicrobial durations of therapy? #ASPchat https://t.co/4ZwFWm1cTc |
| Monica Mahoney @mmPharmD A3. Immunocompromised patients. π #ASPchat |
 | ChiChi Tamagotchi @MedSchool_30 @ASP_Chat Patient improvement on current therapy so err on the side of caution and continue for an additional 14 days though unwarranted #ASPchat |
| Krutika Mediwala Hornback @krutu8 @ASP_Chat It's a resistant organism or they are immunocompromised; while there are recs for immunocompromised, these pts also have more ADEs and still have resistance! I.E. - heme-onc #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @MedSchool_30: @ASP_Chat Patient improvement on current therapy so err on the side of caution and continue for an additional 14 days though unwarranted #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @mmPharmD: A3. Immunocompromised patients. π #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @mmPharmD: @ASP_PharmD @BRxAD @ASP_Chat I can't wait to dive into the supplementary material! π€ #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @KisgenUF #aspchat https://t.co/LBvqiF0UUl |
 | Pharmacotherapy @PharmacoJournal RT @IDstewardship: @ASP_Chat A2. I know it's not the latest and greatest, but this @BradSpellberg editorial really has a special place in my β€οΈ https://t.co/a8gzcwztgj #ASPchat ...more recently I have been reaching to the @JGPharmD article in @PharmacoJournal https://t.co/lh8ttMPZoM #ASPchat https://t.co/DzT8oWnldu |
 | Sumit Gandotra PharmD, BCPS @sgandotraPharmD @ASP_Chat I tend to still struggle with this one but decubitus ulcer wound being treated for 4-6 weeks out of concern for osteo #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @ASP_Chat A3. In patients who are in the outpatient. Lots of fear surrounding the "what if" scenarios and do not have close tabs on patients like the inpatient. It can be a tough balance & every case is unique. #ASPchat |
| Brad Langford @BRxAD @ASP_PharmD @ASP_Chat Will definitely be interesting. So far a good mix of lung, abdo, and urinary sources enrolled. Here's the feasibility pilot results: https://t.co/Y9SGSIEe1c #ASPchat |
| Brad Crane @ASP_PharmD One of my most frequent recommendations "not accepted" relates to the role of PCT with respiratory "conditions" (trying to personalize patient care by using this vs cookbook/standard 5d vs 7d vs 10d vs 14d or "constantine unit factors"). #ASPChat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @ASP_Chat A3. In patients who are in the outpatient. Lots of fear surrounding the "what if" scenarios and do not have close tabs on patients like the inpatient. It can be a tough balance & every case is unique. #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @sgandotraPharmD: @ASP_Chat I tend to still struggle with this one but decubitus ulcer wound being treated for 4-6 weeks out of concern for osteo #ASPchat |
| Monica Mahoney @mmPharmD @MedSchool_30 @ASP_Chat "Nightfloat started gorillacillin and they're getting better ...." #ASPchat |
| ChiChi Tamagotchi @MedSchool_30 RT @krutu8: @ASP_Chat It's a resistant organism or they are immunocompromised; while there are recs for immunocompromised, these pts also have more ADEs and still have resistance! I.E. - heme-onc #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @mmPharmD: @MedSchool_30 @ASP_Chat "Nightfloat started gorillacillin and they're getting better ...." #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: One of my most frequent recommendations "not accepted" relates to the role of PCT with respiratory "conditions" (trying to personalize patient care by using this vs cookbook/standard 5d vs 7d vs 10d vs 14d or "constantine unit factors"). #ASPChat |
 | Rodney E. Rohde, PhD "Doc R" @RodneyRohde RT @IDstewardship: @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF A1. How about we go from a 5-days to a zero-days course of azithromycin for viral infections in the outpatient setting, can we count that? #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_PharmD @ASP_Chat Will definitely be interesting. So far a good mix of lung, abdo, and urinary sources enrolled. Here's the feasibility pilot results: https://t.co/Y9SGSIEe1c #ASPchat |
| Rodney E. Rohde, PhD "Doc R" @RodneyRohde RT @ASP_Chat: Q2. What π published or anticipated publication is on the top of your list for great data on antimicrobial duration of therapy and using shorter courses? #ASPchat #ThePowerOfData https://t.co/qeupBmOd9Y |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @mmPharmD: A2. All of the DOT BSI papers! I feel like this is the most nebulous "infection" . Looking forward to the #BALANCE study! @Guru_JoshD #ASPchat |
