Breakpoints

In this must-listen episode, Dr. Ryan Moenster is joined by Dr. Monica Mahoney and Dr. Mark Gilchrist to dive deep into the evolving landscape of outpatient parenteral antimicrobial therapy (OPAT) and complex outpatient antimicrobial therapy (CoPAT), highlighting real-world challenges, patient selection, and emerging treatment strategies. Navigating outpatient antimicrobial management can be complex, but this episode breaks down key insights and practical applications to help clinicians optimize care beyond the hospital.

References:

1.       Noble AL, Patel S, Birnie E, et al. 2026 updated good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults and children in the UK. JAC Antimicrob Resist. 2026;8(2).

2.       British Society for Antimicrobial Chemotherapy (BSAC). OPAT Global Summit 2027.

3.       Naicker S, Roberts JA, Cheng V, et al. A review of antimicrobial stability testing guidance for outpatient parenteral antimicrobial therapy programmes: Is it time for global harmonization of testing frameworks? JAC Antimicrob Resist. 2024;6(6).

4.       Gilchrist M, Jamieson C, Drummond F, et al. Assessment of ceftolozane/tazobactam degradation profile and toxicity data in elastomeric devices for continuous infusion via outpatient parenteral antimicrobial therapy (OPAT). JAC Antimicrob Resist. 2023;5(2).

5.       Naicker S, Roberts JA, Won H, et al. Evaluation of the stability of ceftazidime/avibactam in elastomeric infusion devices used for outpatient parenteral antimicrobial therapy utilizing a national stability protocol framework. JAC Antimicrob Resist. 2024;6(2).

6.       Wolie ZT, Unwin S, Burke A, et al. Evaluation of the stability of tigecycline in elastomeric infusion devices used for outpatient parenteral antimicrobial therapy. JAC Antimicrob Resist. 2025;7(3).

7.       Solomon DA, Beieler AM, Levy S, et al. Perspectives on the use of outpatient parenteral antibiotic therapy for people who inject drugs: Results from an online survey of infectious diseases clinicians. Open Forum Infect Dis. 2023;10(7):ofad372. doi:10.1093/ofid/ofad372.

8.       Yagnik KJ, Brown LS, Saad HA, et al. Implementation of IV push antibiotics for outpatients during a national fluid shortage following Hurricane Maria. Open Forum Infect Dis. 2022;9(5):ofac117. doi:10.1093/ofid/ofac117.

9.       Boettcher SR, Kenney RM, Everson NA, et al. Discharge delays and costs associated with outpatient parenteral antimicrobial therapy for multidrug-resistant organisms: A retrospective cohort study. Open Forum Infect Dis. 2025;13(1):ofaf770.

10.   Rivera CG, Mara KC, Mahoney MV, Ryan KL. Survey of pharmacists on their roles and perceptions of outpatient parenteral antimicrobial therapy in the United States. Antimicrob Steward Healthc Epidemiol. 2022;2(1):e69.

11.   Rapoport AB, Fischer LS, Santibanez S, et al. Infectious diseases physicians’ perspectives regarding injection drug use and related infections—United States, 2017. Open Forum Infect Dis. 2018;5(7):ofy132. doi:10.1093/ofid/ofy132.

12.   Turner NA, Hamasaki T, Doernberg SB, et al.; Antibacterial Resistance Leadership Group. Dalbavancin for treatment of Staphylococcus aureus bacteremia: The DOTS randomized clinical trial. JAMA. 2025;334(10):866–877. doi:10.1001/jama.2025.12543.

13.   Volk CF, Hutson PR, Rose WE. Simulated target attainment of multidose regimens of dalbavancin for prolonged durations of therapy. Open Forum Infect Dis. 2024;11(6):ofae315. doi:10.1093/ofid/ofae315.

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About

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SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

In this must-listen episode, Dr. Ryan Moenster and Dr. Megan Klatt dive deep into the latest infectious diseases trials, guidelines, and novel therapeutics. Staying current in the field is a challenge, but this podcast episode does the legwork for you.

Note: BCIDP credit is available for this episode.

Google Drive to Slides from Live Session: [https://drive.google.com/file/d/11uHzZoValckfsjUTIdVyAJ35QDSVRfQu/view?usp=sharing](https://drive.google.com/file/d/11uHzZoValckfsjUTIdVyAJ35QDSVRfQu/view?usp=sharing "https://drive.google.com/file/d/11uHzZoValckfsjUTIdVyAJ35QDSVRfQu/view?usp=sharing")

How to Obtain BCIDP Recertification Credit for this Episode: Visit https://sidp.org/BCIDPhttps://sidp.org/BCIDPSIDP - BCIDP Recertification for more information

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

Group A Streptococcal infections remain a global challenge, spanning common conditions like pharyngitis to severe invasive disease. Dr. Shiranee Sriskandan, Dr. Josh Osowicki, and Dr. Tom Parks join host Dr. Erin McCreary to explore the evolving landscape of Group A Strep. From unpacking vaccine development challenges and the ongoing burden of rheumatic fever, to rethinking durations of therapy for strep throat and the role of adjunctive treatments, we have you covered! Join us as we break down key controversies, share expert insights, and highlight practical pearls you can apply in your own practice.

