Noah Wald-Dickler, MD, FACP, on Antimicrobial Stewardship: Insights From SHEA 2024


Noah Wald-Dickler, MD, FACP, discusses the safety and efficacy of oral transition therapy, challenges in antimicrobial stewardship, and evidence-based alternatives presented at SHEA 2024.

Antimicrobial resistance  (Adobe Stock, unknown)

Antimicrobial resistance

(Adobe Stock, unknown)

Focusing on antimicrobial stewardship, his research emphasizes the safety and efficacy of oral transition therapy. With extensive experience and numerous publications, Wald-Dickler advocates for evidence-based practices to address challenges in infection prevention and control.

Through his presentation—and the many other times he has given the same presentation throughout the world—he aimed to challenge entrenched dogmas and promote evidence-based modern approaches, highlighting the importance of oral therapy over traditional IV methods. This ultimately contributed to improved patient outcomes and the advancement of the field of infectious diseases.

ICT: What inspired you to choose the topics for your presentation at the SHEA conference this year?

Noah Wald-Dickler, MD, FACP    (Courtesy of Noah Wald-Dickler, MD, FACP)

Noah Wald-Dickler, MD, FACP

(Courtesy of Noah Wald-Dickler, MD, FACP)

Noah Wald-Dickler, MD, FACP: Antimicrobial stewardship is core to what we all do in infection prevention. Our group at LA General has published several studies on the safety and efficacy of oral transition therapy, and SHEA is a great venue to spread the mantra of "Oral is the New IV."

ICT: Could you elaborate on the key points or takeaways you aimed to deliver to the audience during your session?

NW-D: The key point is that compared to prolonged IV therapy, oral transition therapy is safe and just as clinically effective. It's also intrinsically safer for patients and allows them to be discharged sooner from the hospital. Now that we have an abundance of randomized controlled trials comparing all IV therapy vs oral transition therapy, clinicians really should be using oral transition regimens supported by high-quality randomized control trials.

ICT: Were there any surprising insights or findings that emerged while preparing for your presentation, and if so, how did they impact your approach?

NW-D: Not really. I've given one version or another of this talk several times now (including recently in Colombia in Spanish).

ICT: In your opinion, what are the most significant challenges that epidemiologists and other infection prevention personnel face today, and how does your presentation address these challenges?

NW-D: Unfortunately, old dogmas persist, even when the evidence points to the contrary. The "Oral is the New IV" and "Shorter is Better" movements in antimicrobial stewardship are key in dispelling these myths by providing modern, evidence-based alternatives to decades of dogma.

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