Breakpoints

Episode Notes Join host Dr. Julie Ann Justo and guests Drs. Nicholas Mercuro and Andrew Haynes for the first installment of a two-part series on IV to PO antibiotic transition. Building on landmark studies such as POET, OVIVA, and SABATO, this episode explores the evidence supporting oral therapy for gram-positive bacterial infections, practical implementation strategies, pharmacokinetic and pharmacodynamic considerations, pediatric perspectives, and areas where clinicians may still have concerns about transitioning from IV to PO therapy. References: 1.       https://sidp.org/SIDPEC, search for on-demand CE course from Drs. Jonathan Ryder & Esther Golnabi entitled, "Breaking Points: Landmark Studies that Shaped Infectious Diseases Pharmacotherapy Part 2: Advancing Oral Therapy" from 9/30/26 2.       SABATO: Kaasch AJ, et al. Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial. Lancet Infect Dis. 2024 May;24(5):523-534. doi: 10.1016/S1473-3099(23)00756-9. PMID: 38244557. 3.       Wilcox MH, et al. Complicated skin and skin-structure infections and catheter-related bloodstream infections: noninferiority of linezolid in a phase 3 study. Clin Infect Dis. 2009 Jan 15;48(2):203-12. doi: 10.1086/595686. PMID: 19072714. 4.       OVIVA: Li HK, et al. Oral versus Intravenous Antibiotics for Bone and Joint Infection. N Engl J Med. 2019 Jan 31;380(5):425-436. doi: 10.1056/NEJMoa1710926. PMID: 30699315. 5.       BALANCE: BALANCE Investigators, Daneman N, et al. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. N Engl J Med. 2025 Mar 13;392(11):1065-1078. doi: 10.1056/NEJMoa2404991. PMID: 39565030. 6.       POvIV: Obremskey WT, et al. Oral vs Intravenous Antibiotics for Fracture-Related Infections: The POvIV Randomized Clinical Trial. JAMA Surg. 2025 Mar 1;160(3):276-284. doi: 10.1001/jamasurg.2024.6439. PMID: 39841468. 7.       DATIPO: Bernard L, et al. Antibiotic Therapy for 6 or 12 Weeks for Prosthetic Joint Infection. N Engl J Med. 2021 May 27;384(21):1991-2001. doi: 10.1056/NEJMoa2020198. PMID: 34042388. 8.       Gariani K, et al. Three Weeks Versus Six Weeks of Antibiotic Therapy for Diabetic Foot Osteomyelitis: A Prospective, Randomized, Noninferiority Pilot Trial. Clin Infect Dis. 2021 Oct 5;73(7):e1539-e1545. doi: 10.1093/cid/ciaa1758. PMID: 33242083. 9.       Tone A, et al. Six-week versus twelve-week antibiotic therapy for nonsurgically treated diabetic foot osteomyelitis: a multicenter open-label controlled randomized study. Diabetes Care. 2015 Feb;38(2):302-7. doi: 10.2337/dc14-1514. Epub 2014 Nov 20. Erratum in: Diabetes Care. 2015 Apr;38(4):735. doi: 10.2337/dc15-er04b. PMID: 25414157. 10.   POET: Iversen K, et al. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. N Engl J Med. 2019 Jan 31;380(5):415-424. doi: 10.1056/NEJMoa1808312. PMID: 30152252. 11.   Heldman AW, et al. Oral antibiotic treatment of right-sided staphylococcal endocarditis in injection drug users: prospective randomized comparison with parenteral therapy. Am J Med. 1996 Jul;101(1):68-76. doi: 10.1016/s0002-9343(96)00070-8. PMID: 8686718. 12.   Bactrim upfront: Paul M, et al. Trimethoprim-sulfamethoxazole versus vancomycin for severe infections caused by meticillin resistant Staphylococcus aureus: randomised controlled trial. BMJ. 2015 May 14;350:h2219. doi: 10.1136/bmj.h2219. PMID: 25977146. 13.   Bactrim upfront: Markowitz N, Quinn EL, Saravolatz LD. Trimethoprim-sulfamethoxazole compared with vancomycin for the treatment of Staphylococcus aureus infection. Ann Intern Med. 1992 Sep 1;117(5):390-8. doi: 10.7326/0003-4819-117-5-390. PMID: 1503330. 14.   El-Dalati S, et al. Partial Oral Versus Intravenous Antibiotic Therapy for Endocarditis With Management by a Multidisciplinary Team: A Retrospective Cohort Study. Open Forum Infect Dis. 2025 Oct 28;12(10):ofaf625. doi: 10.1093/ofid/ofaf625. PMID: 41164785. 15.   IV to PO Algorithms: El-Dalati S, et al. Shared Decision-Making for Partial Oral Antibiotic Treatment of Infective Endocarditis: A Case Series. Open Forum Infect Dis. 2024 Mar 19;11(4):ofae166. doi: 10.1093/ofid/ofae166. PMID: 38585184. 