Communicating On Antimicrobial Stewardship: Reflections & The Journey Of

December 1st, 2023

Timothy P. Gauthier, Pharm.D., BCPS, BCIDP; Editor-In-Chief and


If you are reading this blog post then you probably know what antimicrobial stewardship is and you know what infectious diseases (ID) is. Given the character limit of social media platforms, these terms can be merged together to form IDstewardship, but hopefully you figured that out already!


IDstewardship started as an Instagram account (@IDstewardship) in 2016 and then grew to having a presence on multiple social media platforms (Twitter/X, Facebook, etc), a multi-faceted website (, a 24/7 antibiotic study resource website (, co-hosting regular Twitter/X chats about ID/stewardship (@ASP_chat), a ~ monthly newsletter, and a workbook of study resources (available on Amazon as Learn Antibiotics, First Edition).


In this article I will discuss some of the areas in which the IDstewardship brand has become engaged, and attempt to provide analytics data along the way. On one hand this is a way for people to learn about IDstewardship. On the other hand this is a way to learn about communicating on stewardship as a whole.



Since launch in May 2016 and up through October 2023 the site has registered >5.7 million page views from >3 million visitors across 213 countries.  There have been over 100 healthcare expert contributors to content development (mostly articles), the majority of whom have been infectious diseases pharmacists. The website is owned under an LLC and is hosted on WordPress.


The website has a few sections, which are:


Articles: This is divided into sections as follows:

    • Residency & Training: Focuses on topics relevant to trainees in the field of infectious diseases pharmacotherapy and clinical pharmacy in general
    • Infectious Diseases & Antimicrobial Stewardship: Hosts a myriad of ID/stewardship topics from basic to advanced content. This section also includes a really fun sub-section of antimicrobial stewardship across the globe where infectious diseases pharmacists provide information about stewardship in their countries (13 countries interviewed to date).
    • Reality Check: Expert pharmacists and others write reflective pieces about their specialty area of practice or experience in a ‘reality versus expectation’ format, meant to help readers learn more about areas of pharmacy practice.
    • Healthcare At Large: This is a potpourri of content that happened to catch my interest. Content ranges from a list of medication inspired names for your pet to an antibiotic emoji puzzle game to new years resolutions for pharmacists.
    • COVID-19: Thank god there has not been such a need to add much content to this area recently, but there are some good pages there.


Learn Antibiotics: Links to the website Read more about it below.


Study Guide: Provides key points, resources and photos for over 120 anti-infective drugs. Meant to be an open-access resource for anyone studying for pharmacotherapy exams, but useful for many others too.


Resources: A listing of resources for antimicrobial stewardship, including links to institutional ASP websites, practice-based resources for ASP, ASP activities for kids, ASP training opportunities, relevant organizations/groups, important guidelines/documents, and more.


Q&A: Clinical and non-clinical questions often asked to infectious diseases pharmacists, answered by infectious disease pharmacists. The most popular one to date is about which oral 3rd generation cephalosporin is best.


ASP Chat: Organized by Brad Langford (Canadian ASP pharmacist) and myself, we have hosted about 70 chats since December 2016. Co-hosts have included SHEA, ACCP ID PRN, SERGE-45, Firstline, biomerieux, VAstewie, and others. It’s managed through @ASP_chat on X/Twitter. To date the chats have registered many millions of impressions and have served as a platform for idea/resource sharing.





“Learn Antibiotics” is easier to remember than, so we made it so goes to our training site which is which is a subdomain of My goal has been to add at least one thing to the site every month and over the last few years this has ballooned into a lot of easy-access content. The focus here is information that is clinically relevant and/or likely to be on an assessment.


There have been around 2000 members with and there are currently several hundred active members. Many people find it helpful for a few years and then move on once they have a better handle on the content. It is used a lot by pharmacy students and pharmacy residents, but also for studying for board exams and by non-pharmacy professionals.


This is a unique resource which is not trying to replace something that already exists. The feedback on this site has been tremendously positive and I rarely get complaints. I think having quick resources that are accessible 24/7/365 is a really big plus. My biggest challenge is unauthorized sharing of content.


