Navigating the Muddled Middle: A Case-Based Exploration of Oral β-Lactams for Systemic Gram-Negative Infections.

Oral β-lactams are frequently referred to as low bioavailability agents that are inferior in the treatment of systemic gram-negative infections. This notion limits their utility beyond their use. The pharmacokinetic/pharmacodynamic profiles of oral β-lactams differ among agents, and each agent must be considered individually in the context of the patient.

Antimicrobial Stewardship and Beyond: The Many Essential Roles of Infectious Diseases Pharmacists.

Infectious diseases (ID) pharmacists are experts in antimicrobial pharmacology and pharmacotherapy and have the training and expertise for collaborative patient care with ID providers. Although ID pharmacists are recognized as key members of antimicrobial stewardship (AS) programs, this is not where the specialty began, and ID pharmacists fill multiple other roles beyond AS. The specialty of ID pharmacy initially arose as a form of consultancy for complex antimicrobial use cases.

Effectiveness of ceftazidime-avibactam versus ceftolozane-tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study.

Background: Ceftolozane-tazobactam and ceftazidime-avibactam are preferred treatment options for multidrug-resistant Pseudomonas aeruginosa infections; however, real-world comparative effectiveness studies are scarce. Pharmacokinetic and pharmacodynamic differences between the agents might affect clinical response rates. We aimed to compare the effectiveness of ceftolozane-tazobactam and ceftazidime-avibactam for treatment of invasive multidrug-resistant P aeruginosa infections.

Student Performance Outcomes and Perceptions in Two Content Areas in Conventional Versus Integrated Pharmacy Curricula.

To compare student performance measures and perceptions of learning in 2 content areas, conventional and integrated pharmacy curricula, at a single institution. Prospective cohort study of pharmacy students enrolled in either conventional (cohort C) or integrated (cohort I) curricula. Summative examination performance in the neuropsychiatric and infectious diseases courses, student self-rating of confidence and comfort in integrating and applying knowledge, and performance on a delayed knowledge assessment were compared between cohorts.

Changes in Pharmacy Students' Self-Reported Learning Strategies Across a Four-Year Doctor of Pharmacy Program.

Few studies describe changes in students' class preparation, note-taking, and examination preparation over the course of professional school. This study aims to describe the use of these learning and study strategies by pharmacy students and to analyze changes during their education. We performed a prospective, observational cohort study of students at a single US pharmacy school from 2016-2019.

Longitudinal study of grit among pharmacy students: Impact of cohort and professional year.

Introduction: Whether grit changes over a student's enrollment in health professions school is unknown. We aimed to measure grit across 13 cohort-years of students in a four-year doctor of pharmacy (PharmD) program.

Methods: We administered the Short Grit Scale (Grit-S) to first-year (P1), second-year (P2), third-year (P3), and fourth-year (P4) PharmD students between 2016 and 2019.

Systematic review of drug-drug interactions between rifamycins and anticoagulant and antiplatelet agents and considerations for management.

Rifamycins (rifampin, rifabutin, and rifapentine) play an essential role in the treatment of mycobacterial and some nonmycobacterial infections. They also induce the activity of various drug transporting and metabolizing enzymes, which can impact the concentrations and efficacy of substrates. Many anticoagulant and antiplatelet (AC/AP) agents are substrates of these enzymes and have narrow therapeutic indices, leading to risks of thrombosis or bleeding when coadministered with rifamycins.

Evaluation of the Infectious Diseases Society of America's Core Antimicrobial Stewardship Curriculum for Infectious Diseases Fellows.

Background: Antimicrobial stewardship (AS) programs are required by Centers for Medicare and Medicaid Services and should ideally have infectious diseases (ID) physician involvement; however, only 50% of ID fellowship programs have formal AS curricula. The Infectious Diseases Society of America (IDSA) formed a workgroup to develop a core AS curriculum for ID fellows. Here we study its impact.

Investing in the Future: A Role for Professional Societies to Prepare the Next Generation of Healthcare Leaders Through Curriculum Development and Dissemination.

Professional societies serve many functions that benefit constituents; however, few professional societies have undertaken the development and dissemination of formal, national curricula to train the future workforce while simultaneously addressing significant healthcare needs. The Infectious Diseases Society of America (IDSA) has developed 2 curricula for the specific purpose of training the next generation of clinicians to ensure the future infectious diseases (ID) workforce is optimally trained to lead antimicrobial stewardship programs and equipped to meet the challenges of multidrug resistance, patient safety, and healthcare quality improvement. A core curriculum was developed to provide a foundation in antimicrobial stewardship for all ID fellows, regardless of career path.

A Randomized, Crossover Pilot Study of a Novel Web-Based/Mobile Platform for Collaborative Small Group Practice in Therapeutic Reasoning.