16.   Freling S, et al. Real-World Application of Oral Therapy for Infective Endocarditis: A Multicenter, Retrospective, Cohort Study. Clin Infect Dis. 2023 Sep 11;77(5):672-679. doi: 10.1093/cid/ciad119. PMID: 36881940. 17.   DeSimone DC, et al. Infective Endocarditis: Diagnosis, Antibiotic Therapy, and Management: A Scientific Statement From the American Heart Association. Circulation. 2026 Oct 13;154(15):e593-e619. doi: 10.1161/CIR.0000000000001466. PMID: 42708190. 18.   VanScoy BD, et al. Evaluation of Oral Tebipenem as a Step-Down Therapy following Intravenous Ertapenem against Extended-Spectrum β-Lactamase-Producing Escherichia coli in a Hollow-Fiber In Vitro Infection Model. Antimicrob Agents Chemother. 2023 Mar 16;67(3):e0090822. doi: 10.1128/aac.00908-22. PMID: 36757190. 19.   Bock M, et al. Attainment of Target Antibiotic Levels by Oral Treatment of Left-Sided Infective Endocarditis: A POET Substudy. Clin Infect Dis. 2023 Jul 26;77(2):242-251. doi: 10.1093/cid/ciad168. PMID: 36947131. 20.   USCAST Presentation: Andes D. Oral cephalosporin STIC against S. aureus and E. coli. 2024 Dec. Accessed at https://www.uscast.org/presentations. 21.   Haynes AS, et al. Cephalexin Model-Informed Dosing Recommendations for Severe Infections: A Pooled Pharmacokinetic Analysis From Infancy to Adulthood. Open Forum Infect Dis. 2026 Sep 26;13(10):ofag611. doi: 10.1093/ofid/ofag611. PMID: 42898747. 22.   Woods CR, et al. Clinical Practice Guideline by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America: 2021 Guideline on Diagnosis and Management of Acute Hematogenous Osteomyelitis in Pediatrics. J Pediatric Infect Dis Soc. 2021 Sep 23;10(8):801-844. doi: 10.1093/jpids/piab027. PMID: 34350458. 23.   Hikmat S, et al. Efficacy and tolerability of high-dose cefalexin 45 mg/kg/dose (maximum 1.5 g) three times daily in children with bone and joint infections. J Antimicrob Chemother. 2025 Feb 3;80(2):409-412. doi: 10.1093/jac/dkae423. PMID: 39568056. 24.   Ongoing BEST trial of high-dose oral cephalexin among pediatric patients with bone and joint infections in Australia and New Zealand: BonE and Joint Infections - Simplifying Treatment in Children Trial (BEST). Clinicaltrials.gov. 2026 Oct. NCT04538053. 25.   Breakpoints Episode #61 – Dosing Consult – Linezolid Therapeutic Drug Monitoring. 2022 Aug 22. Accessed at https://breakpoints-sidp.org/61-dosing-consult-linezolid-therapeutic-drug-monitoring/. 26.   Walls G, et al. Patient-reported Perceptions, Experiences, and Preferences Around Intravenous and Oral Antibiotics for the Treatment of Staphylococcus aureus Bacteremia: A Descriptive Qualitative Study. Clin Infect Dis. 2026 Apr 30;82(4):e635-e642. doi: 10.1093/cid/ciaf522. PMID: 40988120. 27.   Nursing time for IV vs. PO: Jenkins A. IV to oral switch: a novel viewpoint. J Antimicrob Chemother. 2023 Oct 3;78(10):2603-2604. doi: 10.1093/jac/dkad239. PMID: 37549305. 28.   Antibiotic Waste Calculator. Accessed at https://ecorxchoice.com. 29.   Juskowich JJ, et al. Using the Comparing Oral versus Parenteral Antimicrobial Therapy (COPAT) Clinical Trial to Influence Institutional Practice Transformation Towards Earlier Transition to Oral Antibiotics. Clin Infect Dis. 2026 Apr 30;82(4):e674-e681. doi: 10.1093/cid/ciaf707. PMID: 41419216. 30.   Hawkins MR, et al. Implementing Oral Antibiotics for Bone and Joint Infections: Lessons Learned and Opportunities for Improvement. Open Forum Infect Dis. 2024 Nov 16;11(12):ofae683. doi: 10.1093/ofid/ofae683. PMID: 39660026. 31.   MaineHealth Oral Switch Guideline: Schulz J, et al. Unlocked PO-tential: Impact of an Oral Switch Guideline for Osteomyelitis. 2026 MAD-ID & SIDP Annual Meeting. 2026 May 14-17, Orlando, FL. For a pdf of the poster, please email Nicholas Mercuro, PharmD at [email protected] 32.   Ongoing VA INTREPID Trial: Investigation of Rifampin to Reduce Pedal Amputations for Osteomyelitis in Diabetics (VA INTREPID). Clinicaltrials.gov. 2026 Apr. NCT03012529. Find out more at https://sidp.pinecast.co

