Torsten Joerger, MD, MSCE, is a Clinical Assistant Professor in the Division of Infectious Diseases in the Department of Pediatrics. He serves as the Associate Medical Director of the Antimicrobial Stewardship Program at Stanford Lucile Packard Children’s Hospital. His research interests center around the optimal use of antimicrobials in children as well as epidemiological studies of infections in children.

Clinical Focus

  • Pediatric Infectious Diseases

Academic Appointments

Administrative Appointments

  • Associate Director of Antimicrobial Stewardship, Stanford Lucile Packard Children's Hospital (2021 - Present)

Honors & Awards

  • Antimicrobial Stewardship Fellow Award, Pediatric Infectious Disease Society (2020)

Boards, Advisory Committees, Professional Organizations

  • Member, Pediatric Infectious Disease Antimicrobial Stewardship Education Committee (2020 - Present)
  • Member, Pediatric Infectious Diseases Society (2015 - Present)
  • Member, Infectious Disease Society of America (2015 - Present)

Professional Education

  • Board Certification: American Board of Pediatrics, Pediatric Infectious Diseases (2021)
  • Board Certification, American Board of Pediatrics: Pediatric Infectious Diseases (2021)
  • Fellowship: Children's Hospital of Philadelphia Infectious Disease Program (2021) PA
  • MSCE, University of Pennsylvania (2021)
  • Residency: Thomas Jefferson University/AI duPont Hospital (2018) DE
  • Board Certification: American Board of Pediatrics, Pediatrics (2018)
  • Medical Education: Medical College of Wisconsin (2015) WI

Current Research and Scholarly Interests

I am interested in using the tools of epidemiology to study antimicrobial use and optimize the care of children with infectious diseases.

All Publications

  • Racism, Not Race: the Root of Racial Disparities in Penicillin Allergy Labeling. Hospital pediatrics Gilliam, C., Joerger, T. 2022

    View details for DOI 10.1542/hpeds.2022-006695

    View details for PubMedID 35661883

  • Factors Associated With Penicillin Allergy Labels in Electronic Health Records of Children in 2 Large US Pediatric Primary Care Networks. JAMA network open Taylor, M. G., Joerger, T., Li, Y., Scheurer, M. E., Russo, M. E., Gerber, J. S., Palazzi, D. L. 2022; 5 (3): e222117


    Penicillin allergy labels influence clinical decision-making, yet most children who are labeled do not have type 1 hypersensitivity allergic reactions and instead have a history of predictable adverse reactions or unspecified illness symptoms while receiving penicillin for viral infections. Studies describing penicillin allergy labeling in the pediatric outpatient setting are lacking.To describe the epidemiology and factors associated with penicillin allergy labels across 2 large US pediatric primary care networks.This retrospective, longitudinal birth cohort study was conducted in 90 primary care pediatric practices serving a diverse population of children across Houston, Texas, Austin, Texas, Philadelphia, Pennsylvania, and parts of New Jersey. Participants were children born between January 2010 and June 2020 who had a health care visit in the first 14 days of life and at least 2 additional visits in the first year of life at one of 90 primary care pediatric practices. Censoring criteria were additionally applied to exclude data from children no longer seeking health care in the 90 clinics over time. Statistical analysis was performed from February to May 2021.Basic patient demographics, health care utilization, penicillin exposure, and primary clinic location.Addition of penicillin allergy label in the electronic medical record.Among 334 465 children in the birth cohort, 164 173 (49.1%) were female; 72 831 (21.8%) were Hispanic, 59 598 (17.8%) were non-Hispanic Black, and 148 534 (44.4%) were non-Hispanic White; the median (IQR) age at censoring was 3.8 (1.7-6.6) years; 18 015 (5.4%) were labeled as penicillin allergic, but the prevalence of penicillin allergy labeling ranged from 0.9% to 10.2% across practices. Children were labeled at a median (IQR) age of 1.3 (0.9-2.3) years. Non-Hispanic White children were more likely to be labeled compared with non-Hispanic Black children after controlling for potential confounders (adjusted odds ratio, 1.7 [95% CI, 1.6-1.8]). There were 6797 allergic children (37.7%) labeled after receiving 1 penicillin prescription and 1423 (7.9%) labeled after receiving 0 penicillin prescriptions.In this cohort study of more than 330 000 children, penicillin allergy labeling was common and varied widely across practices. Children were labeled early in life, and almost half were labeled after receiving 1 or 0 penicillin prescriptions. These findings raise questions regarding the validity of penicillin allergy labels. Future work exploring the fidelity of and outcomes associated with penicillin allergy-labeling in children is warranted.

    View details for DOI 10.1001/jamanetworkopen.2022.2117

    View details for PubMedID 35285918

  • Leveraging antimicrobial stewardship programs in response to the coronavirus disease 2019 (COVID-19) public health emergency Antimicrobial Stewardship & Healthcare Epidemiology Joerger, T. A., Bio, L., Puckett, L., Schwenk, H. 2022; 2 (1)

    View details for DOI 10.1017/ash.2022.34

  • Treatment-Resistant Bacterial Lymphadenitis in an Otherwise Healthy Girl. Pediatrics in review Henig, O., Jyonouchi, S., Joerger, T., Kennedy, K. 2021; 42 (6): 339-341

    View details for DOI 10.1542/pir.2020-0057

    View details for PubMedID 34074722

  • Suppurative Intracranial Complications of Pediatric Sinusitis: A Single-Center Experience. Journal of the Pediatric Infectious Diseases Society Otto, W. R., Paden, W. Z., Connors, M., Joerger, T., Buzi, A., Rizzi, M., Huh, J., Storm, P., Heuer, G., Kennedy, B., McGuire, J., Swami, S., Lang, S. S. 2021; 10 (3): 309-316


