ID Themes of 2019

Segment Description: Jason Gallagher, PharmD, FCCP, FIDSA, BCPS, clinical professor at Temple University College of Pharmacy and editor-in-chief of Contagion®, discusses some of the broader themes in ID over the course of 2019.

Interview Transcript (modified slightly for readability):

Gallagher: Two of the broader themes continuing forward in infectious diseases that we saw more data on in 2019, are, as I'd mentioned earlier, changing from IV to PO antibiotics for indications for which we would traditionally treat IV, but also continuing to shorten courses of antibiotics.

And this is one that I've become a very passionate believer in because I think the single biggest impact we can have on every patient isn't so much de-escalating their therapy as it is shortening the overall course. And from an antimicrobial stewardship standpoint, is sometimes an easier intervention to make as well. Because preventing that broad spectrum use or getting someone to narrow it before they see what they're actually dealing with is difficult, and sometimes it's justified that they don't want to do that.

But when you have evidence that says that training for shorter courses is just as effective as the longer ones that's useful. You know, it's kind of ironic that, we don't yet have this evidence, but a lot of these patients that we've been telling “make sure you take all of your antibiotics” and they stopped taking them after they feel better, for a lot of indications, they're probably right when they do that; now I’ll probably get myself in trouble for saying that.

But I think the future may actually be symptom guided therapy, or something more objective than just these random courses that we have come up with because they're convenient football scores.