Episode Notes Join host Dr. Whitney Buckel and guests Drs. Priya Nori and Brad Langford as they highlight recent publications from Antimicrobial Stewardship & Healthcare Epidemiology (ASHE). This episode explores antimicrobial stewardship workforce trends, leadership competencies, innovative educational strategies, and environmental sustainability, with practical takeaways to help stewardship professionals strengthen programs and advance patient care References: Breakpoints: The SIDP Podcast. Episode 133: Trash Talk: Earth Day Special on Healthcare Sustainability and Stewardship. Released on April 16, 2026. Available at:Breakpoints website CASCADES website: CASCADES – Creating a Sustainable Canadian Health System in a Climate Crisis Hirsch EB, Mott DA, Gilson AM, Aitken SL, Basalyga V, Bergman SJ, Buckel WR, DeSear KE, Farber M, Gaither CA, Gross AE. A national survey of the infectious diseases and antimicrobial stewardship pharmacist workforce in the United States: work settings, characteristics, employment activities, resources and needs. Antimicrobial Stewardship & Healthcare Epidemiology. 2026 Jan;6(1):e76. Holubar M, Bhowmick T, Buckel WR, Cosgrove SE, Evans C, File Jr TM, Fitzpatrick M, Leung E, Malani AN, Rios A, Preusker J, Nori P. Guidance for the Knowledge and Skills required for Antimicrobial Stewardship Leaders: an update from the Society for Healthcare Epidemiology of America, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Antimicrobial Stewardship & Healthcare Epidemiology. 2026 Jan;6(1):e130.  Jeffres MN, McCann T, Salam ME, Brade KD. Seven days, seven quests: gamification to enhance engagement with antimicrobial stewardship resources during Antibiotic Awareness Week. Antimicrobial Stewardship & Healthcare Epidemiology. 2026 Jan;6(1):e72.  Langford BJ, Baily P, Livorsi DJ, et al. Five steps to high quality antimicrobial stewardship research. Antimicrob Steward Healthc Epidemiol. 2024 May 9;4(1):e82.  Lee PS, Gordon H, Ferguson T, Dinh T, Vu M, Nguyen M, Hsiao C, Fong G. EcoRxChoice.com- an SIDP-funded calculator integrating environmental metrics with antimicrobial stewardship. Antimicrob Steward Healthc Epidemiol. 2026 Jul 6;6(1):e199.  Sustainabil-ID website: Sustainabil-ID The ASHE Podcast. Episode 32: A Survey of the Infectious Diseases and Antimicrobial Stewardship Pharmacist Workforce in the United States. Released on June 25, 2026. Available via Apple Podcasts or Spotify. The ASHE Podcast. Episode 35: Guidance for the Knowledge and Skills required for Antimicrobial Stewardship Leaders. Released August 19, 2026. Available via Apple Podcasts or Spotify. Find out more at https://sidp.pinecast.co