References:

1. https://www.lancefieldsociety.org/

2. Osowicki J, Lamagni TL. Invasive Group A Streptococcal Disease in the US. JAMA. 2025;333(17):1493-1494. doi:10.1001/jama.2025.3257

3. Davis K, Abo YN, Steer AC, Osowicki J. Chains of misery: surging invasive group A streptococcal disease. Curr Opin Infect Dis. 2024;37(6):485-493. doi:10.1097/QCO.0000000000001064

4. Osowicki J, Azzopardi KI, Fabri L, et al. A controlled human infection model of Streptococcus pyogenes pharyngitis (CHIVAS-M75): an observational, dose-finding study. Lancet Microbe. 2021;2(7):e291-e299. doi:10.1016/S2666-5247(20)30240-8

5. Hla TK, Osowicki J, Marsh JA, et al. Establishing the lowest penicillin concentration to prevent pharyngitis due to Streptococcus pyogenes using a human challenge model (CHIPS): a randomised, double-blind, placebo-controlled trial. Lancet Microbe. 2025;6(5):101038. doi:10.1016/j.lanmic.2024.101038

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About

Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) or @breakpointspodcast_sidp (https://www.instagram.com/breakpointspodcast_sidp/)https://www.instagram.com/breakpointspodcast_sidp/?hl=en

Facebook: https://www.facebook.com/sidprx

LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

Small hospitals bring unique stewardship challenges, but also unique opportunities. Dr. Tina Khadem and Dr. Ashley Cubillos join host Dr. Whitney Buckel to discuss the realities of antimicrobial stewardship in small and critical access hospitals. From navigating competing priorities and limited resources, to building strong provider relationships in close-knit communities, we have you covered! Join us as we unpack real-world strategies, challenge common perceptions, and highlight the practical pearls you can apply in your own setting.

References:

Implementation of Core Elements at Small and Critical Access Hospitals: https://www.cdc.gov/antibiotic-use/media/pdfs/core-elements-small-critical-508.pdf

Stenehjem E, Hyun DY, Septimus E, Yu KC, Meyer M, Raj D, Srinivasan A. Antibiotic Stewardship in Small Hospitals: Barriers and Potential Solutions. Clin Infect Dis. 2017 Aug 15;65(4):691-696.

Veillette JJ, May SS, Gabrellas AD, Gelman SS, Albritton J, Lyons MD, Stenehjem EA, Webb BJ, Dalto JD, Throneberry SK, Stanfield V, Grisel NA, Vento TJ. A Fully Integrated Infectious Diseases and Antimicrobial Stewardship Telehealth Service Improves Staphylococcus aureus Bacteremia Bundle Adherence and Outcomes in 16 Small Community Hospitals. Open Forum Infect Dis. 2022 Oct 14;9(11):ofac549.

Cubillos AL, Fortier K, Hoang A. P-920. Impact of Positive Blood Culture Antimicrobial Stewardship on Staphylococcus aureus Bloodstream Infection Management across Critical Access, Small, and Medium Community Hospitals. Open Forum Infect Dis. 2026 Jan 11;13(Suppl 1):ofaf695.1126.

Smith LM, Ahern JW. Establishing Antibiotic Stewardship Programs in Rural Hospitals to Decrease Fluoroquinolone Prescribing: The Vermont Experience. Infect Prev Pract. 2021 Jan 21;3(1):100121.

Kassamali-Escobar Z, et al. Antimicrob Steward Healthc Epidemiol 2024. doi: 10.1017/ash.2024.458. Imlay H, Ciarkowski CE, Bryson-Cahn C, et al Infect Control Hosp Epidemiol 2025. 46: 150–155, doi: 10.1017/ice.2024.206

Ciarkowski CE, Imlay HN, Bryson-Cahn C, et al. Infect Control Hosp Epidemiol 2025. 46: 143–149, doi: 10.1017/ice.2024.171

Stenehjem E, et al. JAMA Netw Open. 2023;6(5):e2313011. doi:10.1001/jamanetworkopen.2023.13011

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About

Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) or @breakpointspodcast_sidp (https://www.instagram.com/breakpointspodcast_sidp/)https://www.instagram.com/breakpointspodcast_sidp/?hl=en

Facebook: https://www.facebook.com/sidprx

LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

Professor Mical Paul and Professor Jesús Rodríguez-Baño join Professor Josh Davis and Dr Erin McCreary for a special Breakpoints and Communicable podcast collaboration. This episode discusses the ‘Trials Run’ session at ESCMID Global, where two randomized, clinical trials are presented in great depth. This year, both trials focused on treatment of cephalosporin-resistant Enterobacterales bacteremia. Listen to the authors describe why they performed these trials, results, and implications for clinical practice.

References:

1.      Paul, M., & Rodríguez-Baño, J. (2026, April 20). The trial run: treatment of ESBL bacteraemia[LW1]  - off to never-never land. [Presentation]. ESCMID Global 2026, Munich, Germany. ESCMID Global Virtual Platform.

2.      Bitterman R, Koppel F, Mussini C, et al. Piperacillin-tazobactam versus meropenem for treatment of bloodstream infections caused by third-generation cephalosporin-resistant Enterobacteriaceae: a study protocol for a non-inferiority open-label randomised controlled trial (PeterPen). BMJ Open. 2021;11(2):e040210. Published 2021 Feb 8. doi:10.1136/bmjopen-2020-040210

3.      Marín-Candón A, Rosso-Fernández CM, Bustos de Godoy N, et al. Temocillin versus meropenem for the targeted treatment of bacteraemia due to third-generation cephalosporin-resistant Enterobacterales (ASTARTÉ): protocol for a randomised, pragmatic trial [Internet]. BMJ Open. 2021 Sep 27;11(9):e049481. Available from: bmj.com doi: 10.1136/bmjopen-2021-049481

Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About

Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) or @breakpointspodcast_sidp (https://www.instagram.com/breakpointspodcast_sidp/)https://www.instagram.com/breakpointspodcast_sidp/?hl=en

Facebook: https://www.facebook.com/sidprx

LinkedIn: https://www.linkedin.com/company/sidp/

SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/