Where Are They Now? Q & A with Dr. Sameer Alzaidi

By: Cara Slaton, PharmD, BCIDP

Sameer Alzaidi, PharmD, BCPS, BCIDP, AAHIVP

Training: PGY-2 Infectious Diseases at Intermountain Health in Salt Lake City, Utah

Current position: Infectious Diseases Clinical Pharmacist at Taif Health Cluster,

PGY-1 Pharmacy Residency Program Director, and Clinical Pharmacy Manager at King Abdulaziz Specialist Hospital in Taif Health Cluster, Taif Saudi Arabia

Interests: Immunocompromised infectious diseases, MDROs, and PK/PD

Research presented at the 2023 MAD-ID Annual Meeting - now published in Open Forum Infectious Diseases:

Oral Beta-Lactams, Fluoroquinolones, or Trimethoprim-Sulfamethoxazole for Definitive Treatment of Uncomplicated Escherichia coli or Klebsiella species Bacteremia from a Urinary Source

Dr. Alzaidi and colleagues retrospectively evaluated adults with uncomplicated E. coli and Klebsiella spp. bacteremia who received oral step-down therapy after ≤ 4 days of intravenous antibiotics and compared outcomes between fluoroquinolones (FQs), trimethoprim/sulfamethoxazole (TMP/SMX), or high bioavailability beta-lactams (HBBLs). FQs and TMP/SMX had similar 60-day recurrence and HBBLs were associated with higher recurrence, but suboptimal dosing could have contributed to these findings. 

Questions:

1. What prompted your study group to evaluate the effectiveness of various oral stepdown options for Gram-negative bloodstream infections (GN-BSIs)? Data are conflicting when it comes to the optimal oral step-down therapy for GN-BSIs. Within our health system, we recognized the opportunity to expand upon the current data with our robust database and varying prescribing practices amongst sites within the system.
   

2. How have the results of your study impacted your practice related to oral step-down therapy for treatment of GN-BSIs Great question. As expected, we saw prescribing variability across the Intermountain Health System. This study helped us expand upon our GN-BSIs guidelines, and we currently list agents for GNB in order of data available. The present study has reinforced the need to educate prescribers on preferred HBBL dosing.
   

3. What are some unanswered questions related to your findings that you believe should be further investigated? We still believe HBBLs could be a great option for GN-BSIs due to their favorable safety profile. A robust pharmacokinetic study is needed to determine the optimal dose and target population.

The MAD-ID ‘Where Are They Now?’ series highlights research presented at the MAD-ID Annual Meeting now published in the infectious diseases literature.