Objective: To assess association of pharmacist gender with acceptance of antibiotic stewardship recommendations. Design: A retrospective evaluation of the Reducing Overuse of Antibiotics at Discharge (ROAD) Home intervention. Setting: The study was conducted from May to October 2019 in a single academic medical center. Participants: The study included patients receiving antibiotics on a hospitalist service who were nearing discharge. Methods: During the intervention, clinical pharmacists (none who had specialist postgraduate infectious disease residency training) reviewed patients on antibiotics and led an antibiotic timeout (ie, structured conversation) prior to discharge to improve discharge antibiotic prescribing. We assessed the association of pharmacist gender with acceptance of timeout recommendations by hospitalists using logistic regression controlling for patient characteristics. Results: Over 6 months, pharmacists conducted 295 timeouts: 158 timeouts (53.6%) were conducted by 12 women, 137 (46.4%) were conducted by 8 men. Pharmacists recommended an antibiotic change in 82 timeouts (27.8%), of which 51 (62.2%) were accepted. Compared to male pharmacists, female pharmacists were less likely to recommend a discharge antibiotic change: 30 (19.0%) of 158 versus 52 (38.0%) of 137 (P < .001). Female pharmacists were also less likely to have a recommendation accepted: 10 (33.3%) of 30 versus 41 (8.8%) of 52 (P < .001). Thus, timeouts conducted by female versus male pharmacists were less likely to result in an antibiotic change: 10 (6.3%) of 158 versus 41 (29.9%) of 137 (P < .001). After adjustments, pharmacist gender remained significantly associated with whether recommended changes were accepted (adjusted odds ratio [aOR], 0.10; 95%confidence interval [CI], 0.03–0.36 for female versus male pharmacists). Conclusions: Antibiotic stewardship recommendations made by female clinical pharmacists were less likely to be accepted by hospitalists. Gender bias may play a role in the acceptance of clinical pharmacist recommendations, which could affect patient care and outcomes.

Contrast sensitivity is reduced in older adults and is often measured at an overall perceptual level. Recent human psychophysical studies have provided paradigms to measure contrast sensitivity independently in the magnocellular (MC) and parvocellular (PC) visual pathways and have reported desensitization in the MC pathway after flicker adaptation. The current study investigates the influence of aging on contrast sensitivity and on the desensitization effect in the two visual pathways. The steady- and pulsed-pedestal paradigms were used to measure contrast sensitivity under two adaptation conditions in 45 observers. In the non-flicker adaptation condition, observers adapted to a pedestal array of four 1°×1° squares presented with a steady luminance; in the flicker adaptation condition, observers adapted to a square-wave modulated luminance flicker of 7.5 Hz and 50% contrast. Results showed significant age-related contrast sensitivity reductions in the MC and PC pathways, with a significantly larger decrease of contrast sensitivity for individuals older than 50 years of age in the MC pathway but not in the PC pathway. These results are consistent with the hypothesis that sensitivity reduction observed at the overall perceptual level likely comes from both the MC and PC visual pathways, with a more dramatic reduction resulting from the MC pathway for adults >50 years of age. In addition, a similar desensitization effect from flicker adaptation was observed in the MC pathway for all ages, which suggests that aging may not affect the process of visual adaptation to rapid luminance flicker.

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