Episode Notes Join host Dr. Ryan Moenster and guests Drs. Kaitlyn Rivard and Ross England as they discuss current strategies for preventing RSV in infants. Topics include maternal vaccination, long-acting monoclonal antibodies, differences between available products, safety considerations, vaccine hesitancy, and practical implementation strategies to help protect infants from severe RSV disease. Don't miss this timely discussion packed with expert insights and practical pearls for clinicians caring for infants and families during RSV season. Funding for this podcast was provided by Sanofi Reference: 1.      Hammitt LL, Dagan R, Yuan Y, et al. Nirsevimab for Prevention of RSV in Healthy Late-Preterm and Term Infants. N Engl J Med. 2022 Mar 3;386(9):837-846. doi: 10.1056/NEJMoa2110275. PMID: 35235726. 2.      Bebia Z, Reyes O, Jeanfreau R, et al. Safety and Immunogenicity of an Investigational Respiratory Syncytial Virus Vaccine (RSVPreF3) in Mothers and Their Infants: A Phase 2 Randomized Trial. J Infect Dis. 2023 Aug 11;228(3):299-310. doi: 10.1093/infdis/jiad024. PMID: 36722147; PMCID: PMC10420396. 3.      Kampmann B, Madhi SA, Munjal I, et al. Bivalent Prefusion F Vaccine in Pregnancy to Prevent RSV Illness in Infants. N Engl J Med. 2023 Apr 20;388(16):1451-1464. doi: 10.1056/NEJMoa2216480. Epub 2023 Apr 5. PMID: 37018474. 4.      Wilkins D, Wählby Hamrén U, Chang Y, et al. RSV Neutralizing Antibodies Following Nirsevimab and Palivizumab Dosing. Pediatrics. 2024 Nov 1;154(5):e2024067174. doi: 10.1542/peds.2024-067174. PMID: 39350745. 5.      Pérez Marc G, et al. Real-world effectiveness of RSVpreF vaccination during pregnancy against RSV-associated lower respiratory tract disease leading to hospitalisation in infants during the 2024 RSV season in Argentina (BERNI study): a multicentre, retrospective, test-negative, case-control study. Lancet Infect Dis. 2025;25:1044-1054. 6.      Simões EAF, et al. Efficacy, safety, and immunogenicity of the MATISSE (Maternal Immunization Study for Safety and Efficacy) maternal respiratory syncytial virus prefusion F protein vaccine trial. Obstet Gynecol. 2025;145:157-167. 7.      Zar HJ, Simões EAF, Madhi SA, et al. Clesrovimab for Prevention of RSV Disease in Healthy Infants. N Engl J Med. 2025 Oct 2;393(13):1292-1303. doi: 10.1056/NEJMoa2502984. Epub 2025 Sep 17. PMID: 40961446. 8.      Zar HJ, Bont LJ, Manzoni P, et al. Clesrovimab in Infants and Children at Increased Risk for Severe RSV Disease. N Engl J Med. 2025 Oct 2;393(13):1343-1345. doi: 10.1056/NEJMc2506107. Epub 2025 Sep 17. PMID: 40961423. 9.      Banooni P, et al. Efficacy, immunogenicity, and safety of an investigational maternal respiratory syncytial virus prefusion F protein-based vaccine. Clin Infect Dis. 2026;82:e146-e155. 10. Jabagi M-J, et al. Nirsevimab vs RSVpreF vaccine for respiratory syncytial virus-related hospitalization in newborns. JAMA. 2026;335:787-798. 11. Moline HL, et al. Effectiveness and impact of maternal RSV immunization and nirsevimab on medically attended RSV in US children. JAMA Pediatr. 2026;180:314-324. 12. Shittu E, Pahud BA, Radley D, Gurtman A, Munjal I. Efficacy and safety outcomes from the MATISSE phase 3 trial of maternal bivalent RSVpreF vaccination among pregnant women vaccinated at 32 to 36 weeks of gestation. Swiss Med Wkly. 2026;156:4711. 13. Committee on Infectious Diseases. Recommendations for the Prevention of RSV Disease in Infants and Children: Policy Statement. Pediatrics. 2026 Sep 2. doi: 10.1542/peds.2026-079047. Epub ahead of print. PMID: 42683691. 14. Valtuille Z, et al. Effectiveness of nirsevimab immunisation after birth versus RSVpreF maternal vaccination in preventing RSV-related hospitalisations in infants: a population-based retrospective cohort study. Lancet Child Adolesc Health. 2026;10:481-490 Find out more at https://sidp.pinecast.co