| Antimicrobial SP @SHUHNASP @ASP_Chat Without a doubt it's been stopping therapy for bacteriuria in "asymptomatic" cognitively impaired patients. Have to rely on rockstar nurses to report on whether pt behaviour has changed at all, and it's always a hard sell. #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @KirstenBrooks0: @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Treatment of UTIs in asymptomatic hospitalized patients. Just because an organism has been isolated doesn't mean it needs antimicrobial therapy. #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @BRxAD: @ASP_Chat Looking forward to the results of the BALANCE trial: @ASP_Chat Looking forward to the results of the BALANCE trial: 7 vs 14 days for bacteremia, international RCT currently enrolling patients https://t.co/SRTSP5Z8Zn #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @SHSUHNASP: @ASP_Chat Without a doubt it's been stopping therapy for bacteriuria in "asymptomatic" cognitively impaired patients. Have to rely on rockstar nurses to report on whether pt behaviour has changed at all, and it's always a hard sell. #ASPchat |
| Brad Langford @BRxAD @ASP_Chat Still hesitant to use shorter course therapy for urinary infections with beta-lactams. But encouraging to see others here have had success #ASPchat |
 | Madeline Belk @MadelineBelk RT @ASP_PharmD: HAP/VAP of 7d per guidelines (assuming clinical improvement). ICU great place to have core group to start with this and can prolong when slow improvement. #ASPChat |
| Monica Mahoney @mmPharmD @BRxAD @ASP_Chat I cringed when we updated the renal dosing card and added a "UTI" indication for cefpodoxime π¬ #ASPchat @RachelBPharmD |
| Krutika Mediwala Hornback @krutu8 @SHSUHNASP @ASP_Chat currently doing a project involving psych patients unable to endorse sx and ASB - looking forward to findings! #aspchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @krutu8 @mmPharmD @Guru_JoshD @ASP_Chat Agree. I don't know of any data saying "because is drug resistant organism, you need to treat for a longer duration"... indefinite therapy is a crazy thing, but sometimes it can be reasonable for extremely complex patient w/ source control issues. #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_Chat Still hesitant to use shorter course therapy for urinary infections with beta-lactams. But encouraging to see others here have had success #ASPchat |
 | Antibiotic Tweets @khalideljaaly @ASP_Chat A3. π€Start counting CDI duration of therapy after DC other Abx π€Pt still have ANC<500 #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @krutu8 @mmPharmD @Guru_JoshD @ASP_Chat Agree. I don't know of any data saying "because is drug resistant organism, you need to treat for a longer duration"... indefinite therapy is a crazy thing, but sometimes it can be reasonable for extremely complex patient w/ source control issues. #ASPchat |
| Brad Langford @BRxAD @IDstewardship @ASP_Chat Shorter courses have also been a challenge in long-term care. Physicians often off-site and will pick a duration that coincides with their next visit, and still many myths about stopping antibiotics early. #ASPchat |
| Brad Crane @ASP_PharmD This is one specific area that I am still confused about - shorter duration for UTI's yet does the drug (class) make a difference for duration (FQ < other atbx except fosfo) along with severity of disease (uncomplicated cystitis vs pyelo w/ bacteremia)? #ASPchat |
| David Ha @DHpharmd @ASP_PharmD Agree with this. Procal is not the magic bullet, need providers to believe in it. Easy intervention when the do, impossible when they don't. Other related issue is dealing with "secretions" in vented patients in the ICU... #ASPchat |
| #ASPchat @ASP_Chat Q4. Short or long, what are your go-to π± resources and π©ββοΈπ¨ββοΈ clinical factors to consider when making decisions about length of antimicrobial therapy? #ASPchat https://t.co/Ma9PyytlUC |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_PharmD: @BRxAD @ASP_Chat Have to wonder how the source of the bacteremia will impact outcomes... #ASPChat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_Chat: Q4. Short or long, what are your go-to π± resources and π©ββοΈπ¨ββοΈ clinical factors to consider when making decisions about length of antimicrobial therapy? #ASPchat https://t.co/Ma9PyytlUC |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @khalideljaaly: @ASP_Chat A3. π€Start counting CDI duration of therapy after DC other Abx π€Pt still have ANC<500 #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @DHpharmd: @ASP_PharmD Agree with this. Procal is not the magic bullet, need providers to believe in it. Easy intervention when the do, impossible when they don't. Other related issue is dealing with "secretions" in vented patients in the ICU... #ASPchat |
