Emily Heil
@emilylheil
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Associate Professor @UMSOP and Infectious Diseases Pharmacist practicing in Baltimore. @UNCPharmacy roots. Big fan of @SIDPharm . On a mission to #saveabx
Joined April 2013
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Watched Don’t Look Up on Netflix with the family. So many parallels to the current world. DiCaprio’s scene about peer review was the chef’s kiss. And the lyrics in Ariana Grande’s song. Whew.
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Campus going remote. Brought my giant HIV to give me something to look at while lecturing. Didn’t realize cameras were already rolling. Lecture recording now opens with me placing Mr. HIV in the front row and patting its head. Students will think I’ve lost it.
#COVID2019
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Thank you
#twitterRx
for the love, and a huge debt of gratitude to Dr. Kottilil for trusting me with this. I don’t think he will ever understand how much this meant to me. For all the
#pharmacists
out there continuing to work their tails off in the pandemic, this one is for you.
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What if we all just agreed to not email each other for the next 10 days?
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Time to put the nail in the coffin on probiotics for the primary prevention of C.difficile infection? I think yes.
Most well done studies have not demonstrated a benefit of probiotics to prevent CDI. (1/n)
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The quintessential conference boxed lunch red delicious apple is the worst apple.
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This is really, really important, particularly after the 2nd dose of the mRNA based vaccines. Efficacy data extremely promising and worth feeling crummy for a few hours- but we can't send HCW in with low-grade fevers, chills in a pandemic. How to handle?
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It’s hereeeee!
FDA Approves Sulbactam-Durlobactam for Bacterial Pneumonia via
@contagionlive
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Ok...I just have to say it. CRO is the official abbreviation for ceftriaxone, not CTX. That's cefotaxime.
Phew, now I feel better.
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Strong work
@DASON_duke
- this antibiotic rank is very helpful to define de-escalation.
#idweek2017
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This
@SIDPharm
merch is not only comfortable, but quite the conversation starter.
What’s an ID Pharmacist? Never heard of that before.
So glad you asked...
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Day 3 of oxymetazoline is the saddest day. The responsible pharmacist in you knows you should stop using it...but the ability it gives you to breathe through your nose again is just so sweet...
#notCOVID
#probsomeothercoronavirusthough
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Genuine question - how is an overtaxed community pharmacist already juggling 1000 things supposed to have the info available to them to ensure a patient qualifies for Paxlovid or molnupiravir? How do we prevent stockpiling of therapies like HCQ circa early 2020?
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Does your lab use Vitek2? Ever wonder how many of your Enterobacterales are truly cefazolin susceptible since Vitek can only report MIC <4?
@MandeeNoval
dug into our freezers and tested nearly 200 isolates to answer this question!
#idtwitter
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.
@ErinMcCreary
presenting on one of my favorite studies of late - every day of unnecessary abx matters. Embrace pharmaceutical inelegance - change regimens as often as needed to minimize unnecessary exposure.
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The
@UMMC
Antimicrobial Stewardship Team started our weekly huddle off with a visit from our favorite dogtor. 10/10 would accept stewie recommendations from this good girl.
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Antibiotic awareness week trivia made sweeter with cookies made by the amazing
@MandeeNoval
and stewardship mascot stickers designed by
@ClaeysKcclaeys
! Do you reaaaally need that antibiotic?
#aaw2021
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Hearing that everything happens for a reason can feel like a gut punch after everything you have invested into this day. Try to frame it as everything happens for an opportunity.
We are here to celebrate victories and develop Plan Bs.
#RxMatch2021
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This new article on antibiotic dosing in CRRT is a much needed update to the older review articles out there. And that comprehensive table that includes the molecular weights and free fractions for so many antibiotics?? Swooning. 🥰
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Don’t even know what day it is so going for bright sides:
1. Escaped the hospital in time to catch signs of spring
2. Commute to the hospital is so fast
3. Theoretical party our ID division is planning when this is over will be epic
4.
@SIDPharm
support as we all navigate is 👍
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Printing your poster on fleece. So functional. Thanks for the life hack
@ClaeysKcclaeys
and
@jordraph
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Stewardship means right drug for the bug, which often includes escalation and expense. Stewardship is not about saving money. Let’s change the narrative. And let’s get these companies paid so we can get new antibiotics.
