Clinical Infectious Diseases Pharmacists in the United States: A Problem of Both Supply and Demand

Rapid diagnostic technologies (RDTs) significantly reduce organism identification time and can augment antimicrobial stewardship program (ASP) activities. An electronic survey quantified familiarity with and utilization of RDTs by clinical pharmacists participating in ASPs. Familiarity was highest with polymerase chain reaction (PCR). Formal infectious diseases training was the only significant factor influencing RDT familiarity. Infect Control Hosp Epidemiol 2017;38:863-866.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pharmacists’ Familiarity with and Institutional Utilization of Rapid Diagnostic Technologies for Antimicrobial Stewardship

Foster

Kuper²,

Zhiqiang

et al. 2017

“…The declining rate of applicant interest for a career in infectious diseases is concerning and may be attributed to factors such as a growing number of hospital-based positions, lack of mentorship in infectious diseases, and lower salary compared to other subspecialties 10 11 Likewise, current infectious diseases training opportunities, such as residencies, fellowships, and certificate programs for pharmacists in the United States are considered inadequate to meet the demand for pharmacists with advanced training in antimicrobial stewardship (AS) 12 . Due to the demand, lack of infectious diseases training programs and personnel, and high prevalence of infections, it is likely that all physicians, pharmacists, and trainees will be involved with AS to some degree.…”

mentioning

confidence: 99%

All aboard!: Involvement of medical and pharmacy trainees in antimicrobial stewardship

Childs‐Kean

Briggs

Cho

2018

Antimicrobial stewardship (AS) involves the appropriate selection of antimicrobials. Antimicrobial stewardship programs are mandated in hospitals and are expanding to involve outpatient arenas. Multiple articles have been published describing the need for AS education for medical and pharmacy students, beginning early in the students’ career to develop into competent AS practitioners. Additionally, publications have described the role and impact of medical and pharmacy trainees on AS programs. Here, we review the published evidence describing medical and pharmacy trainees’ involvement in AS and call for future research in this area.

“…Despite the critical role of pharmacists in antibiotic stewardship, only half of US hospitals reported having pharmacists with ID training. Specialized pharmacy training programs are a more recent development and training spots are in short supply, 21 potentially limiting access to ID pharmacists, especially at smaller hospitals. Instead, clinical pharmacists without ID training often develop local expertise to improve antibiotic prescribing or obtaining additional training in stewardship through national organizations.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic stewardship teams and Clostridioides difficile practices in United States hospitals: A national survey in The Joint Commission antibiotic stewardship standard era

Vaughn

Greene

Ratz

et al. 2019

Objective: Clostridioides difficile infection (CDI) can be prevented through infection prevention practices and antibiotic stewardship. Diagnostic stewardship (ie, strategies to improve use of microbiological testing) can also improve antibiotic use. However, little is known about the use of such practices in US hospitals, especially after multidisciplinary stewardship programs became a requirement for US hospital accreditation in 2017. Thus, we surveyed US hospitals to assess antibiotic stewardship program composition, practices related to CDI, and diagnostic stewardship. Methods: Surveys were mailed to infection preventionists at 900 randomly sampled US hospitals between May and October 2017. Hospitals were surveyed on antibiotic stewardship programs; CDI prevention, treatment, and testing practices; and diagnostic stewardship strategies. Responses were compared by hospital bed size using weighted logistic regression. Results: Overall, 528 surveys were completed (59% response rate). Almost all (95%) responding hospitals had an antibiotic stewardship program. Smaller hospitals were less likely to have stewardship team members with infectious diseases (ID) training, and only 41% of hospitals met The Joint Commission accreditation standards for multidisciplinary teams. Guideline-recommended CDI prevention practices were common. Smaller hospitals were less likely to use high-tech disinfection devices, fecal microbiota transplantation, or diagnostic stewardship strategies. Conclusions: Following changes in accreditation standards, nearly all US hospitals now have an antibiotic stewardship program. However, many hospitals, especially smaller hospitals, appear to struggle with access to ID expertise and with deploying diagnostic stewardship strategies. CDI prevention could be enhanced through diagnostic stewardship and by emphasizing the role of non–ID-trained pharmacists and clinicians in antibiotic stewardship.