Clinicians are faced with many complex factors to consider when treating patients. Frontline pharmacist Emily Heil, PharmD, BCIDP, BCPS, AQ ID, AAHIVP, coordinator of the Antimicrobial Stewardship Program at the University of Maryland Medical Center and associate professor at the University of Maryland, and Sarah Wieczorkiewicz, PharmD, BCIDP, BCPS, FIDSA, senior clinical content specialist and co-author of The Pharmacist's Guide to Antimicrobial Therapy and Stewardship, discussed how healthcare providers can make antimicrobial stewardship a central piece of their patient safety efforts in a recent virtual panel discussion.
In the webinar, Heil and Wieczorkiewicz are joined by Liz Tomsik, PharmD, Senior Director for Reference Content, and Bill Alvarez, PharmD, BCPS, Director of Content Harmonization at Wolters Kluwer, Health, to moderate the discussion. Through use cases, they show how clinicians can better consider various physical changes and external modalities while using a central reference with the best available evidence and guidance in order to improve antibiotics prescriptions and curb resistance.
Renewed attention on antimicrobial resistance
The CDC's antimicrobial resistance (AR) efforts were thrust into the spotlight in 2013 with the AR Threats Report, a study that stratified pathogens by level of risk and recommended steps to start tracking and improving appropriate antibiotic use across the country in an effort to lower resistance. In 2019, a follow-up study revealed that since implementing the 2013 recommendations, there were:
- 18% fewer deaths from antibiotic resistance overall
- 28% fewer deaths from AR in hospitals
While these numbers seem encouraging, the CDC still reports more than 2.8 million annual cases of antimicrobial resistant infections in the U.S., including notably rising rates of infections related to erythromycin resistant invasive group A Streptococcus, drug-resistant Neisseria gonorrhoeae, and ESBL-producing Enterobacteriaceae.
The best "D"-fense: Diagnosis, Dose, De-escalation, Duration
In the webinar, Wieczorkiewicz shares how the antimicrobial stewardship model of Diagnosis, Dose, De-escalation, Duration, guides how clinical drug guidance is formulated and vetted by Lexicomp® editors and experts. Heil shares what information and guidance she most needs at a patient bedside. She cited complex renal function and obesity/body weight and how those conditions can affect drug disposition and dosing. She values having fast access to central insights into dosing for those complex conditions.
Alvarez noted that working with pharmacists in practice like Heil was vital to developing a more effective drug information resource. "We particularly focus on gaining expert clinical insight from both pharmacists and physicians," he added. "And instead of just reporting the facts, we go beyond providing just the dose to really synthesizing the content with a goal of improving patient outcomes and providing you the information at your fingertips."