Background And Purpose: Therapeutic reasoning-the mental process of making judgments and decisions about treatment-is developed through acquisition of knowledge and application in actual or simulated experiences. Health professions education frequently uses collaborative small group work to practice therapeutic reasoning. This pilot study compared the impact of a web-based/mobile tool for collaborative case work and discussion to usual practice on student perceptions and performance on questions designed to test therapeutic knowledge and reasoning.

A Comprehensive Survey of Infectious Diseases Curriculum Among US Pharmacy Schools.

To describe what and how infectious diseases (ID) topics are taught in US schools of pharmacy and summarize pharmacy faculty members' and students' perceived successes and challenges in teaching and learning about ID. A 23-item survey instrument was distributed electronically to ID faculty members at 137 US pharmacy schools. Data collected included curricular hours and format, topics covered, active-learning strategies, and curricular successes and concerns.

Longitudinal Associations Between Grit, Academic Outcomes, and Residency Match Rates Among Pharmacy Students.

To characterize Grit-S scores in pharmacy students, determine whether Grit-S scores change within individual pharmacy students and cohorts over time, and investigate the relationship between Grit-S scores, academic outcomes, and professional outcomes. A survey was conducted in fall 2016 and again in fall 2017 to determine Grit-S scores in first- through fourth-year pharmacy students. Participant demographic variables, grade point average (GPA), advanced pharmacy practice experience (APPE) ratings, and residency match results were collected.

Recognizing and Overcoming Resistance to New Beta-Lactam/Beta-Lactamase Inhibitor Combinations.

Purpose Of Review: To describe the mechanisms and clinical relevance of emergent resistance to three recently introduced beta-lactamase inhibitor combinations (BLICs) active against resistant Gram-negative organisms: ceftolozane-tazobactam, ceftazidime-avibactam, and meropenem-vaborbactam.

Recent Findings: Despite their recent introduction into practice, clinical reports of resistance to BLICs among typically susceptible organisms have already emerged, in some cases associated with therapeutic failure. The resistance mechanisms vary by agent, including mutations in beta-lactamase active sites, upregulation of efflux pumps, and alterations in the structure or expression of porin channels.

Comprehensive Assessment of Didactic Curriculum and Career Interest in Infectious Diseases Among Graduating United States Pharmacy Students.

Background: The growing need for clinicians with antimicrobial stewardship (AS) skills has resulted in an examination of educational methods for pharmacy and medical learners. This study explores characteristics associated with student assessment of didactic infectious diseases (ID) education quality and variables associated with a career interest in ID and/or AS.

Methods: Infectious diseases faculty from US pharmacy schools were sent a 15-question survey in September 2017.

Preventing the Post-Antibiotic Era by Training Future Pharmacists as Antimicrobial Stewards.

Antimicrobials enable modern medicine, but their efficacy is a limited resource. In the past 20 years, antimicrobial development has slowed dramatically while antimicrobial resistance continues to rise. In response to this, there has been an increased focus on strategically managing antimicrobial use with an approach called "antimicrobial stewardship.

Multidrug-Resistant Pseudomonas Infections: Hard to Treat, But Hope on the Horizon?

Purpose Of Review: As the sixth most common nosocomial pathogen in the USA, Pseudomonas aeruginosa poses a significant threat to patients within the healthcare system. Its intrinsic and acquired resistance mechanisms also significantly limit the choices for antimicrobial therapy, prompting an increase in the research and development of antibacterial agents with enhanced activity against multidrug-resistant (MDR) P. aeruginosa.

Antimicrobial stewardship education in US colleges and schools of pharmacy.

Background: Pharmacists are key members of antimicrobial stewardship (AS) teams. It is unknown if and how US colleges and schools of pharmacy incorporate AS into their Doctor of Pharmacy (PharmD) curricula.

Methods: This study was a cross-sectional, multicentre, electronic survey distributed to infectious diseases faculty or department chairs of 137 accredited and candidate-status PharmD programmes.

An Interprofessional Curriculum on Antimicrobial Stewardship Improves Knowledge and Attitudes Toward Appropriate Antimicrobial Use and Collaboration.

Background: Inappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare.

A Novel Teaching Tool Combined With Active-Learning to Teach Antimicrobial Spectrum Activity.

To design instructional methods that would promote long-term retention of knowledge of antimicrobial pharmacology, particularly the spectrum of activity for antimicrobial agents, in pharmacy students. An active-learning approach was used to teach selected sessions in a required antimicrobial pharmacology course. Students were expected to review key concepts from the course reader prior to the in-class sessions.

Sustainable Pharmacy: Piloting a Session on Pharmaceuticals, Climate Change, and Sustainability within a U.S. Pharmacy Curriculum.

Objective: To design and assess an innovative session for pharmacy students that addresses the role of pharmaceuticals with climate change and sustainability.

Innovation: One hundred and sixteen third-year students at the University of California, San Francisco School of Pharmacy participated during their required Health Policy course. This 3-hour session included guided pre-course activities, an interactive lecture, a panel of healthcare professionals discussing complex decision-making and small group case-based learning.