Tristan Timbrook
tttimbrook.bsky.social
Tristan Timbrook
@tttimbrook.bsky.social
Barnes Jewish Hospital Infectious Disease & OPAT Pharmacist
PharmD, MPH (Biostatistics), MBA, BCIDP, FIDSA
Exploring diagnostics, bugs, pharmacy, data, and methods
🌆 St. Louis, MO | Views are my own
Reposted by Tristan Timbrook
To learn more about opportunities to improve antibiotic use in adults and kids, please join us on Nov 20 at 12:00 noon CST for an enlightening discussion with Drs @tttimbrook.bsky.social, Chanu Rhee, and Jeffrey S. Gerber. CE is available! www.cidrap.umn.edu/antimicrobia...
October 23, 2025 at 8:32 PM
Reposted by Tristan Timbrook
We have a new paper out in @ofidjournal.bsky.social this week, the 'Methods' paper I have been wanting to write for a while. I am grateful to my collaborators, Kim Claeys and @tttimbrook.bsky.social, for taking this journey in IVD thought leadership with me.
#IDSky
academic.oup.com/ofid/article...
Beyond Accuracy: Methodological Advances for Assessing the Clinical Impact of Infectious Disease Diagnostics
Abstract. Evaluating the clinical impact of in vitro diagnostic tests (IVDs) for infectious diseases is complex given their effectiveness depends on contex
academic.oup.com
October 23, 2025 at 6:41 PM
Reposted by Tristan Timbrook
Please join us on Nov 20 for a webinar on improving antibiotic spectrum choice for adults and kids!

We're happy to be joined by Drs @tttimbrook.bsky.social, Chanu Rhee, and Jeffrey Gerber for a discussion moderated by @cidrap.bsky.social's Dr Marnie Peterson

www.cidrap.umn.edu/antimicrobia...
October 15, 2025 at 2:56 PM
Reposted by Tristan Timbrook
"I'm still in shock. I know that there have been political issues around Harvard in recent weeks, but antibiotic resistance isn't one of them." My conversation with Harvard microbiologist @baym.lol, one of many researchers there who just lost millions in fed. grants. www.wbur.org/news/2025/05...
Antibiotic research at Harvard lab threatened by federal funding cuts
Microbiologist Michael Baym studies antibiotic resistance at Harvard Medical School. He lost millions in federal funding this week.
www.wbur.org
May 16, 2025 at 10:59 PM
Reposted by Tristan Timbrook
#SNAP PSSA silo results #escmidglobal
Should we be using Benzylpenicillin all the time? Looks superior and has less AKI
April 12, 2025 at 2:44 PM
Reposted by Tristan Timbrook
One of our wonderful medical students has categorized what itraconazole side effects look like in a modern cohort.

It turns out, Itraconazole is better tolerated long-term than Fluconazole, based on earlier work.

Side effects associated with itraconazole therapy academic.oup.com/jac/article-...
Side effects associated with itraconazole therapy
AbstractBackground. Itraconazole is the treatment of choice for many fungal infections, including histoplasmosis. While the tolerability of itraconazole ha
academic.oup.com
February 6, 2025 at 3:39 PM
𝐌𝐚𝐤𝐞 𝐲𝐨𝐮𝐫 𝐜𝐥𝐢𝐧𝐢𝐜𝐚𝐥 𝐩𝐫𝐞𝐝𝐢𝐜𝐭𝐢𝐨𝐧 𝐫𝐞𝐬𝐞𝐚𝐫𝐜𝐡 𝐦𝐚𝐭𝐭𝐞𝐫!

Scoping review on rpredictor and outcome variables for 𝐦𝐨𝐫𝐭𝐚𝐥𝐢𝐭𝐲 𝐦𝐨𝐝𝐞𝐥𝐬 𝐫𝐞𝐟𝐥𝐞𝐜𝐭𝐢𝐧𝐠 𝐭𝐢𝐦𝐢𝐧𝐠 𝐚𝐧𝐝 𝐦𝐞𝐭𝐡𝐨𝐝𝐬 𝐨𝐟 𝐦𝐞𝐚𝐬𝐮𝐫𝐞𝐦𝐞𝐧𝐭 𝐰𝐞𝐫𝐞𝐧'𝐭 𝐫𝐞𝐩𝐨𝐫𝐭𝐞𝐝 𝐢𝐧 𝐚𝐬 𝐡𝐢𝐠𝐡 𝐚𝐬 68% 𝐨𝐟 𝐭𝐡𝐞 𝐭𝐢𝐦𝐞. Critical for external validations and use.
www.sciencedirect.com/science/arti...
January 30, 2025 at 12:46 PM
Reposted by Tristan Timbrook
Nice review of an antibiotic -- pivmecillinam -- that's been available in other countries for many years, and soon *should* be available here.