| Monica Mahoney @mmPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @EMpharmgirl @SICUPharmD It WAS this ... but sad (and WONDERFUL) how rapidly outdated this already is. @JGPharmD #ASPchat https://t.co/YnQREa6te4 |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: This is one specific area that I am still confused about - shorter duration for UTI's yet does the drug (class) make a difference for duration (FQ < other atbx except fosfo) along with severity of disease (uncomplicated cystitis vs pyelo w/ bacteremia)? #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @IDstewardship @ASP_Chat Shorter courses have also been a challenge in long-term care. Physicians often off-site and will pick a duration that coincides with their next visit, and still many myths about stopping antibiotics early. #ASPchat |
| Antimicrobial SP @SHUHNASP @krutu8 @ASP_Chat That's excellent. What's the study design for this? #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @maccall_laura @ASP_Chat LOL... transplant, the world of little data and "that sounds reasonable" #ASPchat ...Multivisceral transplants are a crazy thing that result in crazy problems. |
| David Ha @DHpharmd @mmPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @EMpharmgirl @SICUPharmD @JGPharmD Yes please write another @JGPharmD, and then another 6 months later, and so on... π #ASPchat |
| Brad Crane @ASP_PharmD I usually start with the related society's guidelines and inquire if there is a good reason to deviate from general consensus guidelines (sometimes yes, sometimes no). #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @DHpharmd: @mmPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @EMpharmgirl @SICUPharmD @JGPharmD Yes please write another @JGPharmD, and then another 6 months later, and so on... π #ASPchat |
| Sumit Gandotra PharmD, BCPS @sgandotraPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD Johns Hopkins Antimicrobial Guide has been my go to as a student #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @maccall_laura @ASP_Chat LOL... transplant, the world of little data and "that sounds reasonable" #ASPchat ...Multivisceral transplants are a crazy thing that result in crazy problems. |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @mmPharmD @ASP_PharmD @BRxAD @ASP_Chat #NerdAlert but I love it! #ASPchat #ThisStuffIsActuallyReallyInteresting |
| Krutika Mediwala Hornback @krutu8 RT @mmPharmD: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @EMpharmgirl @SICUPharmD It WAS this ... but sad (and WONDERFUL) how rapidly outdated this already is. @JGPharmD #ASPchat https://t.co/YnQREa6te4 |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @mmPharmD: A3. Immunocompromised patients. π #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: I usually start with the related society's guidelines and inquire if there is a good reason to deviate from general consensus guidelines (sometimes yes, sometimes no). #ASPchat |
 | Tony Gerlach @SICUPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl I think we often forget 1. Was source control achieved and 2. is patient clinically better 3. Do they look better #ASPChat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_PharmD: One of my most frequent recommendations "not accepted" relates to the role of PCT with respiratory "conditions" (trying to personalize patient care by using this vs cookbook/standard 5d vs 7d vs 10d vs 14d or "constantine unit factors"). #ASPChat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @mmPharmD @ASP_PharmD @BRxAD @ASP_Chat #NerdAlert but I love it! #ASPchat #ThisStuffIsActuallyReallyInteresting |
| Krutika Mediwala Hornback @krutu8 @IDstewardship @mmPharmD @ASP_PharmD @BRxAD @ASP_Chat learning so much! Already have 5 studies to read... #ASPchat https://t.co/QtgoNpq2BT |
| Krutika Mediwala Hornback @krutu8 RT @SICUPharmD: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl I think we often forget 1. Was source control achieved and 2. is patient clinically better 3. Do they look better #ASPChat |
| Jamie Kisgen @KisgenUF RT @ASP_Chat: Q4. Short or long, what are your go-to π± resources and π©ββοΈπ¨ββοΈ clinical factors to consider when making decisions about length of antimicrobial therapy? #ASPchat https://t.co/Ma9PyytlUC |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @ASP_PharmD Related, I learned never to say "cookbook" in front of MDs. Especially ER MDs. They don't want to hear that jazz. Amazing how context, social factors, and verbiage have a big impact on the ability to curb institutional culture. #ASPchat what do you think @iEMPharmD @EMpharmgirl? |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @ASP_PharmD Related, I learned never to say "cookbook" in front of MDs. Especially ER MDs. They don't want to hear that jazz. Amazing how context, social factors, and verbiage have a big impact on the ability to curb institutional culture. #ASPchat what do you think @iEMPharmD @EMpharmgirl? |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @BRxAD @ASP_Chat I think you are justified with that hesitation. I have not seen good data saying otherwise for this. #ASPchat |
