Been at three different centers now with varying practices for antibiotics and ECMO. It's difficult to steward for sure.

100% agree! Then at discharge we restart the clock for an additional 1-2 weeks of prolonged antimicrobials.

🙋‍♂️we have IP submit results. I was not involved in the mapping/ troubleshooting, so probably will not be helpful, but can ask my colleagues that were!

I don't have experience with cefadroxil for UTIs. Though, cefazolin as the surrogate w/ cefadroxil for uUTIs had an accuracy of 91.6%. Just my interpretation is maybe you can get away with TID?

PMID: 883822; PMID: 7073267; PMID: 32659466; PMID: 32349909; PMID: 3501710

Thoughts? #IDSky #PharmSky

Using posaconazole since theoretically less interactions with rifampin. Some case reports with high dose posconazole 600-800 mg daily + rifampin reached posa troughs >1.

Also thought about rifabutin 150 mg + voriconazole 200-300 mg TID based on another case report.

📌

Nice! Our UTI guidance document incorporates a watch and wait approach and a FAQ section with updated EBM to support not treating, but the lack of physician champion from ED and IM may be a reason for low uptake.

The auditing adherence is the hard part that I’m trying to optimize rather than doing manual chart review. My previous Epic had a slicer dicer for outpatient antimicrobial prescribing where I would use it to audit durations of therapy (new Epic hasn’t validated this yet)

Sadly not at my site

We're evaluating a protocol/workflow now. Prelim last line for patients that failed appropriate abx, CI to linezolid, no complicated infection, and would have been an ED obs/brief inpatient. MUE plans 12 months after rollout.

📌