There are memberships that include different access and there is a student membership that has a selection of content for early-learners. Some of the content offered includes:


Cheat Sheets: 1-page cheat sheets on various topics such as antibiotic classes, disease states, and biostatistics


Practice Tests: Provided in several formats, practice tests are good for learning antibiotic names or acquiring key knowledge about common antibiotics.


Games: This section has crossword puzzles, word searches, ID LIBS, word scrambles, and tic tac toe games.


Rotation Resources: Patient monitoring forms, renal dosing assessment worksheet, IV to PO review worksheet, and more.


Fill In The Blanks: Memorization sheets to help learn things like all the drugs that cover MRSA, drugs of choice, and antibiotic resistance principles. memberships range from $74.99 to $199.99 per year. This is the primary funding source for IDstewardship as a whole.




Instagram: The goal has been to teach people about antibiotics via Instagram and that has evolved a lot over the years. Currently the @IDstewardship account has 36K followers. Instagram has changed a lot over the years and I post a lot of stories because those tend to have the best reach lately. We do regular posts periodically as well, commonly using memes to emphasize key points. In the last month the account has reached 23K accounts, and this has not been a super active time period for me.


Twitter/X: This platform took off during COVID and then has really cooled off since Musk came around. Currently the @IDstewardship account has 36K followers. This platform has been used more for sharing emerging literature and discussing antimicrobial stewardship at large. I rarely tweet anything that is not related to IDstewardship. Twitter analytics has gotten a bit strange lately, but it says the account has >220K impressions in the last month.


Facebook: Facebook has dramatically reduced the reach of pages over the years, so I cross-post from Instagram to Facebook, but don’t post on Facebook as much as years previous. The @IDstewardship account on Facebook has over 20K followers.


IDstewardship can be found on other social media platforms, but these are the 3 where I have the most presence. Social media has helped extend the reach of the original content from IDstewardship and also to help promote other great work to a community people interested in IDstewardship.


Other – Newsletter

On the topic of reaching the audience, IDstewardship has a mailing list through Mailchimp which has around 25K subscribers and the most recent monthly newsletter had an open rate of over 50%. This is an important way I reach the audience, but it’s very expensive. Mailchimp currently costs $265 per month. Without the memberships from LearnAntibiotics, I couldn’t sustain the newsletter.


Growth on social media and for the newsletter has been steady and continues. It has gotten more overwhelming to keep track of the little details as these platforms never sleep and use sophisticated AI to manipulate content producers like myself.




Released in December 2022 and available on Amazon for $49.99 in many countries now, Learn Antibiotics First Edition has sold over 2,000 copies worldwide, reaching all continents across the globe (except Antarctica as far as I know at least). The workbook is designed for all learners and teachers of infectious diseases and is a selection of content available from It was peer-reviewed independently by two board-certified infectious diseases pharmacists.


I did not anticipate the book would be of such interest, but it turns out people really enjoy having a hard copy of the work. I think having it on Amazon makes it easy to purchase and that helps a lot, as they print and ship it as purchases are made. It’s all done through Kindle Direct Publishing (KDP).



It has been a lot of fun to create IDstewardship and then work with so many talented people to develop content for the websites and book. I’ve been taken aback by the worldwide audience who is interested in the content I collaboratively produce and share. The reach of the platforms and accounts is very difficult to quantify, but there is no doubt that it has been helpful for hundreds of thousands (if not millions) of people.


The biggest thing on the horizon for IDstewardship is to develop a book of games for helping to learn about antimicrobial drugs. Beyond that, managing the existing components is another goal. Although I will need to be very strategic about the work having a full time job, two young children, and being professionally engaged.


Overall IDstewardship has been a lot of work but also a blessing. I am so grateful to all the people who have helped keep it going over the years and contributed to the work or shared it with a friend.



Timothy P. Gauthier, Pharm.D., BCPS, BCIDP

Infectious Diseases & Antimicrobial Stewardship Pharmacist

Editor-In-Chief &

Social media: @IDstewardship

Miami, FL, USA



Dr. Brechot’s Health Research & Care Blog

April 25th, 2023



Do we need to be concerned about avian flu?

Everyone has noticed that the prices of eggs and poultry have gone up. One reason is the continued spread of avian flu. So, what is avian flu? Should we be worried?