| Brad Langford @BRxAD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD Have worked on some resources to support shorter courses of antibiotic therapy in long-term care: Cystitis https://t.co/txShxamgc8 Pneumonia https://t.co/9NjXlL47Ae Cellulitis https://t.co/kORL5l0DVu #ASPchat |
| #ASPchat @ASP_Chat Q5. What do you see as the ππΌ best approach antimicrobial stewardship programs can take (inpatient or outpatient) to promote appropriate selection for duration of therapy? #ASPchat https://t.co/4y03CM0oI6 |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD Have worked on some resources to support shorter courses of antibiotic therapy in long-term care: Cystitis https://t.co/txShxamgc8 Pneumonia https://t.co/9NjXlL47Ae Cellulitis https://t.co/kORL5l0DVu #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @BRxAD @ASP_Chat I think you are justified with that hesitation. I have not seen good data saying otherwise for this. #ASPchat |
| Jamie Kisgen @KisgenUF @DHpharmd @mmPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @ABsteward @khalideljaaly @emilylheil @EMpharmgirl @SICUPharmD @JGPharmD Maybe @JGPharmD and his resident can do an annual update similar to the significant publications in ID pharmacotherapy. #ASPchat https://t.co/4M1jZxRGyV |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_Chat: Q5. What do you see as the ππΌ best approach antimicrobial stewardship programs can take (inpatient or outpatient) to promote appropriate selection for duration of therapy? #ASPchat https://t.co/4y03CM0oI6 |
 | Jennifer Girotto @jgirotto3 @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Agree CAP is great.low hanging fruit for shortened antibiotic treatments... At least in peds. #ASPchat |
| Antimicrobial SP @SHUHNASP @IDstewardship @ASP_PharmD @iEMPharmD @EMpharmgirl Presentation is everything. I started practicing when I was 24 and you quickly learn how important your dress, tone, and wording is. My secrets: #Glasses #FacialHair #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @SHSUHNASP: @IDstewardship @ASP_PharmD @iEMPharmD @EMpharmgirl Presentation is everything. I started practicing when I was 24 and you quickly learn how important your dress, tone, and wording is. My secrets: #Glasses #FacialHair #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @jgirotto3: @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Agree CAP is great.low hanging fruit for shortened antibiotic treatments... At least in peds. #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @KisgenUF: @DHpharmd @mmPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @ABsteward @khalideljaaly @emilylheil @EMpharmgirl @SICUPharmD @JGPharmD Maybe @JGPharmD and his resident can do an annual update similar to the significant publications in ID pharmacotherapy. #ASPchat https://t.co/4M1jZxRGyV |
| Tony Gerlach @SICUPharmD @ASP_Chat In the icu they need to partner with non id pharmacists and engage others especially surgeons #ASPChat |
| Antimicrobial SP @SHUHNASP RT @BRxAD: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD Have worked on some resources to support shorter courses of antibiotic therapy in long-term care: Cystitis https://t.co/txShxamgc8 Pneumonia https://t.co/9NjXlL47Ae Cellulitis https://t.co/kORL5l0DVu #ASPchat |
| Jamie Kisgen @KisgenUF Thank you for posting these!Always helpful to have targeted resources in this setting. π¨π¦ leading the charge! #ASPchat |
| Krutika Mediwala Hornback @krutu8 @ASP_Chat 1. Agree on institutional guidelines based on updated literature 2. HANDSHAKE STEWARDSHIP 3. Create an app (working on this one) #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @SICUPharmD: @ASP_Chat In the icu they need to partner with non id pharmacists and engage others especially surgeons #ASPChat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @ASP_Chat A5. Best case scenario IMO is provider-specific data delivered to that provider and coupled with education during a neutral moment where steward is non-threatening yet listened to. Issue is this is so labor intensive, but that is an ASP theme of existence. #ASPchat |
| Krutika Mediwala Hornback @krutu8 @SICUPharmD @ASP_Chat @heatherevansmd @Tribidibidy we love our surgeon stewards! #aspchat |
| ChiChi Tamagotchi @MedSchool_30 RT @ASP_Chat: Q5. What do you see as the ππΌ best approach antimicrobial stewardship programs can take (inpatient or outpatient) to promote appropriate selection for duration of therapy? #ASPchat https://t.co/4y03CM0oI6 |
| Jamie Kisgen @KisgenUF RT @krutu8: @ASP_Chat 1. Agree on institutional guidelines based on updated literature 2. HANDSHAKE STEWARDSHIP 3. Create an app (working on this one) #ASPchat |
