Gauthier is passionate about IDstewardship and enjoys providing antibiotic expert information through writing in his free time as a creative outlet.
Gauthier provides insight into the global spread of antimicrobial resistance and the importance of reducing unnecessary antimicrobial use whenever possible by getting the right diagnosis, right drug, right dose, and right duration of treatment for infections. Antibiotics should not be prescribed when they are not needed, and when they are indicated, it is crucial to use them wisely. Pharmacists can play an important role in antimicrobial stewardship programs, and Gauthier contributed to the Society of Infectious Diseases Pharmacists outpatient care position statement on the topic.
“Pharmacists can promote awareness of the current antimicrobial resistance problems and encourage safe antimicrobial drug use. As a trusted member of society, pharmacists are well positioned to help (especially in this time where misinformation is so prolific on social media),” says Gauthier. “Pharmacists can also use their pharmacotherapy and healthcare systems expertise to improve care. This can be through developing resources, improving elements of practice, or making patient-specific interventions.”
Gauthier also discussed the future of antimicrobial stewardship and how the programs will continue to develop and expand as organizations such as The Joint Commission are making this a priority to fight antimicrobial resistance.
“I believe pharmacists in all practice settings will play an increasingly important role in formalized antimicrobial stewardship program activities, and I hope IDstewardship can continue to be a valuable resource as this occurs,” says Gauthier.
Lily Garcia, PharmD, BCPS, is an infectious diseases clinical pharmacist specialist at Broward Health Medical Center (BHMC), in Ft. Lauderdale, FL. Garcia described that the antimicrobial stewardship program at BHMC aims to meet all of the seven core elements recommended by the CDC and includes pharmacists and physicians leading the program. Pharmacists provide their drug expertise to prescribers and perform daily interventions such as IV to oral dose conversions, renal dose adjustments, and vancomycin/aminoglycoside monitoring. “As an infectious diseases clinical specialist, I have an active role in new policy development and implementation as well as tracking and reporting of antimicrobial prescribing practices. I monitor hospital-wide antimicrobial use to ensure appropriate utilization of high cost/restricted antimicrobials and serve as a resource to my colleagues and physicians for appropriate prescribing and monitoring,” says Garcia.
Garcia is involved in training students and residents on clinical rotations. “The overuse and misuse of antimicrobials secondary to a lack of practitioner education and unlimited access to broad spectrum antibiotics are the greatest factors contributing to antimicrobial resistance.”
The decentralized pharmacist model at BHMC enables pharmacists to actively educate prescribers in real time about appropriate antimicrobial use. Garcia helped to develop hospital acquired infections (HAI) performance improvement committees that review patients with HAIs and provide guidance on how to manage these cases. Hospital staff are also provided with education through newsletters that include important information regarding antibiotic resistance, policy updates, and restricted antimicrobials.
1. Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016;315(17):1864-1873.
2. Mody L, Washer LL, Kaye KS, et al. Multidrug-resistant organisms in hospitals: what is on patient hands and in their rooms? Clin Infect Dis. [Published April 13, 2019 ahead of print]. doi: 10.1093/cid/ciz092.
3. Core elements of hospital antibiotic stewardship programs. CDC website. https://www.cdc.gov/antibiotic-use/healthcare/implementation/core-elements.html. Accessed June 19, 2019.