Anyone have any experience with it? What's holding up availability? #IDSky

doi.org/10.1093/cid/...
Safety and Tolerability of Pivmecillinam During More Than Four Decades of Clinical Experience: A Systematic Review
Pivmecillinam has recently been approved for treatment of uncomplicated urinary tract infection in the United States. This systematic review of 110 studies
doi.org
January 28, 2025 at 10:37 AM
"Reasons for choosing rezafungin over daily echinocandins were...cost effectiveness compared with the cost of daily caspofungin administration by the OPAT nurses." 💡https://academic.oup.com/jacamr/article/7/Supplement_1/dlae217.004/7976576
O04 Use of the novel antifungal rezafungin in outpatient parenteral antibiotic therapy: early experience from a single centre
AbstractBackground. Rezafungin is a novel long-acting echinocandin antifungal drug with weekly dosing, which was licensed for treatment of invasive candidi
academic.oup.com
January 26, 2025 at 8:06 PM
Excellent read from Debra Goff on her impactful, long, and continuing career in antimicrobial stewardship as well as examining the challenges in this profession towards it's sustainability

www.cambridge.org/core/journal...
Who will steer the antibiotic stewardSHIP ship when I am 80? | Antimicrobial Stewardship & Healthcare Epidemiology | Cambridge Core
Who will steer the antibiotic stewardSHIP ship when I am 80? - Volume 5 Issue 1
www.cambridge.org
January 23, 2025 at 11:29 AM
Hernan et al expand on why the proportional hazards assumption is both implausible and unnecessary in most medical studies, particularly in RCTs. They conclude that using survival analysis methods that do not rely on PH is typically the preferred course of action

academic.oup.com/aje/advance-...
Invited Commentary: Why use methods that require proportional hazards?
Abstract. We recently questioned the utility of testing for proportional hazards in survival analysis. Here we expand on why the proportional hazards assum
academic.oup.com
January 15, 2025 at 11:53 AM
Kudos to Lanford, Daneman, and colleagues on the use of modern epi approaches (e.g. IV analysis) for such practical and timely questions 👏👏👏
January 15, 2025 at 11:42 AM
Reposted by Tristan Timbrook
how would you treat and ICD infection with lead and valvular vegetation that grew Staph aureus mecA gene positive per Biofire but Oxacillin susceptible per routine blood culture? Would you treat as MSSA with cefazolin or as MRSA with Vanco or Dapto ?
January 9, 2025 at 1:59 AM
Reposted by Tristan Timbrook
#AMR is a risk to antibiotic failure & death, but if this happens, do we record it on death certificates? Our centre data = NO!

👉In 1 year, 4% of deaths were AMR-attributed & NONE were recorded on death certificates!👈

Need to quantify this better to increase awareness! #IDSky @jac-amr.bsky.social
Antimicrobial resistance–attributable mortality: a patient-level analysis
AbstractBackground. The impact of antimicrobial resistance (AMR) on death at the patient level is challenging to estimate. We aimed to characterize AMR-att
academic.oup.com
January 8, 2025 at 3:22 PM
Reposted by Tristan Timbrook
Antimicrobial resistance (AMR) is a major threat to human health.

Bur it's GROSSLY under reported

This study showed 4% of ALL deaths at a major London hospital were actually caused AMR but NONE were on the death certificate as cause of death.
#AMR is a risk to antibiotic failure & death, but if this happens, do we record it on death certificates? Our centre data = NO!

👉In 1 year, 4% of deaths were AMR-attributed & NONE were recorded on death certificates!👈

Need to quantify this better to increase awareness! #IDSky @jac-amr.bsky.social
Antimicrobial resistance–attributable mortality: a patient-level analysis
AbstractBackground. The impact of antimicrobial resistance (AMR) on death at the patient level is challenging to estimate. We aimed to characterize AMR-att
academic.oup.com
January 9, 2025 at 8:21 AM
𝐂𝐚𝐧 𝐆𝐞𝐧𝐨𝐭𝐲𝐩𝐢𝐜 𝐀𝐌𝐑 𝐆𝐮𝐢𝐝𝐞 𝐃𝐞-𝐞𝐬𝐜𝐚𝐥𝐚𝐭𝐢𝐨𝐧 𝐢𝐧 GN-BSI? Our meta in CMI (74 studies, 24590 samples) finds mol tests for BSI have 92–99% sens & 99–100% spec for ID. AMR: 91–99% & 99–100%. P𝐞𝐫𝐟𝐨𝐫𝐦𝐚𝐧𝐜𝐞 𝐟𝐨𝐫 𝐀𝐌𝐑 𝐰𝐚𝐬 𝐠𝐞𝐧𝐞𝐫𝐚𝐥𝐥𝐲 𝐜𝐨𝐧𝐬𝐢𝐬𝐭𝐞𝐧𝐭 𝐚𝐜𝐫𝐨𝐬𝐬 𝐫𝐞𝐠𝐢𝐨𝐧𝐬 www.clinicalmicrobiologyandinfection.com/article/S119...
January 3, 2025 at 12:36 PM
Reposted by Tristan Timbrook
UPMC & Pitt are looking for a Medical Director, System Antimicrobial Stewardship! This person will partner with Dr. Graham Snyder, Tina Khadem, & myself to lead 37 US-based hospitals' antimicrobial stewardship and infectious diseases quality efforts. #idsky #medsky