| Monica Mahoney @mmPharmD #ASPchat ok, gotta go read some Thomas the Tank to the kiddos. Be useful little engines of stewardship, all! |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @ASP_Chat A5. Best case scenario IMO is provider-specific data delivered to that provider and coupled with education during a neutral moment where steward is non-threatening yet listened to. Issue is this is so labor intensive, but that is an ASP theme of existence. #ASPchat |
| Sumit Gandotra PharmD, BCPS @sgandotraPharmD @ASP_Chat Have a deep understanding of the medication, infection, and the patient; Be able to back up claims with studies; know when to pick your battles #ASPchat |
 | Mike Stevens @Dr_Mike_Stevens @SICUPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl Most infectious syndromes in immuncompetent patients have well defined optimal durations of therapy. Agree that the absence of optimal source control changes management (and therapy needs to be tailored to the individual patient). #ASPchat |
 | Carlene Chung @carlene_chung @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD IDSA guidelines & Johns Hopkins Antimicrobial Guide, but more importantly, whether or not the patient is improving clinically (temp, WBC, physical exam, etc.). #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @BRxAD: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD Have worked on some resources to support shorter courses of antibiotic therapy in long-term care: Cystitis https://t.co/txShxamgc8 Pneumonia https://t.co/9NjXlL47Ae Cellulitis https://t.co/kORL5l0DVu #ASPchat |
| Krutika Mediwala Hornback @krutu8 @IDstewardship @ASP_Chat What we need.... #ASPchat https://t.co/usKdDZTOgn |
| Krutika Mediwala Hornback @krutu8 RT @carlene_chung: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD IDSA guidelines & Johns Hopkins Antimicrobial Guide, but more importantly, whether or not the patient is improving clinically (temp, WBC, physical exam, etc.). #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @Dr_Mike_Stevens: @SICUPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl Most infectious syndromes in immuncompetent patients have well defined optimal durations of therapy. Agree that the absence of optimal source control changes management (and therapy needs to be tailored to the individual patient). #ASPchat |
| Brad Langford @BRxAD @ASP_Chat Encouraging duration to be incorporated into clinical order sets is a good start. Some ASPs provide prospective audit and feedback on strategic days of therapy (e.g. 72h) to re-assess duration #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @mmPharmD: #ASPchat ok, gotta go read some Thomas the Tank to the kiddos. Be useful little engines of stewardship, all! |
| Brad Crane @ASP_PharmD Good working relationships with the providers, with both sides (provider and one making the recommendation) listening to each other. There are multiple times I was not aware of all the relevant info that otherwise would have changed my thought process. Continued efforts. #ASPchat |
| Jamie Kisgen @KisgenUF RT @Dr_Mike_Stevens: @SICUPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl Most infectious syndromes in immuncompetent patients have well defined optimal durations of therapy. Agree that the absence of optimal source control changes management (and therapy needs to be tailored to the individual patient). #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: Good working relationships with the providers, with both sides (provider and one making the recommendation) listening to each other. There are multiple times I was not aware of all the relevant info that otherwise would have changed my thought process. Continued efforts. #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD A4. For the more complex cases, I think this is where the team approach really comes in. When a bunch of smart people put their heads together to make a decision, that's when we see the system working correctly. #ASPchat |
| Krutika Mediwala Hornback @krutu8 @ASP_PharmD I also think that sometimes we forget this about our ID providers - they also may need updating so the consult service can provide good ASP representation @ASP_Chat #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @mmPharmD: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @EMpharmgirl @SICUPharmD It WAS this ... but sad (and WONDERFUL) how rapidly outdated this already is. @JGPharmD #ASPchat https://t.co/YnQREa6te4 |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_Chat Encouraging duration to be incorporated into clinical order sets is a good start. Some ASPs provide prospective audit and feedback on strategic days of therapy (e.g. 72h) to re-assess duration #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD A4. For the more complex cases, I think this is where the team approach really comes in. When a bunch of smart people put their heads together to make a decision, that's when we see the system working correctly. #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_PharmD: I usually start with the related society's guidelines and inquire if there is a good reason to deviate from general consensus guidelines (sometimes yes, sometimes no). #ASPchat |
