Tuesday, April 29, 2014

Rotation 7: Infectious Diseases – St. Joseph Mercy Hospital, Ann Arbor, MI

Posted by Jennifer at Tuesday, April 29, 2014

During pharmacy school, I found that the one of the most difficult therapeutic areas was infectious diseases (ID), primarily due to the many different antibiotics which each cover different types of infections.  I knew that I wanted to strengthen my knowledge in this area, so I was very glad to be matched to an ID antimicrobial stewardship rotation.

What is an antimicrobial stewardship?  It has several purposes, including making sure that antimicrobials are being used correctly (best drug, appropriate dose, route of administration, and duration of therapy), so that the best patient outcomes may be obtained while minimizing adverse drug effects.  Other purposes include decreasing hospital stays, decreasing costs, and limiting the ever-increasing antimicrobial resistance to antibiotics.  In an effort to help with these goals, some antimicrobials are restricted, meaning that there are certain criteria that a patient must satisfy in order to be able to receive a  drug.  For example, perhaps a patient needs to have tried and failed a few other antibiotics before resorting to a stronger antibiotic.  These rules are in place for the benefit of the patient and for helping to manage antibiotics appropriately.

My day would start out at the hospital looking at computer profiles of patients who had an infection.  I would find out what infection they were suspected/determined to have and then look at the current antimicrobial therapy and determine if therapy was appropriate.  I would try to determine if there was a better, more optimal regimen and then meet with my preceptor and a PGY1 resident later on to discuss the patients.  We also had specific valuable topic discussions about specific diseases and their treatments.  Later on in my rotation, I went on ID rounds with the ID team and visited the patients whose medication profiles I was monitoring. 

I definitely improved my ID knowledge while on this rotation, but there is of course much more to learn!  It was great to see first-hand how an antimicrobial stewardship works.

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