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Socially distanced picnic to celebrate
@MandeeNoval
... with a SARS-CoV-2 cake. So proud of Mandee and all of our
@umsop
residents!
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Pre-requisite for working on our stewardship team: baking skillz
Thanks to our awesome team for this great surprise today! Best co-workers around!
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If you're not mad, you're not paying attention.
Close your eyes.
Imagine living during the largest global viral pandemic in a century...
(Thread 1/5)
#COVID19
#ICE
#HigherEd
#PharmEd
@AACPharmacy
@pharmacists
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My friend’s mama sent a box of these cookies today and I didn’t know a virus i hated so much could be so adorable
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There’s no “I” in Stewardship!
(ok, well there is but successful antimicrobial stewardship programs are all about the team).
@SIDPharm
@accpinfdprn
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#SIDP2018
great idea from
@julie_justo
: let’s roll CAP, HCAP and HAP all into one pneumonia treatment category and focus on the important risk factors for MDR bugs in guiding empiric treatment.
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Aztreonam plus avibactam or clavulanate restores activity of aztreonam in 80% of steno isolates in vitro, still need more data on the combos in vivo.
Awesome talk from the stenoluvr himself,
@OncIDPharmd
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The data we have been waiting for with the Trojan horse is here...it just may not be the war hero we need.
2 trials of cefiderocol, a new antibiotic.
1) Cefiderocol versus high-dose, extended-infusion meropenem for the treatment of Gram-negative nosocomial pneumonia (APEKS-NP): a randomised, double-blind, phase 3, non-inferiority trial
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This study would not have been possible without the support of
@SIDPharm
. Their annual young investigator research awards help junior researchers like me get projects off the ground!
A new article by
@emilylheil
@jasonroberts_pk
and Dr. Nicolau in
@ASMicrobiology
PK/ PD based antibiotic dosing calculator provides beta-lactam doses with high likelihood of PTA in critically ill patients. Great work.
@SIDPharm
@accpinfdprn
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More ammo for daptaroline, now to just figure out which patients should be prioritized for this cocktail.
Great work
@ErinMcCreary
!!
New in OFID: An exploratory study suggests that combination therapy (daptomycin plus ceftaroline) for
#MRSA
bacteremia may be more beneficial than other treatments if used earlier.
#OpenForumInfectDis
#IDSAJournals
@Warren_E_Rose
@PaulSaxMD
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Happy
@CDCgov
Antibiotic Awareness week - answer some ID trivia questions correctly and receive a sweet treat! Cupcakes made by our excellent PGY2 ID resident
@MandeeNoval
!
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CrCl not a great predictor of Cefepime PK but it’s the primary driver of Cefepime dosing.
@IDPharmacometrx
emphasizes the need for beta-lactam TDM to be used in clinical practice.
@IDPLab
and
@jasonroberts_pk
have made it happen, now for the rest of the world!
#IDWeek2019
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Welcome to
@umsop
's PGY2 ID program where you'll write a review article in the first month of your residency. Congrats
@laurengroft
!
#nonCOVIDpost
#butpleasevotetoday
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@SIDPharm
@jpogue1
@ErinMcCreary
@TheIDApprentice
@julie_justo
@kellidpharm
@IDstewardship
@ABsteward
@IDPharmacist
@JGPharmD
Remember that time
@jpogue1
and
@ErinMcCreary
wrote a review article in like a day in the midst of a global pandemic?
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Adventures in virtual teaching day 180 - forgot to close out other applications on my computer before the lecture (I should know better by now...). Nice awkward reminder to call the plumber pops up at the end.
Welcome to adulting kids!
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Calling all pharmacy students, residents and fellows interested in ID - want to attend
@IDSAInfo
#IDWeek2020
for free?!
@SIDPharm
will be awarding many travel awards this year to cover your registration!
Call for applications for SIDP Trainee Awards! Award recipients will be given free registration to attend the virtual 2020 IDWeek meeting!
Applications are due September 25th!
#IDTwitter
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True story. Vaccine clinic is the happiest place on earth.
The joy of vax: The people giving the shots are seeing hope, and it’s contagious
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Talking about antibiotic stewie with third year pharmacy students at the University of Zambia
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Stewie team holiday gifts thanks to
@MandeeNoval
’s cricut skills and
@ClaeysKcclaeys
for making this the most commonly used gif on our team group text thread.
