Helen Ding

Excited to finally share this data from my residency research project! Found low rates of MRSA and PsA as causes of CAP at our institution and identified areas for improvement in diagnostic stewardship/empiric treatment. 📑 Open access article here: pubmed.ncbi.nlm.nih.gov/39012119/

MRSA nares screening can reliably be used for de-escalation of anti-MRSA therapy within 28 days of bacterial culture for all patients, including transplant recipients and patients with neutropenia. ⭐NPV = 95.8% across all anatomical culture sites doi.org/10.1093/ofid/o…

@stacypharmon @Floralquinolone @emilylheil @julie_justo @IDSAInfo @IDstewardship @accpinfdprn @PharmD_Kev @mjparisim @ErinMcCreary @SIDPharm 100% agree with you!

@HelenPharmD @Floralquinolone @emilylheil @julie_justo @IDSAInfo @IDstewardship @accpinfdprn @PharmD_Kev @mjparisim @ErinMcCreary @SIDPharm No, I haven’t seen a steno that didn’t respond to bactrim +/- mino in…….??? This is going to be a rare case unless 1) I see some truly compelling evidence 2) micro testing for cefiderocol speeds up for me 3) I’m no longer getting the yearly abx spend driving rx costs lecture

It's the mooooost, wonderful tiiiiiiime of the yeeeeear! 🎶🦠 Love the "Notable Updates from the 2023 guidance document" section! idsociety.org/practice-guide…

@Floralquinolone @emilylheil @julie_justo @IDSAInfo @IDstewardship @accpinfdprn @PharmD_Kev @mjparisim @ErinMcCreary @SIDPharm Logistical barriers aside, still not sure if these would be my first choice clinically. Critically ill with steno BSI, fine - questionable relevance from a respiratory culture, not sure if we need to be so aggressive upfront 🤷🏻‍♀️

@HelenPharmD @emilylheil @julie_justo @IDSAInfo @IDstewardship @accpinfdprn @PharmD_Kev @mjparisim @ErinMcCreary @SIDPharm Still have major logistical barriers to ceftaz/avi + aztreonam at my health-system. That's a driving reason why my health-system went with cefiderocol over ceftaz/avi + aztreonam. That and availability of susceptibility testing!

Not looking forward to seeing the implications of this 😖

@Floralquinolone @PharmD_Kev @IDstewardship @AFieldPharmD @TinaZhengRx @mjparisim @julie_justo @ErinMcCreary I love this and would be on board!

Honestly, one of my favorite post-residency initiatives is starting a "Lowkey journal club". Everyone is expected to read the article before hand. 90% of the conversation is discussion. 10% is me talking about cool gems I found in the supplement. #IDTwitter #TwitteRx #IDxTweets

Does anyone work at or know of hospitals that use Labcorp or another third party lab for internal microbiology processing? If so, would love to get connected!

@morelli_md 🤮🤮

When your infection preventionist starts as attending on service and these are the new Monday consults 😬😷 #IDTwitter #AMR #help

It’s so good to know all of the hard work has finally paid off 🥹 #BCIDP

@BIDMCPharmRes @mmPharmD @AJWPharm @AndreaSikora @BrighamPharmacy @UMassRxRes @NYUPharmRes I am so jealous 😭

Asking for a friend that is transitioning to #Epic: 💊 Tips for rounding 💊 Workflow optimization 💊 Anything else #TwitteRx-related 🙏🙏🙏 @mmPharmD @AJWPharm @AndreaSikora @BrighamPharmacy @UMassRxRes @NYUPharmRes #PharmICU

@PharmD_intheED I also find myself often asking how many patients have real, symptomatic cystitis requiring treatment. In cases of true infection, I certainly prefer to maximize our chances of successful treatment even if it is based largely on PK data

@PharmD_intheED We did not specifically study this. Just based on PK data like you mentioned & fairly minimal cost increase. Here’s a recent retro eval though of cefdinir vs cephalexin that saw numerically higher treatment failure w/ cefdinir academic.oup.com/ajhp/article-a…

‼️Did you know that susceptibilities for many PO cephalosporins are inferred from cefazolin, not ceftriaxone? May overcall resistance but safest option if unable to test directly. Removed cefdinir from our adult formulary and switched to cefuroxime. Here’s why! #downwithcefdinir

@Zaydovudine @BDubbMD Yes VAN+LZD appears to have the most significant antagonistic activity. This is a pt >150 kg with vanc infusion reaction going to a facility where teflaro can’t be administered. Just poking around at alt options that might be more feasible at dc but seems pretty limited😕

@HelenPharmD @BDubbMD iirc there is antagonistic in vitro stuff for vanc + linezolid too. No idea how clinically significant it is. Haven’t had failures, but typically would just use the one drug.

Has anyone actually experienced treatment failure with dapto combo tx with bacteriostatic agents (e.g., doxy, linezolid) in MRSA BSI c/b lung involvement? There’s some in vitro stuff suggesting an antagonistic effect. How concerned should we really be? #IDtwitter @BDubbMD

Me, minding my own business Enterococcus in a polymicrobial culture with Enterobacterales:

@kristabachert @SIDPharm TID currently but working on standardizing it to BID for most scenarios!

What dosing strategy are you currently utilizing at your facilities for metronidazole? @SIDPharm

@mmPharmD @dosyn_zosyn @Sarah_mch • Guilty as a "UTI” • Who's Afraid of Little Old ESBLs? • I Can Fix Him (No Really I Don't Need an ID Consult) • loml (love of my linezolid) • I Can Do It With Cefazolin • The smallest MIC Who Ever Lived • The Ampho B • Clarithromycin (2/2)

@mmPharmD @dosyn_zosyn @Sarah_mch • (Waiting on Cultures for a) Fortnight • The Tortured Pharmacists Department • My Boy Only Cultures His Favorite UAs • (IV) Drugs Bad • So Long, Levaquin • But Daddy I Love Meropenem • Fresh Out The Zosyn • C. diff! (feat Every Antibiotic Ever) (1/2)

My coworker @dosyn_zosyn received this gem from his student today. This may be the most iconic thing to have happened in ID pharmacy history!!! Which one is your fave? Creds: @sarah_mch

@summerasize @dosyn_zosyn @Sarah_mch Right? She’s so creative 😭

@HelenPharmD @dosyn_zosyn @Sarah_mch Omg 😭😭 too many good ones to pick