Although elevations in CPK increased in high-risk obese patients on daptomycin, discontinuation rates due to ADEs remained low. Further evaluation in a prospective trial is warranted.

This retrospective cohort study examined the impact of the pandemic on antimicrobial use (AU) in South Carolina hospitals. AU in days of therapy (DOT) per 1000 days-present was evaluated in 17 hospitals in South Carolina. Matched-pairs mean difference was used to compare AU during the pandemic (March-June 2020) to that during the same months in 2019 in hospitals that did and did not admit patients with COVID-19. There was a 6.6% increase in overall AU in the 7 hospitals admitting patients with COVID-19 (from 530.9 to 565.8; mean difference: 34.9 DOT/1000 days-present, 95% CI: 4.3, 65.6; p=0.03). There was no significant change in overall AU in the remaining 10 hospitals that did not admit patients with COVID-19 (mean difference 6.0 DOT/1000 days-present, 95% CI: -55.5, 67.6; p=0.83). Most of the increase in AU in the 7 hospitals that admitted patients with COVID-19 was observed in broad-spectrum antimicrobial agents. A 16.4% increase was observed in agents predominantly used for hospital-onset infections (from 122.3 to 142.5; mean difference: 20.1 DOT/1000 days-present, 95% CI: 11.1, 29.1, p=0.002). There was also a 9.9% increase in the use of anti-MRSA agents (from 66.7 to 73.3; mean difference: 6.6 DOT/1000 days-present, 95% CI: 2.3, 10.8; p=0.01). COVID-19 pandemic appears to drive overall and broad-spectrum antimicrobial use in South Carolina hospitals admitting patients with COVID-19. Additional antimicrobial stewardship resources are needed to curtail excessive antimicrobial use in hospitals to prevent subsequent increases in antimicrobial resistance and Clostridioides difficile infection rates given the continuing nature of the pandemic.

With an increasing number of antimicrobial stewardship–related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an “actionable” intervention for 2017. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the “actionable” intervention used by antimicrobial stewardship programs to provide key stewardship literature for training and teaching and identify potential intervention opportunities within their institutions.

Antimicrobial stewardship efforts are an emphasis among many institutions around the world to combat inappropriate antimicrobial utilization, rising healthcare costs and emerging antimicrobial resistance.  Implementation of new innovative strategies may be challenging for many institutions with limited or constrained resources. Using proven effective methods as evidenced by other institutions in the peer-reviewed literature may offer an opportunity to evaluate institution-specific practices, which may be implemented locally.  A structured examination and survey of the peer-reviewed, stewardship literature by an expert group of clinicians, scholars and educators determined the most influential publications from 2016. Herein, the top thirteen manuscripts are reviewed to aid clinicians identify potential stewardship opportunities and serve as an educational tool for trainees and others.

Staying current on literature related to antimicrobial stewardship can be challenging given the ever-increasing number of published articles. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an actionable intervention for 2019. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the actionable intervention used by antimicrobial stewardship programs to provide key stewardship literature for teaching and training as well as to identify potential intervention opportunities within one’s institution