| Mike Stevens @Dr_Mike_Stevens @ASP_Chat Well defined clinical guidelines created w/ input from key stakeholders; we released on a mobile app thatβs been really successful (> 20,000 opens in ~ 18 months). Just released separate peds ABX guide this week!!! @VCUHealth #ASPchat https://t.co/KVuWZRrx3u |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @SICUPharmD: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl I think we often forget 1. Was source control achieved and 2. is patient clinically better 3. Do they look better #ASPChat |
 | Cynthia Nguyen @cynth_ID RT @IDstewardship: @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF This @DASON_duke @tmjones6 image does a nice job of identifying where we can look from 5π7 based one literature... #ASPchat cc: @BradSpellberg https://t.co/W6Cu4TknDx |
| Tony Gerlach @SICUPharmD RT @Dr_Mike_Stevens: @ASP_Chat Well defined clinical guidelines created w/ input from key stakeholders; we released on a mobile app thatβs been really successful (> 20,000 opens in ~ 18 months). Just released separate peds ABX guide this week!!! @VCUHealth #ASPchat https://t.co/KVuWZRrx3u |
| Krutika Mediwala Hornback @krutu8 RT @Dr_Mike_Stevens: @ASP_Chat Well defined clinical guidelines created w/ input from key stakeholders; we released on a mobile app thatβs been really successful (> 20,000 opens in ~ 18 months). Just released separate peds ABX guide this week!!! @VCUHealth #ASPchat https://t.co/KVuWZRrx3u |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @SICUPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl Having "eyes on the patient" is a critical factor to clinical decision making. #ASPchat |
| Brad Langford @BRxAD @ASP_Chat Curious if others have found success with automatic antibiotic stop dates? We have not seen improvement after switching from 7 to 5 days (and now have switched to mandatory duration on all orders) #ASPchat |
 | Mauricio SΓ‘nchez @HectorMSRz RT @BRxAD: @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl @SICUPharmD Have worked on some resources to support shorter courses of antibiotic therapy in long-term care: Cystitis https://t.co/txShxamgc8 Pneumonia https://t.co/9NjXlL47Ae Cellulitis https://t.co/kORL5l0DVu #ASPchat |
| Jamie Kisgen @KisgenUF Such great points. They need to see that you are focusing on the patient, not the number. Is the patient clinically improving? Is the duration based on a lack of knowledge vs an emotional decision vs an objective decision? #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_Chat Curious if others have found success with automatic antibiotic stop dates? We have not seen improvement after switching from 7 to 5 days (and now have switched to mandatory duration on all orders) #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @IDstewardship: @SICUPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl Having "eyes on the patient" is a critical factor to clinical decision making. #ASPchat |
| Tony Gerlach @SICUPharmD RT @IDstewardship: @SICUPharmD @ASP_Chat @adamcifu @accpinfdprn @SIDPharm @KisgenUF @ABsteward @khalideljaaly @emilylheil @mmPharmD @EMpharmgirl Having "eyes on the patient" is a critical factor to clinical decision making. #ASPchat |
| Brad Crane @ASP_PharmD @krutu8 @ASP_Chat Sometimes ID specialists may not be the best stewards but if they are on the case then probably not one of the standard cases where the traditional therapy likely fits; often have some de-escalation inquiries moreso than duration. #ASPchat |
| Brad Langford @BRxAD @ASP_Chat Another study from Ontario showing no change when removing ASO policy #ASPchat https://t.co/oiJoJJJWWv |
| Tony Gerlach @SICUPharmD @BRxAD @ASP_Chat Never tried #aspchat |
