David Butler

@Xinergistic @PrecisionAbxLab It’s so weird how Tobra is just “the little drug who could” in the biofilm. Consistent killing little by little. I guess I’m #TeamTobra

PK/PD of inhaled abx is wildly different than IV abx for Pseudomonas VABP. Who knew? 🙋🏻‍♀️   We used a biofilm air-liquid interface model to simulate PK/PD of tobramycin vs polymyxin B! rdcu.be/dAR1L @PrecisionAbxLab #IDTwitter #IDXposts #SIDPharm #accpidfnprn #idsa

Great data with inhaled PK/PD model. Turns out tobra works pretty well. Congrats to Xing and Zack!

@sarubactam @ThoPham27 @SIDPharm If the MIC is that low, you’re basically guaranteeing no relevant AMEs. There will be a handful of cases when gent is more active than tobra. This is like PCN for Staph. I mean, yes, sometimes, technically. But, straight PCN is inconvenient and ⬆️CNS tox

@ThoPham27 @SIDPharm Hold on, CLSI removed gent for PsA, USCAST has it on!?

A nice summary of updated 2023 USCAST breakpoints for aminoglycosides with TDM against Enterobacterales and Pseudomonas by Dr. Bhavnani! #ASMicrobe @SIDPharm #IDTwitter

@mmPharmD @SIDPharm I wanted a full zip I could wear professionally, but compromised to get this and wear it casually on lab days. I guess it is what it is. I’ll reinforce the seams when I have time. Maybe I’ll just make my own full zip from scratch.

@ID_PharmDavid @SIDPharm I LOVE the embroidered crew neck sweatshirt. That is thick and actual sweatshirt material. And the long sleeve t is what it is advertised as. I agree that this hoodie is t shirt material & not the best. Would rec not including this as a potential purchase next time around.

@OncIDPharmd MIC within achievable range *should* be a surrogate of half-decent PK/PD… it’s not, but we usually pretend and teach it is for simplicity.

@HIVPharmD I did a quick search and @navcillin seems available if Navaneeth wants to go for it!

Dr. Narayanan dropping knowledge at IDweek, myth busting! Even though it is preaching to the choir, that choir is learning new Hymns! BTW, pit in my stomach for missing IDweek this year 😭... fomo for real. Also, can we start a petition to get Dr. Nav on Twitter? #idweek2022

@njrhodes_rx Oh, yeah, there’s always more at play. My takeaway is that immunocompetence, nidus, organism, etc., are parts of the puzzle—and usually inform drug choice and treatment much more than calling a drug “bacteriostatic”

@ID_PharmDavid Interesting stuff. Begs the question are all BSI created equal. Likely not, right?

Navaneeth Narayanan (no twitter?) walking us through the fact that words don’t cause outcomes and patients aren’t a Petri dish. Static =/= failure #sidp #IDWeek2022

Dr. Doernberg sharing my soapbox that TMP/SMX can be totally appropriate for ABSSSI and sometimes preferable over other options. @SDoernberg @IDWeek2022 @SIDPharm

@SIDPharm @IDWeek2022

@SIDPharm @IDPharmacometrx @jwagsIDPharmD @blandman19 @stephshealymay @IDWeek2022 @accpinfdprn Like @IDPharmacometrx said, having Bayesian on your phone at the bedside will be a game changer. Will be (emphasis mine). If your hospital won’t do real AUC, you’re probably better off picking something else.

Is #Vancomycin still a First-Line #MRSA Agent? Head over to @IDPharmacometrx and @jwagsIDPharmD's debate moderated by @blandman19 and @stephshealymay to decide if vancomycin is "Still the One!" What side are you on? @IDweek2022 @accpinfdprn #SIDP2022 #IDWeek2022

@IDPharmacometrx @ErinMcCreary @njrhodes_rx @OncIDPharmd @GermHunterMD @MaggieMonogue @a_lepak Suuuucks. Your talk was great, but you sounded miserable.

missed these amazing humans so much! @njrhodes_rx @OncIDPharmd @GermHunterMD @ID_PharmDavid @MaggieMonogue @a_lepak and twitterless Joe

@ErinMcCreary Not great, but about what I expected. The stewardship pharmacists at Albany fight to stop meropenem. Every time I want to get under their skin, I remind them about the incipient tebipenem conversations. This is fuel for the fire. 😂

tebipenem 👀 🤔 #ECCMID2022

@IDstewardship @IDPharmacometrx @SIDPharm @ABsteward Or just making vanco second line for most infections… (“But we have to protect our jobs”)

@IDPharmacometrx @SIDPharm @ABsteward My biggest challenge with this is the energy/resources we all have is finite… Should we be focusing on AUC training and systems and QA?… or focusing on flat out reducing inappropriate vanco use and de-escalations first?… Interested in other 🤔 on this debate. #IDtwitter

It’s good to know that the things we teach students continue to hold true. Gram-stains are good and can help guide appropriate therapy ja.ma/3JvFGAw #MedTwitter #IDtwitter

@Itsalltox In my modest experience, employees are treated as an investment and given leeway. Residents are treated like a used car in an area with strict lemon laws.

Just wondering...if we have to terminate residents if they aren't licensed by the deadline in the standard, does that mean all hospitals now have policies terminating any new hire who isn't licensed (or reciprocated) within that same time period?

Matching to your first choice is so overrated. You’re applying to residency and you’ve got grit. You’ve got moxie (and find alternatives for moxi). Your determination determines your success.

@mwupharmacy @IDPharmacometrx! You need a new headshot to show off your glorious beard.

Kudos! Drs Rhodes & Scheetz for their research in the Int’l Jrnl Antimicrobial Agents, “Impact of early antimicrobial stewardship intervention in patients with positive blood cultures: results from a randomized comparative study: Impact of stewardship on BSI outcomes.” #MWUproud

@njrhodes_rx @wfwrighID @mwupharmacy @SoniaRaoID @IDPharmacometrx I’ll really lay on the praise and tell him it was from you.

@wfwrighID @mwupharmacy @SoniaRaoID @IDPharmacometrx Couldn't have done this study without the Twitterless Nick O'Donnell and many students