Christopher R. Frei, Pharm.D., M.Sc.

Dr. Chris Frei

Division Head and Professor of Pharmacotherapy
William J. Sheffield Centennial Endowed Professor
Program Director, Translational Science PhD Program

Dr. Christopher R. Frei is the Pharmacotherapy Division Head; one of six divisions in the UT Austin College of Pharmacy, and the only division located outside of Austin, in San Antonio. He is also the Director of the Pharmacotherapy Education and Research Center in the School of Medicine at the UT Health Science Center San Antonio. On June 1, 2015 he became the Program Director for the multidisciplinary joint Translational Science PhD Program, involving four UT institutions in the Austin and San Antonio areas. The program recruits physicians, pharmacists, nurses, dentists, and others with professional doctoral degrees, and trains them to conduct innovative Clinical and Translational Research. Dr. Frei’s research laboratory is currently pursuing two major research ventures. One is to build and analyze large patient cohorts using the national Veterans Affairs data repositories. The other is to conduct prospective clinical and translational studies in medical practices. Dr. Frei’s independent and collaborative research has been supported by AHRQ, NIH, PCORI, universities, professional societies, and the pharmaceutical industry. He has published more than 95 peer-reviewed papers in leading journals, including JAMA, JAMA Internal Medicine, the American Journal of Medicine, Chest, and Drugs. He has also given more than 400 scientific and educational presentations. He has been recognized as “Mentor of the Year” by the Texas Society of Health System Pharmacists, “Young Investigator of the Year” by the Society of Infectious Diseases Pharmacists, and “Distinguished Young Alumnus of the Year” by the UT Austin College of Pharmacy. He is a Board Certified Pharmacotherapy Specialist and a Fellow of the American College of Clinical Pharmacy and the American Association of Colleges of Pharmacy. Finally, he serves as an Ambassador for the NIH Loan Repayment Program.

Antibiotic Pharmacokinetic-Pharmacodynamic (PK/PD) Modeling: The Clinical and Laboratory Standards Institute (CLSI) is an international organization that critically evaluates clinical, laboratory, and PK-PD information to establish interpretive criteria for antibiotic susceptibility tests. The CLSI sets “breakpoints” which are a set of rules that microbiologists use to tell clinicians if a particular antibiotic is likely to be effective against a particular pathogen. Most developed countries use CLSI’s rules and validated methodologies in their clinical microbiology laboratories. Breakpoints are typically set at the time a drug is developed. Over time, the pathogen develops new resistance mechanisms that may render the old breakpoints invalid. During my postdoctoral training, I hypothesized that the breakpoints for beta-lactam antibiotics had been compromised because of emerging resistance in Gram-negative bacteria. My laboratory developed a comprehensive program to re-evaluate breakpoints for several antibiotic classes against key Gram-negative bacteria. We found major discrepancies for beta-lactam and fluoroquinolone antibiotic classes. I presented these results to CLSI. This work helped lead to a revision of CLSI’s breakpoints for the cephalosporin antibiotic class. This policy change has major implications for clinical microbiology laboratories around the world. PK-PD models can also be used to design dosing regimens to ensure patients get the most of their antibiotics. In some clinical studies at local hospitals, my research collaborators and I have found that patients who received PK-PD based dosing experienced better health outcomes than patients who received traditional dosing. Antimicrobial stewardship teams across the country now use these articles as strong evidence to implement PK-PD based dosing at their own hospitals to improve safety and effectiveness for their patients.

Clinical Epidemiology, Health Outcomes, and Comparative-Effectiveness Research: My laboratory studies national data from federal agencies like the AHRQ, CDC, DOD, and VHA to detect emerging diseases, describe changes in medication use patterns, and calculate the economic burden on our national economy. We also compare health outcomes for patients receiving two or more treatments for different health conditions in an effort to identify the most cost-effective treatments for U.S. residents. We were the first to determine that patients with healthcare-associated pneumonia (HCAP) do not experience better health outcomes when treated with antibiotic recommendations consistent with national clinical practice guidelines. This and other papers have led the organizations that produced those guidelines to reconsider how they define the HCAP population and the antibiotics they recommend for that population. We have also determined that statins, angiotensin II receptor blockers, and angiotensin-converting enzyme inhibitors are associated with better health outcomes in pneumonia patients admitted to the hospital; that antibiotic use has decreased among children and adolescents, but has increased for older adults–especially broad-spectrum antibiotic use; and that some measures of patient retention in HIV expert care are better than others to predict health outcomes. These findings are useful to health care providers and public health organizations as they seek ways to optimize the health of their patients.

Community Based Participatory Research: I have built and led a multidisciplinary group of researchers and practitioners (part of a regional Practice Based Research Network [PBRN] of primary care practices) to conduct a series of prospective clinical and translational studies to improve the health of their patients with MRSA skin and soft tissue infections (SSTIs). Together, we have determined that MRSA SSTIs are highly prevalent in our PBRN. We have identified objective markers available at baseline that can be used to predict which patients are most likely to experience treatment failure and recurrence. We have also identified practice behaviors that are associated with worse patient outcomes and have educated providers to avoid these practices. We have also conducted whole genome sequencing of the MRSA isolates to investigate genetic markers that may be contributing to treatment failure and recurrence. Finally, we have begun to implement new practice-based interventions to combat high rates of treatment failure and recurrence in our local patient population. We have even partnered with a group of biomedical engineers to develop and patent a point-of-care testing device to be used in the clinic to rapidly identify the pathogenic bacteria and test an array of antibiotics to see which are most likely to result in a positive patient outcomes. We continue to publish important study findings from this rich collaboration to help other practitioners who are also facing high rates of treatment failure and recurrence in their MRSA SSTI patients.