 | Ben T @ABXsteward @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Bacteremia 2/2 UTI in relatively healthy patients (ie βuncomplicatedβ)....old dogma of 14 days is a tough habit to break. #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @ABXsteward: @ASP_Chat @BRxAD @accpinfdprn @IPACCanada @IPACPANA @CIDRAP_ASP @SIDPharm @IDSAInfo @APIC @PergamIC @KisgenUF Bacteremia 2/2 UTI in relatively healthy patients (ie βuncomplicatedβ)....old dogma of 14 days is a tough habit to break. #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: @krutu8 @ASP_Chat Sometimes ID specialists may not be the best stewards but if they are on the case then probably not one of the standard cases where the traditional therapy likely fits; often have some de-escalation inquiries moreso than duration. #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @mmPharmD @ASP_PharmD @iEMPharmD @EMpharmgirl Well... I made an indirect reference towards using an algorithm, which led to them making a snarky comment about cookbook medicine, which I did not catch, then they got very mad (not at me at the whole concept). So wasn't a me problem, was a failed discussion problem. #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @KisgenUF: Such great points. They need to see that you are focusing on the patient, not the number. Is the patient clinically improving? Is the duration based on a lack of knowledge vs an emotional decision vs an objective decision? #ASPchat |
| #ASPchat @ASP_Chat Q6. What π€π research questions do you still have with regards to durations of antimicrobial therapy? #ASPchat https://t.co/3lNHoqjdMH |
| Jamie Kisgen @KisgenUF π Love the use of technology!Paper handbooks are from the past. We need to get something that is institution specific and at their fingertips!! ππ #ASPChat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship @krutu8 @ASP_Chat AI someday? #ASPchat https://t.co/AYdvmxgxBC |
| Krutika Mediwala Hornback @krutu8 @ASP_Chat 1. SOT patients 2. Febrile neutropenia - can someone please call ECIL back into the game?!?!? #ASPchat |
| Tony Gerlach @SICUPharmD @ASP_Chat Length for NSTI after source control acheived! #ASPChat |
| Krutika Mediwala Hornback @krutu8 RT @KisgenUF: π Love the use of technology!Paper handbooks are from the past. We need to get something that is institution specific and at their fingertips!! ππ #ASPChat |
| Sumit Gandotra PharmD, BCPS @sgandotraPharmD Apps for antibiotic use will usher in a new era of abx stewardship. Trust the process. #ASPchat |
| Jamie Kisgen @KisgenUF After seeing the success of POET and OVIVA with oral therapy, can we now shorten the total duration of therapy for endocarditis and osteomyelitis??π€ #ASPchat https://t.co/pGt4h9A6op https://t.co/xWwIi4kafH |
| Krutika Mediwala Hornback @krutu8 RT @SICUPharmD: @ASP_Chat Length for NSTI after source control acheived! #ASPChat |
| Krutika Mediwala Hornback @krutu8 RT @sgandotraPharmD: Apps for antibiotic use will usher in a new era of abx stewardship. Trust the process. #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @KisgenUF: After seeing the success of POET and OVIVA with oral therapy, can we now shorten the total duration of therapy for endocarditis and osteomyelitis??π€ #ASPchat https://t.co/pGt4h9A6op https://t.co/xWwIi4kafH |
| Brad Crane @ASP_PharmD As already mentioned a few times in #ASPchat tonight is comparing duration of therapy of different abx classes for different UTI syndromes (safe to use shorter duration for beta-lactams or trim/sulfa as being recommended with FQ's)? |
| Cynthia Nguyen @cynth_ID @ASP_Chat A2. Sometimes it takes a guideline update for late-adopters/ laggards and skeptics (e.g., DOT for Pseudomonas PNA) #ASPChat |
| Ben T @ABXsteward @ASP_Chat Pneumonia w/COPD. Many physicians I encounter are hesitant to de-escalate or d/c abx when patient still w/SOB or high O2 req. #cefepimedoesntfixcrappylungs #ASPchat |
| Brad Langford @BRxAD @ASP_Chat Would be great to see more patient centered duration of therapy studies - esp in outpatients. E.g. if patients are feeling better why are we counseling them to "finish the full course"? https://t.co/kxugXwZ1kw #ASPchat |
| Brad Langford @BRxAD RT @ASP_Chat: Q6. What π€π research questions do you still have with regards to durations of antimicrobial therapy? #ASPchat https://t.co/3lNHoqjdMH |
| Jamie Kisgen @KisgenUF RT @BRxAD: @ASP_Chat Would be great to see more patient centered duration of therapy studies - esp in outpatients. E.g. if patients are feeling better why are we counseling them to "finish the full course"? https://t.co/kxugXwZ1kw #ASPchat |
| Mike Stevens @Dr_Mike_Stevens @KisgenUF Itβs definitely huge to be able to update guidelines in real time and automatically push out that content to all users! And also to be able to track in real time what content is being used (and by which provider groups). Good stuff! #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @BRxAD: @ASP_Chat Would be great to see more patient centered duration of therapy studies - esp in outpatients. E.g. if patients are feeling better why are we counseling them to "finish the full course"? https://t.co/kxugXwZ1kw #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @ABXsteward: @ASP_Chat Pneumonia w/COPD. Many physicians I encounter are hesitant to de-escalate or d/c abx when patient still w/SOB or high O2 req. #cefepimedoesntfixcrappylungs #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @cynth_ID: @ASP_Chat A2. Sometimes it takes a guideline update for late-adopters/ laggards and skeptics (e.g., DOT for Pseudomonas PNA) #ASPChat |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: As already mentioned a few times in #ASPchat tonight is comparing duration of therapy of different abx classes for different UTI syndromes (safe to use shorter duration for beta-lactams or trim/sulfa as being recommended with FQ's)? |
