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IV Fluid Shortage Mitigation Actions

To conserve IV fluids during this critical shortage, it is more important than ever to throughly evaluate the need for resistant Gram-positive coverage with IV vancomycin.  For those patients that do need resistant Gram-positive coverage, we have implemented several temporary measures to make alternatives available.  For ADULTS, Linezolid ID restriction has been lifted and daptomycin now require ID telephone approval rather than beside consult.  Please read more here and don't hesitate to SecureChat the group 'ASET Med' / 'ASET Surg' or page 970-6666 with questions.

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Blood Culture Diagnostic Stewardship in DUHS

The BD BACTEC Blood culture bottle global shortage of 2024 has now largely resolved in DUHS. However, thinking carefully about when to use Blood Cultures remains an important focus for Duke clinicians. Review Adult Guidance and Pediatric Guidance on CustomID and linked in Maestro order panels. See Educational Content for teams implementing Blood Culture Stewardship in their areas. Questions about how to access unit-level data on blood culture use -- ask a member of ASET!

BCID2 UPDATE - JULY 2024: Duke Clinical Microbiology Lab Announcement

Beginning July 9, 2024, the micro lab will report additional genotypic markers of antimicrobial resistance in Gram negative rods from the Blood Culture Identification (BCID) molecular panel. Check out the Adult or Pediatric Rapid Diagnostics at DUH (BCID2, Biofire) for treatment pathway recommendations. 

Additionally, the results for each of the 42 organism and resistance targets on the BCID panel will now be automatically reported. Thus, these results will look DIFFERENT!

Reach out to the covering Adult ASET pharmacist (970-6666) or Pediatric ASET pharmacist (206-9309) for any questions!

NEW - June 2023: Staphylococcal Spp. Susceptibility Reporting Updates

See the link below from the Clinical Microbiology Laboratory with updates to current reporting for Staphylococcal spp. These changes are live as of Monday, June 5, 2023.  

As always, don't hesitate to call your friendly ASET pharmacist with any questions (970-6666)!

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Meet the Infectious Diseases/Antimicrobial Stewardship Pharmacist Team!

NEW!!  Chat with an ID PharmD on secure chat (ASET Med, ASET Surgery, or ASET Pediatrics) to help with your anti-infective therapy questions for hospitalized patients with infectious diseases!!

We also have ambulatory pharmacists based in 1K focused on HIV, transitions of care, and outpatient parenteral antimicrobial therapy (OPAT).

See additional ways to contact us at the link below. We look forward to hearing from you!

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Confused by that resistance pattern and when you can use piperacillin-tazobactam?

See the memo link below from the DUHS Clinical Microbiology Laboratory with updates to current reporting for E. coli, Klebsiella pneumoniae, Klebsiella oxytoca, and Proteus mirabilis that will go live 5.31.22.  As always, don't hesitate to call your friendly ASET pharmacist with any questions (970-6666)!

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What's in Your Pocket?

The Duke Antimicrobial Stewardship & Evaluation Team has collected several frequently used clinical references on a single page to serve as a helpful resource.

Have further questions??  Page 970-6666 to chat with an Infectious Diseases Pharmacist!  We're here to help!

 

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What to Choose?? Treatment guidance for the Emergency Department

Decisions about antibiotics in the ED can be hard.  We've made some new ED-specific resources to help!

Have further questions??  Page 970-6666 to chat with an Infectious Diseases Pharmacist!  We're here to help!

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Is Your Patient Penicillin Allergic??

Patients with reported penicillin allergies often have worse clinical outcomes.  Many of these patients are not truly allergic and could recieve optimal therapy with beta lactams. 

ASET is here to help with penicillin skin testing! Click below to learn more about the program and how it can benefit your patient. 

Have further questions??  Page 970-6666 to chat with an Infectious Diseases Pharmacist.  We're here to help!

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What is the BEST duration to effectively treat and minimize unintended consequences of antibiotics??

 View our Targeted Antibiotic Duration document.  We consolidated hundreds of pages of guidelines into 2 pages for easy reference.

Have further questions??  Page 970-6666 to chat with an Infectious Diseases Pharmacist!  We're here to help!

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Welcome to CustomID®

Duke CustomID® is a decision support tool intended to provide clinicians with institution-specific, accessible, easily customizable information about the diagnosis and treatment of infectious diseases.

Duke users with a NetID have full access while online with the Duke Health network. Remote access requires a secure connection via citrix.duke.edu or VPN. Learn more here.

Helpful tip: CustomID® is a web app viewable from most internet browsers, desktop or mobile. Save time by creating a browser bookmark or a shortcut to your desktop/mobile device. For desktop, click the icon on the left side of the address bar and drag to your desktop. For your mobile device, follow phone guidance to add shortcut to your home screen or create a browser bookmark.

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