This year to help all of our new medical and pharmacy residents become better stewards, I'm going to do a weekly Residency Survival Card! Follow us to get all the cards. There will be a new one every Monday.

Our Summit is a sure thing, but you might get a chance to take another gamble. The Saracen Casino Resort has graciously donated a VIP Dining experience to be drawn as our big booth/door prize on Friday. Must be present to win. and you must visit all of our exhibitor booths.

Register before Feb 20 and be eligible for a special door prize worth $100 to be drawn at the conference (must be present to win)

Hope you're having happy Valentine's day because in ID: We don’t fall fast, we wait for sensitivities to commit We don't ghost you, we always follow up on cultures We de-escalate all our drama and our broad-spectrums We narrow our options as soon as we can - looking for Mr/Ms RIght antibiotic

Nothing says love like a date at the Arkansas Summit for Antimicrobial Stewardship. We'll see you on March 13! www.arstewardship.org/2026schedule

Today's featured speaker is Dr. Lincoln Neal. Most of us learned that "men are always complicated" (when it comes to urinary tract infections). The IDSA shook that up last year with their new UTI guidelines. Men can be uncomplicated too. www.arstewardship.org/2026schedule

Meet Dr. Monica Mahoney (@mmpharmd.bsky.social), an infectious diseases pharmacist practicing in the outpatient ID and OPAT clinics at Beth Israel Deaconess Medical Center. She'll be sharing some of her experience at ARSAS. The full schedule is available now: www.arstewardship.org/2026schedule

Despite us being cold in Arkansas today, there's a real risk from the thawing Arctic permafrost. Permafrost is an archive of ancient bacteria and resistance genes that have been locked away. Thawing can release them, and they can share their genes through horizontal gene transfer. Pretty scary.

I'm going to start featuring some of our speakers. The first one is our keynote Dr. Erin McCreary Have you ever listened to the SIDP Breakpoints podcast? Register for ARSAS (March 13, 2026) to hear @erinmccreary.bsky.social speak about microbiology lab collaborations. tinyurl.com/ARSAS2026

It’s finally here! We’re super excited to open up registration for the Arkansas Summit for Antimicrobial Stewardship. We have a new venue with more space and great facilities! We also have some great topics planned. More information to come in the coming weeks.

Here are my top 10 articles (or interesting topics) for 2025 in ID. There were also new COVID guidelines and some research in treatment that didn’t make the list, and we got a few new UTI drugs (Bluejepa and Orlynvah) and Emblaveo. Fosfomycin IV finally made its way to the USA.

I'm watching one of my favorite holiday movies: The Muppet Christmas Carol. It reminded me that Tiny Tim probably had tuberculosis (TB) & rickets. Everything is TB. Several articles have examined the conditions & common ailments in 1800s London. Here's a good one. jamanetwork.com/journals/jam...

Environmental Factors in Tiny Tim's Near-Fatal Illness

Physicians, Dickens scholars, and historians have tried to diagnose the condition that affected Tiny Tim in A Christmas Carol. Leading entities include tuberculosis (TB), rickets, malnutrition, cerebr...

jamanetwork.com

Blujepa was approved in March of this year. Contepo was approved in November. Orlynvah was approved in October of 2024, but I threw it in here too. I actually have heard of Blujepa being used in practice, but I haven't heard of anyone seeing Orlynvah yet.

Stay safe on your travels next week. It's a bit too late to get vaccines for next week's travels, but it's a good idea to make sure you're up to date. Keeping your hands clean is a very important way to reduce infection risks, especially while traveling. Happy #USAAW and Happy Thanksgiving!

Even our vets and pets can contribute to antimicrobial resistance. We mentioned livestock yesterday, but today is about how pet owners and veterinarians can help prevent antimicrobial resistance.

We often overlook agriculture and farming when thinking about antimicrobial stewardship, but we're exposed to numerous resistant bacteria from these sources. Most of the recent food recalls are due to agricultural runoff and poor manure management.

Yesterday's post was about the people in direct contact with the patient. Today's #USAAW week post is about the backbone of most of our stewardship programs: the clinical micro lab. We're all in this together. We all have a role.

For our first #USAAW week post, let's look at the 5 Ds of Stewardship. This is one place were providers, pharmacist, and other patient care team members can make a big difference. #WereInItTogether

Mastery Monday: This came up this weekend, so I made an infographic about it. It's a pretty common question that pharmacy gets from providers at all levels. Is your patient allergic or not? Most PCN allergies aren't real, but we want to be cautious with any allergy a patient reports.

I don't know about you, but my nightmares are filled with superbugs and NDMs, not Freddy Krueger and Jason Voorhees. That makes March, Friday the 13th the perfect time to come together to fight and prevent these real monsters. Save the date: more details to come.

Sometimes, the sodium content of antibiotics matters. Just last week, there was a CHF patient with pneumonia who wasn’t improving - It turns out that the culprit wasn’t infection severity; it was likely the sodium load from Zosyn (piperacillin–tazobactam). Check out our "fry scale."

It's Wednesday and I forgot to post our Mastery Monday post on here. Oops! Drug fever is relatively uncommon, with estimates varying but often placing it around 3-5% of drug-related adverse effects or 1-3% of fevers of unknown origin. If you see a persistent fever, it could be worth considering.

Mastery Monday: I wouldn't say Tygacil is a first line for VRE, but it's an option (and it can be a good one for polymicrobial intrabdominal infections associated with VRE). Linezolid is an option even if someone is on an SSRI, depending on the patient.

Mastery Monday: Azithromycin is a fun antibiotic to learn about because it's kind of weird. It's also not as effective as it used to be, which is a global concern due to overprescribing because it is cheap and easily accessible. Who hasn't had an unnecessary Z-Pak? I think most of us have.

Mastery Monday: This week it's oral cephalosporins.The main point is that even though your isolate is susceptible to a ceftriaxone, that doesn't mean the drugs will cover it. We usually use cefazolin as a surrogate.PharmSoHard did a really good podcast about cefdinir data and controversies in 2023.

Mastery Monday: Since it's early in the school year for our new students, residents, and fellows, I thought I'd start doing some "Mastery Monday" posts with some simple, easy to digest facts that will help you all grow into good stewards. If you have an idea for a future topic, let me know.

We have Amanda's CAP guideline summary here, though there is a little controversy with this one!

I've summarized the new cUTI IDSA guidelines (they came out on July 17. A new CAP guideline came out then too but there's some IDSA/ATS drama so I was waiting on the official IDSA letter for that one - who knew ID was so spicy?).

Sunday kicks off Shark Week, and it’s also the 50th Anniversary of Jaws this summer! You might wonder what sharks have to do with stewardship. As apex predators, they face many of the same challenges we do. Stewardship is a team sport and affects the whole ecosystem! #SharkWeek #jaws50

Did you know that today's holiday used to be associated with tetanus? The severity of the disease led some to compare the holiday's death toll to that of major battles for independence.