| Krutika Mediwala Hornback @krutu8 RT @Dr_Mike_Stevens: @KisgenUF Itβs definitely huge to be able to update guidelines in real time and automatically push out that content to all users! And also to be able to track in real time what content is being used (and by which provider groups). Good stuff! #ASPchat |
| Brad Crane @ASP_PharmD @ABXsteward @ASP_Chat or "still has ___ colored sputum production"... #ASPchat |
| #ASPchat @ASP_Chat π Thank you for participating in the #ASPchat we hope to see you next month! For some of the regular attendees not here this time, hope to see you next time! We are going to talk about π§ antimicrobial dose optimization! #PKPDchat #Vanco #InfusionTimes https://t.co/8HjZ7g9pe6 |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_PharmD: Good working relationships with the providers, with both sides (provider and one making the recommendation) listening to each other. There are multiple times I was not aware of all the relevant info that otherwise would have changed my thought process. Continued efforts. #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_Chat: π Thank you for participating in the #ASPchat we hope to see you next month! For some of the regular attendees not here this time, hope to see you next time! We are going to talk about π§ antimicrobial dose optimization! #PKPDchat #Vanco #InfusionTimes https://t.co/8HjZ7g9pe6 |
| Krutika Mediwala Hornback @krutu8 RT @ASP_Chat: π Thank you for participating in the #ASPchat we hope to see you next month! For some of the regular attendees not here this time, hope to see you next time! We are going to talk about π§ antimicrobial dose optimization! #PKPDchat #Vanco #InfusionTimes https://t.co/8HjZ7g9pe6 |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @Dr_Mike_Stevens: @KisgenUF Itβs definitely huge to be able to update guidelines in real time and automatically push out that content to all users! And also to be able to track in real time what content is being used (and by which provider groups). Good stuff! #ASPchat |
| Krutika Mediwala Hornback @krutu8 RT @ASP_PharmD: @ABXsteward @ASP_Chat or "still has ___ colored sputum production"... #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @BRxAD: @ASP_Chat Would be great to see more patient centered duration of therapy studies - esp in outpatients. E.g. if patients are feeling better why are we counseling them to "finish the full course"? https://t.co/kxugXwZ1kw #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ABXsteward: @ASP_Chat Pneumonia w/COPD. Many physicians I encounter are hesitant to de-escalate or d/c abx when patient still w/SOB or high O2 req. #cefepimedoesntfixcrappylungs #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @ASP_Chat: Q6. What π€π research questions do you still have with regards to durations of antimicrobial therapy? #ASPchat https://t.co/3lNHoqjdMH |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @KisgenUF: Such great points. They need to see that you are focusing on the patient, not the number. Is the patient clinically improving? Is the duration based on a lack of knowledge vs an emotional decision vs an objective decision? #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @krutu8: @SICUPharmD @ASP_Chat @heatherevansmd @Tribidibidy we love our surgeon stewards! #aspchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @KisgenUF: Thank you for posting these!Always helpful to have targeted resources in this setting. π¨π¦ leading the charge! #ASPchat |
| Mike Stevens @Dr_Mike_Stevens @KisgenUF One thing I donβt see being brought up is the lack of confidence in the specific syndrome diagnosis. I think this lack of confidence often drives antimicrobial decision making; this is where stewards and ID docs can really help #ASPchat |
| Ben T @ABXsteward @Dr_Mike_Stevens @krutu8 @ASP_Chat @AspChat I love this! Perhaps my all-star resident @toe_knee_marie with informatics background can help me out with this one?! π€ #ASPchat |
| Bug Pharmacist π𧫠Tim Gauthier @IDstewardship RT @Dr_Mike_Stevens: @KisgenUF One thing I donβt see being brought up is the lack of confidence in the specific syndrome diagnosis. I think this lack of confidence often drives antimicrobial decision making; this is where stewards and ID docs can really help #ASPchat |
 | Toni Darnell @toe_knee_marie @ABXsteward @Dr_Mike_Stevens @krutu8 @ASP_Chat @AspChat I think this is a great next step! @ABXsteward #ASPchat |
#ASPChat content from Twitter.