What is avian flu?

Avian influenza, also known as bird flu, is a highly contagious viral infection that affects both domestic and wild birds. There are several strains of bird flu, among which H5N1 and H7N9 are more worrisome due to the possibility of transmission from birds to humans. While this rarely happens, H5N1 is a highly pathogenic virus. Since 1997, outbreaks of this strain and a few infections in humans have occurred in Asia, Africa, and Europe. H5N1 can infect mammals that eat the dead bird cadavers. Such infections could increase the risk of mutations in the virus that could make it more transmissible to humans. Recently, there has been a spillover of the H5N1 virus into harbor and gray seals in New England.  You can read more about the risk of future mutations in the H5N1 strain of virus in this post by the Global Virus Network.

While very rare, it is possible for people who come into close contact with infected birds, bird saliva or feces to get infected. According to the Centers for Disease Control and Prevention’s latest update on H5N1, 58 million poultry birds in more than 46 states been infected. So far, one human case has been reported in the United States. Between December 2022 and March 2023, 24 countries in Europe reported H5N1 cases in domestic and wild birds.

The symptoms of avian flu

The symptoms of avian flu vary. Infected birds can experience diarrhea, respiratory problems, and a sudden drop in egg production. In severe cases, they may die.

Most people infected with bird flu will experience very mild symptoms, such as  fever, cough, vomiting,  sore throat, and diarrhea, according to the World Health Organization. A few patients may develop more severe symptoms, such as pneumonia, difficulty breathing, respiratory failure, and even death. The fatality rate for humans from infection with H5N1 or H7N9 is much higher than that of seasonal flu infection.

Prevention and treatment

Preventing bird flu is crucial. While most people are at low risk of contracting bird flu, people who handle birds should take precautions.  Proper measurements include isolating infected birds, sterilizing equipment, monitoring bird populations for signs of disease, wearing protective gear, and washing hands frequently. If you suspect you are sick, please seek medical attention immediately.

There are also vaccines for birds, although they are not always effective.

In humans, antiviral drugs such as neuraminidase inhibitors (oseltamivir, zanamivir) can be used to treat bird flu. They are most effective when taken within 48 hours of the onset of symptoms.  Seasonal influenza vaccines do not fully protect against bird flu infection, but they do reduce the risk.

Although we have developed a deep understanding of how bird flu interacts with its host, we still have a long way to go to better understand the evolving bird flu and develop new antiviral drugs and vaccines to fight different strains of bird flu. Closely monitoring virus outbreaks is critical to prevent them from becoming the next pandemic.

Christian Brèchot, MD, PhD
Senior Associate Dean for Research in Global Affairs, USF Health Morsani College of Medicine
Associate Vice President for International Partnerships and Innovation, USF
Professor, Department of Internal Medicine
President, Global Virus Network



Linman Li, MBA, MPH, PMP, CPH
Director, USF- GVN Center
USF Health Morsani College of Medicine
Vice President, Global Virus Network



Dr. Sally Alrabaa is lead author for new American Association of Tissue Banking recommendations to prevent transmission of TB from donor tissue

October 6th, 2022

Dr. Alrabaa was chosen by the American Association of Tissue Banking to lead a sub-committee of member physicians in writing recommendations on reducing transmission of mycobacterium tuberculosis to patients via tissue transplant.  Dr. Alrabaa is the medical director for tissue banking services at Lifelink Tissue Bank. She is also a clinical faculty member of the ID transplant team at Tampa General Hospital, and tuberculosis consultant to the Florida Department of Health in Pinellas County.  The committee’s recommendation can be found here.

A HERO in our midst!

July 3rd, 2022

Easter evening seemed just like any other evening. Dr. Casanas was ready to settle in for the evening and had just gotten out of the shower when she heard a man’s voice yelling from inside of her house. Thinking there was a man in her house, her initial thought was to escape out of the bathroom window, but she quickly realized that was not an option since her 11-year-old daughter was also in the house. Terrified, she ran to the living room to confront the man, but no one was there. Then, she looked out of the front door and saw two men running away from her house. Thinking she had been robbed, her and her daughter began looking around the house to see what was missing. Then, loud banging at the door startled her and she heard a man yelling. Her daughter, Cassandra, was able to make out the word seizure and said “Mommy, open the door, I think someone needs help!”. It was then that Dr. Casanas realized this was all about a medical emergency.

