Dr. Keith Kaye Flips the Script Providing a Physicians’ View on Pharmacists Essential Role in Antibiotic Stewardship
How can pharmacists and physicians best collaborate to improve antibiotic use and prevent the spread of antibiotic resistance?
Pharmacists provide excellent insight and synergy in many ways to physicians. I personally find pharmacist input related to dosing, safety, and drug-drug interactions particularly useful and complementary. Focus on shortening duration of therapy is another synergistic opportunity that physicians and pharmacists can collaborate on together.
What stewardship initiative or antibiotic awareness effort are you most proud of that you have participated in with pharmacist team members?
At the Detroit Medical Center, we demonstrated that real-time alerting to stewardship pharmacists regarding Gram-negative bloodstream infection results improved patient outcomes.
Have you measured the impact of this initiative; if so, what has the impact been; if not what are you planning to assess and/or expect to find?
We published the impact. Patients with stewardship team intervention had decreased time to appropriate therapy, reduced length of stay, and less infection-related mortality.
Have you seen the role of the pharmacist in antimicrobial stewardship efforts evolve over the last 10 years?
Definitely. Pharmacists are much more accepted as clinical team members and increasingly recognized as quality improvement professionals. In places where I have recently worked, stewardship pharmacists are sought after for input and advice, and valued a great deal. They are valuable consultants and advisors.
Where do you see the role of the ID pharmacist going in the next five to 10 years, and how can we further enhance collaborations between ID pharmacists and physicians?
I think ID pharmacists should be more openly and concretely included in Quality and Patient Safety initiatives. They have unique knowledge and skills that can be leveraged on a broader scale in the Quality world.
What practice setting has the most urgent need for pharmacist and physician collaboration to improve antibiotic use?
I think long-term care – particularly Long-Term Acute Care (LTAC) hospitals – need ID pharmacist expertise and input. Combined efforts there between physicians (ideally ID specialists) and ID pharmacists could lead to more effective choice of antibiotics, optimal dosing, decreased duration of therapy, and improved safety and clinical outcomes.
Keith Kaye, MD, MPH
Professor, Infectious Diseases
University of Michigan Medicine