Does oseltamivir harm critically ill patients with influenza? In this Breakpoints and Communicable collaboration, Erin McCreary and Josh Davis are joined by Steve Webb and Steve Tong to discuss the REMAP-CAP trial results that are challenging a long-standing intensive care practice. Together, they review the study design, key findings, and implications for clinical care, while highlighting the importance of randomized clinical trials in shaping evidence-based medicine. At the time of recording, the REMAP-CAP results were available as a preprint. Resources: · REMAP-CAP: A Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia, https://www.remapcap.org/ References: 1. Murthy S, et al. Oseltamivir for Critically Ill Patients with Influenza: A Randomised Trial. Lancet 2026. Preprint http://dx.doi.org/10.2139/ssrn.7172531 Learn more about the Society of Infectious Diseases Pharmacists: https://protect2.fireeye.com/v1/url?k=4063f96c-1ff8c1be-4063b7ad-867b1e11f55a-4ebd02e8eaa2fcc2\&q=1\&e=caf63b63-0143-4fa9-a81b-8d3031af3116\&u=https%3A%2F%2Fsidp.org%2FAboutSIDP – 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/https://www.linkedin.com/company/sidp/ X: SIDP (@SIDPharm) / X SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member Find out more at https://sidp.pinecast.co

Dr. Prathit Kulkarni, lead author of a recent state-of-the-art review on acute and chronic bacterial prostatitis, joins host Dr. Erin McCreary to discuss this complex disease state. They walk through diagnosis, epidemiology, treatment, and more. You won’t want to miss this episode! References: 1. Kulkarni PA, Cortés-Penfield NW, Brehm TJ, et al. State-of-the-Art Review: Diagnosis and Management of Acute and Chronic Bacterial Prostatitis. Clin Infect Dis. 2026;82(1):1-13. doi:10.1093/cid/ciaf483 Learn more about the Society of Infectious Diseases Pharmacists: SIDP - 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/ X: SIDP (@SIDPharm) / X SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member

Gram-negative resistance is beautifully intricate, scientifically elegant, and very complex. Nothing is more exciting than the recently approved and bursting pipeline of beta-lactamase inhibitors. Listen to Drs. Sam Aitken and Christophe Le Terrier, along with host Dr. Erin McCreary, describe the nuanced enzymology and other antibacterial properties of beta-lactamase inhibitors. This episode also discusses the concepts of stand-alone inhibitors, resistance development, and more. If you want to learn more about sulbactam, clavulanic acid, tazobactam, avibactam, relebactam, vaborbactam, durlobactam, enmetazobactam, zidebactam, nacubactam, ledaborbactam, taniborbactam, and xeruborbactam – this episode is for you! Funding for this podcast was provided by Shionogi Inc. References: 1.      Le Terrier C, Nordmann P, Buchs C, et al. Wide dissemination of Gram-negative bacteria producing the taniborbactam-resistant NDM-9 variant: a One Health concern. J Antimicrob Chemother. 2023;78(9):2382-2384. doi:10.1093/jac/dkad210 2.      Le Terrier C, Nordmann P, Buchs C, Poirel L. Effect of modification of penicillin-binding protein 3 on susceptibility to ceftazidime-avibactam, imipenem-relebactam, meropenem-vaborbactam, aztreonam-avibactam, cefepime-taniborbactam, and cefiderocol of Escherichia coli strains producing broad-spectrum β-lactamases. Antimicrob Agents Chemother. 2024;68(4):e0154823. doi:10.1128/AAC.01548-23 3.      Le Terrier C, Freire S, Viguier C, Findlay J, Nordmann P, Poirel L. Relative inhibitory activities of the broad-spectrum β-lactamase inhibitor xeruborbactam in comparison with taniborbactam against metallo-β-lactamases produced in Escherichia coli and Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2024;68(6):e0157023. doi:10.1128/AAC.01570-23 4.      Le Terrier C, Mlynarcik P, Sadek M, Nordmann P, Poirel L. Relative inhibitory activities of newly developed diazabicyclooctanes, boronic acid derivatives, and penicillin-based sulfone β-lactamase inhibitors against broad-spectrum AmpC β-lactamases. Antimicrob Agents Chemother. 2024;68(11):e0077524. doi:10.1128/AAC.00775-24 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/https://sidp.pinecast.co/

Join Dr.  Whitney Buckel and leading HIV experts Dr. William Short and Dr. Ryan Tomlin for an engaging discussion on the current and future state of HIV care. As treatment and prevention options continue to evolve, clinicians face new opportunities and challenges in translating evidence into practice. This episode examines long-acting therapies, prevention innovations, and key implementation considerations, providing practical guidance and real-world perspectives to help healthcare professionals deliver high-quality, evidence-based HIV care. 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/

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 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/

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/