The men told her that one of the neighbors was having a seizure. Hesitant to expose her daughter, she almost didn’t go since EMS had already been called and there is not much that can be done for a seizure, but her daughter looked at her with expectation. So, without further hesitation, she ran down the street with her daughter.

Upon entering the neighbor’s house, she saw the lifeless body of a six-year-old boy lying on the floor. Dr. Casanas was frozen in shock for a moment as she saw the boy, his mother wailing and his father running around in a panic. Faced with the most stressful medical emergency imaginable, she sprang into action. Despite not having any medications nor life-saving equipment, she was able to revive the boy within five minutes. The EMS arrived fifteen minutes later. Dr. Casanas had brought the boy back, but was in angst over whether or not it was enough… would the little boy have any brain damage?

Dr. Casanas got the best news the following day when she received a call from the family thanking her for saving the boy’s life. She was grateful to hear that the boy was doing well and did not have any brain damage.

We applaud Dr. Casanas for her bravery that evening and congratulate her for saving that little boy’s life… she is a real hero!

Congratulations to Dr. Menezes selected for the 2022 COPH Outstanding Alumni Award!

April 1st, 2022

Dr. Lynette Menezes was selected as one of two USF College of Public Health alumni to receive the 2022 Outstanding Alumni Award. Dr. Menezes is a Professor in the Division of Infectious Disease & International Medicine. She serves as the assistant vice president of international programs for USF Health as well as assistant dean of USF Medicine International.

Dr. Menezes joined the ID faculty in 2003. Since that time, she has played an essential role in the growth and success of international programs across USF Health. While leading these programs, she has contributed her epidemiology and public health expertise to international and local research projects. She co-founded and leads the Scholarly Concentration in International Medicine and mentors USF and international trainees in research and public health while acting as a role model for our trainees and junior faculty.

Dr. Menezes oversees more than 90 USF Health collaborations in 38 countries around the world. These collaborations have engaged international medical professionals and students in collaborative research, field experiences, clinical externships, observerships, and hospital administrator training. Under her leadership, over 1900 USF Health students have engaged in global learning, research, and clinical externships abroad and more than 580 international medical and administrative professionals have come to USF for training. Locally, Dr. Menezes has been engaged in expanding services for the homeless while advising the student-run Tampa Bay Street Medicine, and recently co-founded a refugee clinic to serve displaced populations.

During the COVID pandemic, Dr. Menezes has been a key member of the USF COVID-19 taskforce, which has drawn from expertise across the university to create a safe environment for USF students, faculty, and staff.

Dr. Menezes was honored with this award at the 2022 National Public Health Week Annual Awards Ceremony on April 6.

Dr. Beata Casanas is Awarded this Year’s USF Outstanding GME Program Award

January 22nd, 2021

USF Professor and Infectious Diseases Fellowship program director Dr. Beata Casanas has been awarded the 2021 University of South Florida Morsani College of Medicine Outstanding GME Program award.  Dr Casanas has been the USF Division of Infectious Diseases Fellowship program director since 2015, and is also a Professor of Medicine with the Department of Internal Medicine at the Morsani College of Medicine. Under her supervision, the Infectious Diseases Fellowship program has continued to flourish, with 11 competitive fellows participating annually across three USF-affiliated institutions. In addition to her fellowship program duties, Dr. Casanas is also Medical Director of the Hillsborough County Tuberculosis Clinic and is an active participant in multiple clinical trials.

Coronavirus Mythbusting: Dr. Oehler records Two-Podcast Series to Combat Coronavirus Misinformation

July 27th, 2020

As the world passes the 6 month mark since the WHO first declared the 2019 novel Coronavirus a “public health emergency of international concern,” one of the chief impediments to widespread support for public health measures has been online misinformation. Social media has been a hotbed for COVID-19 conspiracy theories and falsehoods. Many experts attribute online misinformation as being a factor in the resistance to mask wearing, quarantine measures, and the acceptance of other advice from public health officials. Misinformation, such as the conspiracy-laden film, “Plandemic,” has been widely circulated online.