cfopitt.taleo.net/careersectio...
Faculty Professor Associate - Full-Time
Click the link provided to see the complete job description.
cfopitt.taleo.net
December 23, 2024 at 1:06 PM
Reposted by Tristan Timbrook
🚨 ID PharmDs looking to join the BILH family, we've got 2 Stewie positions available at some of our community hospitals: 🚨

Needham
jobs.bilh.org/job/needham/...

MAH
jobs.bilh.org/job/cambridg...
December 18, 2024 at 4:42 PM
Reposted by Tristan Timbrook
I read the first post in this thread about mirror life, thought “they can’t mean…”, and then clicked the link.

Yep, that’s exactly what they mean. Bioengineering reversed-chirality microbes.

Vaughn’s piece is a necessary if frightening read.
I’m proud to join more than 30 colleagues today in sharing our analysis of potential risks from “mirror life”. We summarize our findings in a @science.org article, and in greater detail in a 300pg technical report:

Article: www.science.org/doi/10.1126/...
Report: purl.stanford.edu/cv716pj4036
December 12, 2024 at 7:38 PM
Reposted by Tristan Timbrook
Using climate information may help in empiric antibiotic selection when treating patients with diabetic foot infection.

#IDSky

academic.oup.com/ofid/article...
Correlating Climate Conditions With Pseudomonas aeruginosa Prevalence in Diabetic Foot Infections Within the United States
The prevalence of Pseudomonas aeruginosa varies within different United States climate designations. Further studies are needed to determine a threshold fo
academic.oup.com
December 12, 2024 at 2:59 PM
Good read. Reviews opportunities and importance on combining RVP with host markers, need and potential clinical impact of semiquant of viruses, unmet needs on specific viral etiology detections in commercial assays.

In contrast to Betteridge's law, I think the answer here is yes.
December 12, 2024 at 2:28 PM
Reposted by Tristan Timbrook
👀 New in @AJHPOfficial!

academic.oup.com/ajhp/advance...

“You do not currently have access to this article.” as usual. 🤑 #IDsky
December 12, 2024 at 2:21 AM
Reposted by Tristan Timbrook
Here is a nice pre/post cohort study reporting the Stanford Ortho ID group’s experience implementing routine PO switch. They achieved a 45% increase in discharge on PO abx with no diff in 90d clinical outcomes, shorter LOS, and trend toward fewer IV-related AEs:

pubmed.ncbi.nlm.nih.gov/39660026/
Implementing Oral Antibiotics for Bone and Joint Infections: Lessons Learned and Opportunities for Improvement - PubMed
An institutional guideline was effective in increasing the proportion of patients with bone and joint infections discharged on oral antibiotics. We observed similar clinical outcomes after implementin...
pubmed.ncbi.nlm.nih.gov
December 11, 2024 at 3:01 PM
Reposted by Tristan Timbrook
🆕✨Systematic literature review and meta-analysis @cmijournal.bsky.social
Performance of molecular tests for diagnosis of bloodstream infections in the clinical setting
With 🌟s @tttimbrook.bsky.social #idsky #medsky #microsky #EMIMCC
www.clinicalmicrobiologyandinfection.com/article/S119...
DEFINE_ME
www.clinicalmicrobiologyandinfection.com
December 11, 2024 at 8:10 AM
Reposted by Tristan Timbrook
A powerful piece by @melodyschreiber.com. My heart goes out to you.

This line broke me: "Then I cried, because that was not a thought that should ever enter a parent’s mind at a time like this – can we afford to save him? – and yet it did."

www.theguardian.com/commentisfre...
My daughter could have died. I blame US insurance companies | Melody Schreiber
I asked my doctor for a shot to protect my premature daughter against RSV. Then we realized we didn’t qualify for insurance
www.theguardian.com
December 10, 2024 at 11:23 AM