Jackson Stewart

@ABsteward @JAMAInternalMed What was it Nick Fury said? "it's getting damn near past time for you to get with that program" Useless test.

🆕💫 Viewpoint @JAMAInternalMed Nitrites for Urinary Tract Infection—Time to Say Goodbye? Cc @BradSpellberg #idxposts jamanetwork.com/journals/jamai…

@IDdocAdi Copy that

Today is an important day. What you do today matters greatly in the long run. So if you have not done it already then go out there, exercise your civic duty and discontinue the unneeded vancomycin.

A great resource for evaluation and management of drug allergies authored by many of our fellows and faculty #drugallergy @USdrugallergy pubmed.ncbi.nlm.nih.gov/33039007/

@TrubianoJason @ascia_news @ASIDANZ @id_austin @UniMelbMDHS @CAAR_Aus Consider a pharm colleague for a fellowship who has completed PGY-2 ID pharmacotherapy training and who must regularly assist in managing pts with complex allergy histories? 🤔

Last chance to come work with us! 💕#drugallergy #penicillinallergyheaven @ascia_news @ASIDANZ @id_austin @UniMelbMDHS @CAAR_Aus #IDTwitter #MedTwitter

1/ While we're all doom-scrolling through Twitter, I thought I could help provide some distraction for #medtwitter, #dermtwitter & #medstudenttwitter. A #Derm101 #tweetorial on the #dermatology exam: REACTION PATTERNS! AKA: "How a dermatologist approaches a rash!" pc:@AADskin

A 67-year-old man presented with a diffuse bullous eruption while receiving treatment with vancomycin. Direct immunofluorescence revealed linear deposition of IgA along the basement membrane zone, a finding consistent with linear IgA bullous dermatosis.

Currently, we cannot appropriately document vancomycin infusion reactions in the #EHR and the historic terminology "red man syndrome" is problematic. Is your hospital ready to rename this infusion reaction and add a coded reaction for "infusion reaction"?

@AlysaMartinRX Yes. Offer to help as any trained healthcare provider in an emergency. Explain your training, and if another provider appears and wants to take over, cross that bridge! Don’t be nervous to stand up! 💪🏼🩺

Do I stand up and just say “I’m a pharmacist!” Because I’d imagine the response would be “Thanks lady, we don’t need any pills to be counted right now the man is dying”

One of my biggest fears in life is being on a plane with a medical emergency where they yell “is anyone here a doctor?!” I am BLS/ACLS trained, carry narcan & could *possibly* help but imagine trying to explain that you are a pharmacist. I honestly don’t even know what to say

@miramaximos @khalideljaaly Agree. Concept of "therapeutic exposure" implies dichotomous "clinical failure" below this "target". Too many confounders to count. Hypothesis generating at best. Depends on the infection and organism as always!

This 🇦🇺 PK study suggests ceftriaxone 1 g q24h is unlikely to achieve a therapeutic exposure in > 90% of septic ED patients, & recommend Increasing dose to 2 g q24h #IDTwitter Thoughts? 🧐 link.springer.com/article/10.100…

@Cortes_Penfield @WuidQ I think the "erroneous hypothesis-based medicine" concept can be pervasive in RE: to clinical PK/PD and drug penetration. Even the daptomycin pulmonary surfactant inhibition seems to be dogmatic and not necessarily backed by clinical failure data. Conflicting in-vitro data...

@WuidQ I was taught to give ampho deoxycholate because enlchinocandins don’t concentrate in the urine, but recent data suggests this is erroneous hypothesis-based medicine: pubmed.ncbi.nlm.nih.gov/27587066/

67/M w/ poor control DM, BPH, +10 d dysuria. T38.1, BP 120/80, +tender R CVA. WBC 14. U/A: 21 WBC, UCx: (-)bacteria, +Candida glabrata (fluc-R) x 2 samples. BCx(-), CT: +prostate hypertrophy. Has had no response to ceftriaxone. Has no Foley cath. Which of the ff is indicated?

@RazonableMD @k_vaishnani @MayoClinicINFD @cristinacorsini Fentanyl. Fentanyl, tramadol (+tapentadol), and meperidine all have serotonin reuptake inhibition or agonism!

@k_vaishnani @MayoClinicINFD @cristinacorsini What could be the likely interaction, based on what is provided in the stem? :-)

#ScholarlySunday Case by @cristinacorsini 63F. AML s/p BMT. Chronic back pain Rx transdermal patch. Cellulitis. Blood Cx: MRSA Rx: Dapto —> linezolid. 5d later: fever, sweats, tremors, abd pain, N/V/diarrhea. BP 130/85 P113. Cellulitis improving What is the cause? #MayoIDQ

As part of the CSHP Webinar Series, both @canuckIDpharm & @jacksonjstew presented on the ongoing #Vancomycin topic over the past few months. Check out their latest work.

The #Vancomycin AUC debate continues...Check out our letter with @jacksonjstew & twitterless Bruce Dalton sciencedirect.com/science/articl…

@dfrieds89 @GermHunterMD @CDCMMWR Not old enough for that one! 🦠🤷🏻‍♂️

@GermHunterMD @CDCMMWR Anyone else get vivid flashbacks of getting slimed on the pivotal 1990’s YTV game show Uh-Oh!?

🔥🔥New @CADTH_ACMTS critical appraisal of the 2020 #Vancomycin guidelines 👇👇 cadth.ca/sites/default/…

@jennnacion Congrats! From Canadian UBC chapter

Found out today I’m getting inducted into Rho Chi! 😍

@NKalveRx The clinical pharmacist role really shines when we are PROactive. It takes practice, but begin to think: what’s the NEXT step? How will this medical problem be managed today, tomorrow, in a week? You’ll find you’ll recognize more opportunities to be helpful.

Really excited to be starting my General Medicine rotation tomorrow ! I love rounding with a team 😍 Team work makes the dream work, am I right?? #TwitteRx, any advice on working up patients or anything about this rotation in general?

Thank you to all the infectious disease specialists out there

@BBookstaver_USC Hoping for an RDJ/Jude Law Sherlock Holmes 3!

Saturday movie list has slowly dried up since not much coming out. In that spirit... What series do you wish woukd make one more movie? (Could be one already with sequel or maybe one that never made a sequel.)