Brian Hoff

RPD Dr. Lew @AlisonKLew is leading a multi-center study evaluating IV to PO abx stepdown for uncomplicated streptococcal bacteremia. A great opportunity to collaborate with ID PharmDs in Chicagoland to close knowledge gaps! @Sheila_K_Wang @BrianHoff_ @ae_gross @RadhikaIdpharmd

@jc_pharmacist @IDPharmacometrx @LUMCpharmacy

Hi #TwitteRx! We’re joining the #PharmRes community, so follow us for all things @LoyolaHealth pharmacy! For our inaugural post, meet our 2022-2023 PGY1 and PGY2 class!

1/ Excited to share our work that shows reducing antibiotic dosing in early phase septic shock is associated with worse clinical outcomes. pubmed.ncbi.nlm.nih.gov/36154486/ #pharmicu #TwitteRx

Peds/PICU Pharmacist opening in the Chicago area! I’m happy to answer any questions about the hospital or connect you to those who can if your question is position specific. #TwitteRx linkedin.com/jobs/view/3244…

Wonderful collaboration of @mwupce with @NM_IDSteward on this case report and lit review of M. abscessus in CNS; early TDM of abx may help guide abx. H/t @IDPLab for PK. doi.org/10.1093/ofid/o… w/ En-Ling Wu @HeetiOmar @BrianHoff_ @KKruegerMD @jdubbs912 and Phillip Santoiemma

Reminder ☝️ of how much a single dose of antibiotics can impact culture yield. Urine culture positivity decreased from 99% to 35% after one dose of empiric treatment. No (+) culture = no culture directed therapy = often prolonged, overly-broad exposure! pubmed.ncbi.nlm.nih.gov/35289297/

Pharmacists, Residents, students, are you planning a project or writing up a recent study or intervention? Read this article when getting started!

issues w/empirical ABX treatment 1️⃣up to 50% of febrile episodes in ICU aren’t infectious 2️⃣30-80% of pts w/sepsis are culture negative 3️⃣most pts w/community-onset sepsis dont have resistant pathogens yet broad abx are frequently administered #ECCMID2022 pubmed.ncbi.nlm.nih.gov/32297949/

@krutu8 We use an instant messaging type of service for both phone and web. So it isn’t quite as old fashioned as the physical pagers. But you get the idea.

@BrianHoff_ It does! We do everything except the 📟 mode of communication

For those with mandatory ID consults for SAB - what is your workflow? Who is responsible for triggering?

@krutu8 The ID auto consult for SAB & fungemia are two of several interventions we make from this pager. We help guide antimicrobial selection, dosing, duration, labs/diagnostics, etc. We help translate the rapid diagnostic data into therapies (cepheid, bio fire,etc). Hope it helps!

@krutu8 Yes - All positive blood cultures are paged in real time to our pager. We cover first shift and review and intervene M-F. For pages after hours we review them first thing in AM next bus day.Pager always signed into by one of our ID pharmacists, whoever is covering ASP that week.

@AMartinezRocaMD @ABsteward Idk.. might be resource dependent. In my experience OPAT programs are underfunded side gigs within ID clinics without adequate resource allocation. Chasing vital labs that show a day late and dollar short (if at all).

@ABsteward Feasible, safe

How would you describe Outpatient Parenteral Antimicrobial Therapy (OPAT) in two words only? #IDTwitter #medtwitter #TwitteRx #medtwitter #opat

@ABsteward Risky business @JuliaPharm

@IDstewardship Poison Dart Frogs. They metabolize insects from the rainforest to produce poisonous compounds that are secreted on their skin to ward off predators. Their beauty signals their danger. The toxicodynamics are to die for. Plus way cooler than rest of list haha

Most appropriate pet for infectious diseases professionals? #IDtwitter #TwitteRx #MedTwitter

@ErinMcCreary @IdVilchez @watrouny @wfwrighID @DrToddLee @OncIDPharmd @ClancyNeil @mmPharmD @theIDPharmD @JGPharmD Initially, I agree. But I think we use spectrum based on clinically efficacy/utility. Ertapenem still impacts organisms like Pseudomonas despite lack of efficacy. I think we need to do better in stewardship and shift to uncouple spectrum of activity from resistance potential.

@IdVilchez @watrouny @wfwrighID @DrToddLee @OncIDPharmd @ClancyNeil @mmPharmD @theIDPharmD @JGPharmD what am I treating? would argue pip/tazo is broader spectrum than ertapenem…

If the choice is between Zosyn drip or Ertapenem at discharge for more than 2 weeks? Which one is the narrower spectrum or the stewart’s choice? #IDtwitter

🔥🔥Proud of these two for their wonderful SHM Poster FINALIST presentation. Found that antibiotic recommendations made by women pharmacists were less likely to be listened to by hospitalists regardless of MD gender 🤯🤯 #SHMConverge #shm2022

@ValerieVaughnMD @umichmedicine @SIDPharm @UMichPharmacy @TodaysHospital Co-resident sighting! @cyn_hrx

@OncIDPharmd @wfwrighID @JGPharmD @ErinMcCreary @IdVilchez @watrouny @DrToddLee @ClancyNeil @mmPharmD @theIDPharmD Completely agree @OncIDPharmd . To move stewardship practice forward into an evidence-based era we need better data on meaningful impact to the micro biome and, ultimately, predisposition for colonization/infection with pathogenic/drug resistant organisms.