With this in mind, Dr. Oehler, IDPodcast’s Editor-in-Chief, initially recorded a “Coronavirus myths” talk in May addressing some of the early social media misperceptions about coronavirus.  Dr. Oehler’s lecture addressed false social media assertions for such myths as the CDC’s reporting of death numbers, whether the Coronavirus outbeak was “predicted” by the Farmer’s Almanac, whether Coronavirus can be acquired from mail, food, or pets, and did the SARS CoV-2 virus originate from a Chinese scientific lab.  The talk was a hit, garnering more than a thousand views on YouTube.


But as the pandemic progressed well into the summer, combined with social justice protests and spikes of new cases in Florida and other southern states, Dr. Oehler decided that a second lecture was in order. The new lecture addresses issues related to mask wearing, testing, the financial health of hospitals, the effect of protesters on Coronavirus cases in affected communities, and whether we are likely to have a COVID-19 vaccine by early next year.


“Topics of science and medicine have gotten so political in our current climate, especially with the fact that we are in an election year,” Dr. Oehler said.  “I looked at some claims put forth by political leaders, whether or not they were well received by the public, with the perspective of asking, ‘what does the science say?’ What I found, sadly, is that the medical experts’ and public health officials’s advice has often been repeatedly sidelined in favor of political expediency, and not necessarily by just one political party.  ‘Should we go back to stay-at-home orders or is our testing adequate, for instance?’  These are questions best answered with science rather than politics.”


Dr. Oehler concludes, “When the pandemic ends, and we as a global community can reflect, and hopefully learn from this worldwide outbreak, I think we will sadly see that  from China to Europe to America, public health expert science-based guidance was frequently sidelined in favor of other priorities–minimizing a serious public health problem to avoid criticism, preventing economic injury to a state or community, or politicizing aspects of the coronavirus response to preserve a constituency. And the net affect was only to make things worse.”


Dr. Oehler’s Coronavirus Myths talks can be found here:


Coronavirus Myths: Separating fact from Fiction Recorded 5/6/2020

More Coronavirus Myths (And Misperceptions) Recorded 7/22/2020


VuMedi, an online information resource for clinicians, has recently partnered with IDPodcasts to offer segments from Dr. Oehler’s most recent Coronavirus Myths podcast on its platform. The segment on “mask myths” has garnered in excess of 10,000 views as of August 11. All six of the posts can be found here:

Click Here

Registration with the VuMedi site is free but is required to view their content.

IDPodcasts offers Coronavirus Resources during the 2020 Pandemic

May 18th, 2020

Tampa, FL, US – May 18, 2020.  To help clinicians and the public keep up with the latest information on the 2020 Coronavirus pandemic, IDPodcasts has been leveraging its online resources to offer information via its Website and YouTube channel.  Podcasts by USF Infectious Diseases attending Dr. Ana Velez, Dr Richard Oehler, ID Podcasts Editor-in-Chief, Dr. Seema Lakshmi, head of Coronavirus planning and epidemiology at Tampa General Hospital, and Dr. John Greene, Chief of Infectious Diseases at Moffitt Cancer Center and Research Institute, now have been posted on our sites.  In addition, continuously updated coronavirus information is available through the “Latest ID News” scroll via or content partner, CIDRAP.


In addition, ID Podcasts’ extensive podcast archive offers supplementary content on other outbreaks, including podcasts on Smallpox, Ebola virus disease, and Zoonoses.  And IDPodcasts will continue to add new content regarding Coronavirus disease (COVID-19) as the pandemic progresses.

USF Health Scholar Dr. Christian Brechot Authors Blog on the COVID-19 Pandemic

March 25th, 2020

Tampa, FL, US – In an attempt to provide further insights into the Coronavirus  as the disease prevalence continues to escalate within the US, USF Health Professor, researcher, and Senior Associate Dean Dr. Christian Brechot has inaugurated a blog on USF Health’s web site devoted to COVID-19.  Recent topics on the blog include the role of young adults in the pandemic’s spread, counter to their reputation as being, “invulnerable;” the all out scientific push to find effective drugs and a preventative vaccine, and the importance of getting the correct “denominator” in the calculation of mortality rates.