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Why West Virginia's Push To Vaccinate Against COVID-19 Is Ahead Of Other States : Independent pharmacies.
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I was crushed to have to join the official launch of our guidelines via zoom last year (looking at you covid), but walking the halls of the hospital today and seeing these posters hanging everywhere has sparked so much joy. It’s so good to be back.
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On this football Sunday enjoy "Laces Out Dan!", a discussion on tazobactam containing therapies for ESBL-producing infections post-MERINO trial (see what we did there...).
Fun collaboration with the awesome (and far smarter than me)
@jpogue1
.
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Use of DOOR-MAT as a novel way to capture optimal antimicrobial therapy with rapid diagnostic tests, awesome work
@ClaeysKcclaeys
!
#sidp2020
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Standing 👏
@JulieSzymczak
- must change stewardship from being heavy handed abx police to empowering appropriate prescription
#IDWeek2017
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Man walks into local coffee shop, sits down, removes mask, begins to hack up a lung and make phone calls to pharmacies to find a covid test. This is never going to end is it?
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Congrats
@CLiPharmD
, the ☀️on our cloudy days! We are so proud of you and know you will do big things
@mgh_ast
!
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For Antibiotic Awareness Week this year, Scot is making his cookie debut. Coming your way this week
@UMMC
- if you can answer our antibiotic trivia questions correctly!
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Calling all ID (or oncology, or really anyone who likes an engaging non-fiction book) - this is really really good.
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“Why do you bring students with you when you come? What can they possibly learn from us, we have nothing.”
They learn to see the patient, not the computer screen. To think critically when their toolbox is small. To be grateful.
#globalhealth
#perspective
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Another year, another theme party to brand with our stewie mascot. Congrats
@Dan_MRSA
! We’re so proud of you!
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There is no greater joy than parents getting
#COVID19Vaccine
appointments. Many happy tears today.
...but there is still so much work to be done. Supply issues, systems that favor the health literate, need for access to a computer or have an email address, etc.
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Knowledge gaps are only one of many drivers of antibiotic prescribing; stewards often focus on thinking to generate change but we neglect getting people to feel to create long term change (1/2)
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This this this! How much more can we ask community pharmacists to do until we PAY for their services and make sure they have adequate staffing and support?!
Thank you to
@ASHE_Journal
for the invite to write RE: the role of RPhs in prescribing COVID-19 antivirals.
A 🧵 on some key points:
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Solidarity 👊 to all the on-service faculty with this surge. First day back for virtual classes at the school…5 blue screens of death followed by IT fix 20 min before class starts. 32 pages and 48 emails in the 90 minutes I was teaching.
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When two worlds collide....Antibacterial Activity of Ticagrelor Against Resistant Gram-Positive Bacteria
@ATRIUMRx
@brentnreed
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Never met a jar that i couldn’t open between my trusty Levaquin jar opener and the strength that my fluoroquinolone rage brings me.
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@Bensaur
@CVSHealth
To clarify - I’m talking PBMs trying to get through on PAs disconnecting me. Not the stores, which I know are understaffed and over burdened. Community pharmacists work their tails off and I have max respect for them.
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Doing a student journal club on plazomicin and it reminded me of the Achaogen booth at
#idweek
where plazo saved the lady from the Upside Down
#StrangerThings
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I love the
@JAMA_current
"Piece of my Mind" series so I was thrilled when
@PaulSaxMD
brought "Voices of ID" to
@CIDJournal
. I'm thankful to share this piece and I hope it resonates with the stewards fighting the good fight.
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I met Amy at my first SIDP meeting. I was a wide-eyed new practitioner and she was so kind to me, embodying what makes
@SIDPharm
so special. I am so thankful that I got the opportunity to work with her on the Board and deeply saddened by this loss to our ID pharmacy community.
It is with great sadness we share that Amy Pakyz, PharmD, MS, PhD, & SIDP Board Member at Large ('17-'19) has passed away. She was a wonderful colleague, mentor, & leader in our ID community.
Read about her life & contributions to SIDP & ID epidemiology:
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#ECCMID2022
Late Breakers -
@AchimKaasch
presents the SOBATO study of oral step down therapy for S.aureus BSI for patients with *low risk* infection
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The
@Duke_ASET
team absolutely killing it with these
#AAW
videos.
For today's grand finale, we drew inspiration from Dikembe Mutombo for some new
#antimicrobialstewardship
strategies.
*We can neither confirm nor deny that antimicrobial stewardship will save you 15% on car insurance.*
#USAAW23
#WAAW2023
#WAAW
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Congratulations to
@laurengroft
! We are so proud of you and glad you are staying in the Baltimore ID pharmacy family.
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We often get asked to share our internal vanc AUC guidelines. This inspired me to do one better…with the help of 12 brilliant pharmacists who have also implemented AUC dosing, we present you with the
@SIDPharm
vancomycin AUC toolkit!
Go forth and decrease AKI!
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We ❤️ new antibiotics for treating MDR gram-negatives. Our awesome ID resident
@MandeeNoval
and the rest of the
@UMMC
ID pharmacy team (
@ClaeysKcclaeys
,
@MaryBanoub
) summarized the latest on the newest beta-lactam options here:
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Already one of the most interesting and rewarding things I have ever had the opportunity to do. Learning so much everyday. Thank you
@PaulSaxMD
for bringing the ID PharmDs aboard!
That's the
@CIDJournal
editorial group! Here's a collage suitable for framing.
Cannot imagine putting out this important journal without this massive team effort.
And huge thanks to Dr Chip Schooley for his leadership and guidance during the transition!
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More bad news for those labeled with a "penicillin allergy" - Risk of meticillin resistant Staphylococcus aureus and Clostridium difficile in patients with a documented penicillin allergy: population based matched cohort study
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Today is a good day.
@SIDPharm
Annual Meeting, new CAP guidelines are out, and
@julie_justo
got me a
#stewie
pin!
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Some days I think vancomycin is a mythical unicorn that we are not meant to fully understand. Today is one of those days...
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👇 this.
@jpogue1
@IDPharmProf
@Kerry_LaPlante
have always motivated me to slow down and think during these crazy times, and with all the rapid fire data, it’s crucial to be deliberate in your analysis and subsequent decision making based off these articles. Excellent summary.
Guys. We need to talk about this Hydroxychloroquine + Azithromycin thing. It is out of hand. It all stems from this study that came out today. The study design: Comparative viral eradication on day 6 between HCQ, HCQ + Azithro, and control (not treated) COVID-19 patients.
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Thank you
@MAD_ID_ASP
for setting up my “office” on stage to go over 35+ non-covid things you missed in ID with
@ErinMcCreary
.
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Headed to Boston for
#IDWeek2023
and looking for some (free) dinner plans with a side of learning? CCO has symosia on MDR-GN infections (I'll be talking CRAB!), CMV, HIV and NTM this year! Learn more and register here:
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Few things in life bring me greater joy than modernizing and simplifying ARV regimens for patients in clinic.
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While I love the attention that these types of articles bring to the major crisis in antibiotic R&D, the portrayal of hospital pharmacists blocking access to new abx is misleading (1/2)
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Our ID division chair sent out this fascinating read today:
It's amazing to read and see how many sentiments in this article ring true today.
Also scientific writing in 1919 was much more eloquent.
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We're all really good at eINDs now (thanks COVID), but this is great news to simplify access to a drug that when it's needed, is needed stat:
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I know what I'm listening to on the way home from work today!
@PaulSaxMD
interviews
@IDPharmProf
and share some love for ID pharmacists 🙌
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The crusade continues, fluoroquinolone restriction as an effective stewardship intervention:
New review from
@ClaeysKcclaeys
and the Maryland Stewardship Team
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Celebrating
@ali_blackman
and all she accomplished this year. I know she’ll be in good hands with
@BradeKPharmD
at BMC and do big things!
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Emerging and re-emerging infectious diseases lecture uniform. Great minds think alike
@MK_IDpharm
!
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Maryland has the opportunity to curb antibiotic use in their large poultry industry, will they take it? My 1st OpEd:
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@IDPharmacometrx
@JAMAInternalMed
@JAMANetwork
I was in Pfizer phase 1, had a nice little low grade fever and chills after the second dose. Nothing a little APAP couldn’t manage and would do it 100x over again to end this. But agree setting expectations is key.
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