    Suppurative intracranial complications of sinusitis are rare events in children and can lead to harmful neurologic sequelae and significant morbidity. We sought to review the presentation and management of patients admitted at our hospital with these conditions.This was a retrospective study of pediatric patients admitted to a quaternary children's hospital from 2007 to 2019 for operative management of sinusitis with intracranial extension. Clinical characteristics, including surgical and microbiological data, were collected and analyzed.Fifty-four patients were included; the median age was 11.0 years, and there was a male predominance. Eighty-nine percent of patients had prior healthcare visits for the current episode of sinusitis; 46% of patients had an abnormal neurologic exam on admission. Epidural abscess and subdural empyema were the most common complications, and subdural empyema was associated with repeat surgical intervention. The dominant pathogens were Streptococcus anginosus group organisms (74%). The majority of patients completed treatment parenterally, with a median duration of therapy of 35 days. Neurological sequelae, including epilepsy or ongoing focal deficits, occurred in 22% of patients. History of seizure or an abnormal neurological exam at admission were associated with neurological sequelae.Clinicians should consider intracranial complications of sinusitis in patients with symptoms of sinusitis for >1 week. Patients should undergo urgent neuroimaging, as neurosurgical intervention is essential for these patients. Subdural empyema was associated with repeat neurosurgical intervention. Neurological sequelae occurred in 22% of patients, and new onset seizure or an abnormal neurological exam at admission were associated with neurological sequelae.

    View details for DOI 10.1093/jpids/piaa101

    View details for PubMedID 32955086

    View details for PubMedCentralID PMC8023312

  • Acute, Severe Abdominal Pain in a Non-Sexually Active Adolescent Female. Pediatrics in review Beltrán, S., Krass, P., Joerger, T., Chuang, J. H. 2021; 42 (2): 90-92

    View details for DOI 10.1542/pir.2019-0302

    View details for PubMedID 33526574

  • Chronic Meningitis Due to Prototheca zopfii in an Adolescent Girl. Journal of the Pediatric Infectious Diseases Society Joerger, T., Sulieman, S., Carson, V. J., Fox, M. D. 2021; 10 (3): 370-372

    View details for DOI 10.1093/jpids/piaa049

    View details for PubMedID 32415770

    View details for PubMedCentralID PMC8240659

  • Impact of an Antimicrobial Stewardship Policy to Restrict Palivizumab Use. Journal of the Pediatric Infectious Diseases Society Joerger, T., Chan, S., Swami, S. K., Handy, L. K. 2019; 8 (2): 189-190

    View details for DOI 10.1093/jpids/pix091

    View details for PubMedID 29096027

    View details for PubMedCentralID PMC6510943

  • Murine macrophage inflammatory cytokine production and immune activation in response to Vibrio parahaemolyticus infection. Microbiology and immunology Waters, S., Luther, S., Joerger, T., Richards, G. P., Boyd, E. F., Parent, M. A. 2013; 57 (4): 323-8


    Vibrio parahaemolyticus is the most common cause of bacterial, seafood-related illness in the USA. Currently, there is a dearth of published reports regarding immunity to infection with this pathogen. Here, production of both pro- and anti-inflammatory cytokines by V. parahaemolyticus-infected RAW 264.7 murine macrophages was studied. It was determined that this infection results in increased concentrations of IL-1α, IL-6, TNF-α and IL-10. Additionally, decreases in cell surface TLR2 and TLR4 and increases in T-cell co-stimulatory molecules CD40 and CD86 were discovered. The data presented here begin to identify the immune variables required to eliminate V. parahaemolyticus from infected host tissues.

    View details for DOI 10.1111/1348-0421.12034

    View details for PubMedID 23586636

  • Characterization of Vibrio parahaemolyticus serotype O3:K6 activation of murine macrophage. Waters, S., Parent, M., Blumerman, S., Whitaker, B., Joerger, T., Boyd, E. AMER ASSOC IMMUNOLOGISTS. 2011
  • Generation of a proinflammatory response by macrophage following infection with an O3:K6 serotype of Vibrio parahaemolyticus Parent, M., Waters, S., Blurnerman, S., Whitaker, B., Joerger, T., Boyd, E. AMER ASSOC IMMUNOLOGISTS. 2010
  • The role of IL-12p40 during host cell infection with Yersinia pestis KIM D27 Parent, M. A., Joerger, T. A., Golwala, S. N., Smiley, S. T., Blumerman, S. L. AMER ASSOC IMMUNOLOGISTS. 2009
  • Disintegrins in health and disease. Frontiers in bioscience : a journal and virtual library McLane, M. A., Joerger, T., Mahmoud, A. 2008; 13: 6617-37


    Few of the proteins isolated and characterized from snake venom have proven to be more chemically diverse, exquisitely specific or promiscuously active than the family known as disintegrins. These small proteins have shown structural homology with hundreds of cell surface molecules from plants and animals other than snakes, and their precise mimicry of native receptor ligands speaks to evolutionary niches related to survival and geographic locale. Over 100 disintegrins have been named and studied, with the most recent efforts into molecular techniques providing significant clues to taxonomic relationships among four different snake families. Investigators have evaluated disintegrin applications in therapies for cancer, asthma, osteopenia and inappropriate angiogenesis. Crystal and NMR studies have confirmed hypotheses regarding ligand-receptor interactions while illuminating the complexities of structure-function evidence. Disintegrin chimeras with viruses, microbubbles and fluorescent labels have become useful tools in many investigations. While many disintegrin studies still involve platelets, previously unexplored interactions with glial cancer, T lymphocytes and the bacteria Yersinia have blazed new trails for this field. This review will summarize disintegrin investigations since 2003.

    View details for DOI 10.2741/3177

    View details for PubMedID 18508683