In addition to his contributions to this blog, Dr. Brechot serves as a USF Associate Vice President for International Partnerships and Innovation.   In addition, he has served as president of the Global Virus Network since 2017 and is past president of the world-renowned Pasteur Institute.


Dr. Brechot’s USF Health blog can be found at the following link:


Dr. Brechot’s Blog- March 25, 2020


IDPodcasts Contributors Dr. Richard Oehler and Dr. Sandra Gompf author JAMA Viewpoints article on the tenuous US Pharmaceutical Supply Chain

March 21st, 2020

Tampa, FL, US. March 16. USF Health Infectious Diseases specialists and IDPodcasts contributors Dr. Richard L Oehler and Dr. Sandra Gompf have authored a JAMA Viewpoints article addressing vulnerabilites in the U.S. pharmaceutical supply chain. The article was published online on March 16th, 2020.

According to Dr. Oehler, “We felt compelled to write this piece because as frontline Infectious Diseases providers, our patients have increasingly become the victims of the scarcity, rationing, and in some cases, complete and prolonged unavailability of some of our most critical and life-saving antibiotic agents. Over the last few years, we have personally experienced shortages of  antimicrobials such as benzathine penicillin G, metronidazole, ampicillin/sulbactam, and piperacillin-tazobactam (Zosyn).  After a particularly long supply interruption of Zosyn at our hospital, our curiosity got the best of us, and with a simple online search, we found that an explosion at a single plant in mainland China crippled the world’s single source for the active pharmaceutical ingredient (API) of Zosyn. Digging deeper, we found that the piperacillin-tazobactam shortages that have been ongoing for years worldwide were not an isolated event—but a symptom of a fragmented, unreliable, and flawed global antibiotic supply chain.”

Dr. Oehler continued, “The shortcomings we found in antibiotic manufacture and supply were not limited to antibiotics alone.  The entire American pharmaceutical industry, in a race to lower costs, increase profit margins, and simplify domestic production, long-ago outsourced pharmaceutical manufacturing to emerging industrialized nations such as India and China. In doing so, manufacturing facilities previously within U.S. borders moved well beyond the easy reach of U.S. inspectors.  Under much less pressure to adhere to stringent U.S. quality standards, they are now at the long end of a pharmaceutical supply chain that reaches halfway around the world.”

He noted, “The goal of lowering the cost of generic off-patent drugs to a bare minimum has now led to a business environment that has reduced the number of manufacturing plants of vital U.S. medicines and their components (such as benzathine penicillin G) to just a handful of facilities worldwide, mostly in China. As the world’s leading producer of pharmaceutical drugs and APIs, China now has  unprecedented leverage over Western countries. In fact, our medical facilities would literally close in just a few weeks without vital Chinese-manufactured pharmaceutical compounds.”

Interestingly, as Dr’s Gompf and Oehler were drafting the article in November, 2019, they had no idea that China, the West’s primary source for most of the active pharmaceutical components used to make most pharmaceuticals, was about to confront a serious regional outbreak–COVID-19.  As the novel Coronavirus spread from Wuhan, China to other Asian countries, and ultimately, to South Korea, Italy, Spain, and the United States, the strain on the world’s industrial supply chains have reached a breaking point. This is no more true than with pharmaceuticals, as the US is now facing shortages of critical drugs like hydroxychloroquine, azithromycin, and tocilizumab which have been identified as potential therapeutic agents useful to treat the SARS CoV-2 virus. The article is now contributing to the national discussion about renewed pharmaceutical manufacturing within the US and about the importance of stockpiling critical drugs.

Dr. Oehler is a Professor of Medicine at USF Health’s Division of Infectious Diseases and is IDPodcast’s Editor-in-Chief and Webmaster.  Dr. Gompf is longtime Chief of Infectious Diseases at the James A Haley Veterans Hospital, one of the nation’s largest VA facilities.  Drs. Oehler and Gompf have more than 45 years of combined experience in the practice of Infectious Diseases and in the training of infectious diseases fellows.

The article can be found here: