Breakpoints

In this third collaboration between SIDP’s Breakpoints and ESCMID’s Communicable podcasts, hosts Erin McCreary and Angela Huttner invite two veteran authors of guidelines and guidances, Pranita Tamma (Philadelphia, USA) and Benedikt Huttner (WHO, Geneva, Switzerland) [1-3]. Together, they deconstruct the complex landscape of developing and implementing guidelines into digestible components: they discuss why different organizations develop guidelines and what need they hope to fulfil, the framework including the GRADE methodology under which guidelines are written, and major barriers in the uptake of guidelines. The conversation also details the distinction between guideline and guidance as well as the art and science behind formulating recommendations or suggestions, with a few anecdotal cases sprinkled in from the panel.

References

1. WHO handbook for guideline development, 2nd Edition, https://www.who.int/publications/i/item/9789241548960

2. The WHO AWaRe (Access, Watch, Reserve) antibiotic book https://www.who.int/publications/i/item/9789240062382

3. IDSA 2024 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections, https://www.idsociety.org/practice-guideline/amr-guidance/

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Drs. Ted Morton and Christine Lockowitz join Dr. Ryan Moenster to discuss all things amoxicillin, particularly in our pediatric patients. Our guests answer common questions, such as, what formulations should be used for certain infectious conditions and/or organisms and how to dose amoxicillin to maximize PK/PD optimization without inducing potential adverse events. It is a must-listen for all!

This episode also qualifies for 1 hour of BCIDP credit! How to Obtain BCIDP Recertification Credit for this Episode: Visit sidp.org/BCIDP for more information.

References:

Bradley JS, Garonzik SM, Forrest A, Bhavnani SM. Pharmacokinetics, pharmacodynamics, and Monte Carlo simulation: selecting the best antimicrobial dose to treat an infection. Pediatr Infect Dis J. 2010 Nov;29(11):1043-6. doi: 10.1097/INF.0b013e3181f42a53. PMID: 20975453.

Craig WA. Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men. Clin Infect Dis. 1998 Jan;26(1):1-10; quiz 11-2. doi: 10.1086/516284. PMID: 9455502.

Hakenbeck R, Grebe T, Zähner D, Stock JB. beta-lactam resistance in Streptococcus pneumoniae: penicillin-binding proteins and non-penicillin-binding proteins. Mol Microbiol. 1999 Aug;33(4):673-8. doi: 10.1046/j.1365-2958.1999.01521.x. PMID: 10447877.

Bax R. Development of a twice daily dosing regimen of amoxicillin/clavulanate. Int J Antimicrob Agents. 2007 Dec;30 Suppl 2:S118-21. doi: 10.1016/j.ijantimicag.2007.09.002. Epub 2007 Nov 5. PMID: 17983732.

Bielicki JA, Stöhr W, Barratt S, Dunn D, Naufal N, Roland D, Sturgeon K, Finn A, Rodriguez-Ruiz JP, Malhotra-Kumar S, Powell C, Faust SN, Alcock AE, Hall D, Robinson G, Hawcutt DB, Lyttle MD, Gibb DM, Sharland M; PERUKI, GAPRUKI, and the CAP-IT Trial Group. Effect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial. JAMA. 2021 Nov 2;326(17):1713-1724. doi: 10.1001/jama.2021.17843. Erratum in: JAMA. 2021 Dec 7;326(21):2208. doi: 10.1001/jama.2021.20219. PMID: 34726708; PMCID: PMC8564579.

We’re starting 2026 off with a BLAST as Dr. Gregory Eschenauer and Dr. George R Thompson make their Breakpoints debut to discuss Blastomyces, Histoplasma, Coccidioides, and Cryptococcus. They join host Erin McCreary in reviewing epidemiology, diagnostics, clinical presentation, and treatment of these fungal infections. You won’t want to miss this episode!

Ring in the end of the year with our Breakpoints hosts and a review of all things IDWeek 2025! Join Drs. Erin McCreary, Julie Ann Justo, Whitney Buckel, and Ryan Moenster as they cover top late breaking abstracts, new stewardship data, practice-changing clinical trials, and much more.

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

Visit our website! https://breakpoints-sidp.org/

As promised, our host Dr, Ryan Moenster is back and breaking down the recently published ATS pneumonia guidelines — what’s pneu, what’s controversial, and what it means for your antimicrobial game! Dr. Whitney Hartlage (@whithartlage11) is back to join the conversation, plus fresh takes from Drs. Sharon Weissman and Sahil Angelo (@angelo_sahil).

References:

Am J Respir Crit Care Med. 2025 Jul 18. doi: 10.1164/rccm.202507-1692ST. Online ahead of print.

IDSA Sepsis Task Force. Infectious Diseases Society of America (IDSA) POSITION STATEMENT: Why IDSA Did Not Endorse the Surviving Sepsis Campaign Guidelines. Clin Infect Dis. 2018 May 2;66(10):1631-1635. doi: 10.1093/cid/cix997. PMID: 29182749; PMCID: PMC6927848.