Mark Downing

Masks, gloves, goggles at home? Please donate ⁦@MarkADowning⁩ ⁦@TorontoIDDoc⁩ ⁦@BogochIsaac⁩ ppetoronto.com

This is a big step. I wonder how IPAC in Toronto and elsewhere will react. @picardonhealth @theresaboyle @HotaSusy @MarkADowning @AlonVaisman @DFisman @ASPphysician @janinemccready @TorontoIDDoc @FralickMike @JonZipursky @LapointeShaw @kieranlquinn

I want to highlight this from the incredible thread by the Italian ICU MD: "the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists." 1/3

THREAD: In Canada to date we have only seen travel-related #COVID19 cases. This will soon change. China's containment attempts gave us time. We cannot squander this by being complacent. The time to increase funding, improve communication and prepare is now. 1/

@janinemccready @jpowi @HotaSusy @Abx_ID_Doc @MarkADowning @carlyweeks @picardonhealth @BogochIsaac @AlonVaisman @DFisman @PHAC_GC @TOPublicHealth @PublicHealthON @CBCHealth @CDCofBC Canada could be perfect country to see whether #COVID19 can be contained at this point. Universal healthcare, many have paid sick leave, all cases to date can be traced to travel, testing has been rapid. Let's not screw this up @ONThealth! Be proactive. @janinemccready @jpowi

Procalcitonin -guided antibiotic duration combined with #antimicrobialstewardship was associated with 27% adjusted decrease in overall antibiotic use in our community hospital ICU @UnityHealthTO doi.org/10.1016/j.jcrc…

A very important analysis for those trying to understand how 2019-nCoV is spreading nejm.org/doi/full/10.10…

Any health care worker staying on the front lines of this #nCoV2019 is a hero, given how easily the virus can spread to doctors and nurses that are performing pulmonary procedures or screening panicked people in ER facilities. Rest in peace, Dr. Liang.

1. HIV PEP-in-Pocket ("PIP"), an HIV prevention strategy for those with a low frequency of high-risk exposures. Here is longer term follow-up of 79 patients using PIP, with ~100 PIP-years of follow-up. No HIV seroconversions. tinyurl.com/tad8ejp #HIVPIP #PrEP @CATIEinfo

Anyone seen these antibiotic characters lurking around? @MGHToronto #AAW2019 #AntibioticAwarenessWeek #AntibioticResistance

The more we use antibiotics unnecessarily, the less effective they become. One of the ways we can fight #AntibioticResistance is to use antibiotics wisely. choosingwiselycanada.org/antibiotics

@TheIDApprentice @BRxAD @ASP_Mark Or Cipro, take it out of your urine culture reports👍

Manipulating your susceptibility reports can be one of the most effective and simple ASP strategies. Try it out - if your enterobacteriaceae are CRO susceptible, hide the ertapenem results and watch your erta DOT ⬇️. @BRxAD @ASP_Mark @MarkADowning 👏 cambridge.org/core/journals/…

🆕How can we nudge clinicians to choose more appropriate #antibiotic therapy? Our scoping review just published in @ICHEJournal maps the literature on nudging strategies in microbiology reports. Read the full text here: cambridge.org/core/journals/… #VisualAbstract

One of the most clever Halloween yard displays I've seen in Toronto is also a great public service announcement, pumpkins and carrots make up measles virus with a "Vaccinate your Kids" headstone underneath in the City's East End. #halloween2019

Inter-disciplinary, rounds-based prospective audit and feedback is associated with lower antibiotic use in general medicine. 🆕 Our latest paper in @ICHEJournal cambridge.org/core/journals/… #visualabstract #antimicrobialstewardship

There appears to be an autochthonous, mosquito-transmitted case of Zika virus in southern France. This would have been acquired in August when southern France has the appropriate climate and competent mosquito vectors. ecdc.europa.eu/en/publication…

Our latest publication in @JAMMI_Journal: a pilot study of a province-wide #antibiotic use tracking and reporting system #VisualAbstract jammi.utpjournals.press/doi/abs/10.313…

Procalcitonin monitoring in a community ICU was associated with a non-significant decrease in antibiotic use and wide variability in inter-prescriber protocol adherence #IDWeek2019 cdmcd.co/wZpJxk (poster #1995)

With a map like this, it seems like it is time to say goodbye to the Z-pack everywhere in the U.S. for CAP.

@DrKevinSchwartz @TorontoIDDoc @stjoestoronto Will be interesting to compare the two studies. Different populations (more stable in this study I think), different bugs (some gram positives, polymicrobial in BALANCE) and different endpoints (composite vs mortality).

@TorontoIDDoc @stjoestoronto is involved in #BALANCE for ICU and ward patients. BALANCE includes all non-staph aureus bacteremias and using a NI margin of 4%, enrolling over 3000 patients

Love it. Curious, anyone else’s centre on #IDTwitter involved in the BALANCE study? Treating ANY non-Staph aureus bacteremia with 7 vs 14d abx.