Drug Safety: I and my colleagues study active duty military and veteran populations to determine if the medications they receive affect their military readiness or long-term health. We have created cohorts of ambulatory and hospitalized patients and have followed them for up to eight years. Some of our key findings include new information regarding an association of azithromycin with mortality and cardiovascular events among older patients hospitalized with pneumonia and associations between statin exposure and the development of musculoskeletal conditions, arthropathies, injuries, connective tissue disease, diabetes mellitus, and diabetic complications.

Associate Professor and Division Head, Pharmacotherapy Division,
College of Pharmacy, The University of Texas at Austin
Center Director, Pharmacotherapy Education & Research Center,
School of Medicine, The University of Texas Health Science Center at San Antonio
Program Director, Translational Science PhD Program, The University of Texas at Austin,
The University of Texas Health Science Center, The University of Texas San Antonio, and
The University of Texas School of Public Health San Antonio Regional Campus
Research Investigator, Audie L. Murphy Memorial Veterans Hospital
South Texas Veterans Health Care System

Education/Training

INSTITUTION AND LOCATION DEGREE
(if applicable)		 Completion Date
MM/YYYY		 FIELD OF STUDY

Texas A&M University, College Station, TX
Other training 05/1997 Undergraduate
The University of Texas at Austin, Austin, TX PHMD 05/2001 Pharmacy
The University of Texas at Austin, Austin, TX Resident 05/2003 Clinical Pharmacy
The University of Texas at Austin, Austin, TX MS 05/2003 Pharmacy Research
The University of Texas at Austin, Austin, TX Postdoctoral Fellow 12/2005 Pharmacy Research
Univ of TX Hlth Sci Ctr, San Antonio, TX NIH training grant 04/2012 Translational Science
Univ of TX Hlth Sci Ctr, Houston, TX Other training 05/2013 Grad Public Hlth Cert


Personal Statement

I am an Associate Professor of Pharmacy and an established clinical scientist with extramural support from public and private sources. My laboratory has developed several cohorts of patients with infectious diseases using data resources from the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), Department of Defense (DOD), and the Veterans Health Administration (VHA). We have also partnered with a Practice Based Research Network (PBRN) of primary care medical practices for community-based participatory research involving patients with MRSA skin and soft tissue infections. We have used these cohorts effectively for innovative clinical and translational research.

Positions and Honors

Positions and Employment

Date(s) Position
2006 – 2012 Assistant Professor, College of Pharmacy, The University of Texas at Austin, Austin, TX
2006 – 2012 Adjoint Assistant Professor, School of Medicine, Univ of TX Hlth Sci Ctr, San Antonio, TX
2012 – Associate Professor, College of Pharmacy, The University of Texas at Austin, Austin, TX
2012 – Adjoint Associate Professor, School of Medicine, Univ of TX Hlth Sci Ctr, San Antonio, TX
2014 – Division Head, Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, TX
2014 – Director, Pharmacotherapy Education & Research Center, School of Medicine, Univ of TX Hlth Sci Ctr, San Antonio, TX
2015 – Program Director, Translational Science PhD Program, School of Medicine, Univ of TX Hlth Sci Ctr, San Antonio, TX


Honors

Date Honor
2005 Loan Repayment Award, Clinical Research, L30 AI066658, “Antibiotic pharmacodynamics”, Role: Participant, NIH/NIAID (National Institute of Allergy and Infectious Diseases) (renewed 2007)
2009 Loan Repayment Award, Health Disparities, L60 MD003770, “Health disparities among Blacks and Whites with HIV/AIDS”, Role: Supervisor and Mentor (CU Oramasionwu, Participant), NIH/NCMHD (National Center on Minority Health and Disparities) (renewed 2013)
2011 Young Investigator Award, Society of Infectious Diseases Pharmacists
2011 Pharmacy Mentor Award, Texas Society of Health-System Pharmacists
2011 Distinguished Young Alumnus Award, College of Pharmacy, The University of Texas at Austin
2012 Loan Repayment Award, Clinical Research, L30 TR000604, “Prevention of catheter-related bloodstream infections”, Role: Supervisor and Mentor (KR Daniels-Reveles, Participant), NIH/NCATS (National Center for Advancing Translational Sciences) (renewed 2014)
2013 Fellow, American College of Clinical Pharmacy
2014 Academic Research Fellow, American Association of Colleges of Pharmacy
2014 Loan Repayment Award, Clinical Research, “Molecular epidemiology and virulence of Staphylococcus aureus,” Role: Supervisor and Mentor (GC Lee, Participant), NIH/NIAID (National Institute of Allergy and Infectious Diseases)

Dr. Frei has published more than 95 peer-reviewed papers in leading journals, including JAMA, JAMA Internal Medicine, the American Journal of Medicine, Chest, and Drugs. A partial listing of his publications can be found at Dr. Frei’s myNCBI bibliography.

Contact Information

US Mailing Address:
Pharmacotherapy Education & Research Ctr.
University of Texas Health Science Center San Antonio
7703 Floyd Curl Drive – MC 6220
San Antonio, TX 78229-3900
USA