Teamwork Makes the Dream Work

I have always disliked that corny expression because I am not fond of forced motivational phrases. However, as I write my column for this issue of Contagion^®, I find myself thinking about this managerial catch phrase, given a recent white paper and the response it generated among the infectious diseases (ID) community.^1,2

“Antimicrobial stewardship” is obviously a hot term in ID at the moment. Authors find ways to mention terms like this in papers, hoping to catch an editor’s eye; speakers present graphs showing its prevalence in Medline searches by year; and fully integrated ID news resources create “Stewardship and Prevention” sections to ensure that it is comprehensively addressed within their pages. The attention is justified, given the rise in antibacterial resistance and the fact that antibiotic development is not where we need it to be. Accrediting bodies and government organizations have responded with new standards and guidance for health care organizations, which have scrambled to get up to par.^3-5

A multitude of vested professionals need to be at the table for antimicrobial stewardship programs to work. Many of these programs have been started and led by ID pharmacists, often with the support of ID physicians, and vice versa. The push for widespread adoption of stewardship programs has come from both professions. Some stewardship pharmacists work in jobs to implement programs initiated by ID physicians, and some ID physicians are compensated for their stewardship activities through business plans driven by pharmacy departments looking for support. In the vernacular of ID, it really is a synergistic combination, sometimes both clinically and economically.

Although a few recent publications may have distracted from the focus on how this synergy works as groups advocate for their own professions,^1,6 I expect that we will continue to see stewardship programs evolve and expand in ways that meet the needs of our patients regardless of what stakeholders put into print. The rise of ID pharmacy as a profession has been complementary to services uniquely offered by ID physicians, not in competition with them. Together, we lead stewardship programs,⁷ educate ID trainees,⁸ and improve patient care.^4,5

Teamwork really does…well, you know.

Jason C. Gallagher, PharmD, FCCP, FIDSA, BCPS

Editor-in-Chief

Contagion^®

References

1. Ostrowsky B, Banerjee R, Bonomo RA, et al; Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and the Society for Healthcare Epidemiology of American. Infectious diseases physicians: leading the way in antimicrobial stewardship. Clin Infect Dis. 2018;66(7):995-1003. doi: 10.1093/cid/cix1093.
2. Dodds Ashley E, Davis SL, Heil EL, LaPlante KL, Chahine EB, Bosso JA. Best care for patients is achieved through multi-disciplinary stewardship [published online May 15, 2018]. Clin Infect Dis. doi: 10.1093/cid/ciy392.
3. Joint Commission on Hospital Accreditation. APPROVED: new antimicrobial stewardship standard. Jt Comm Perspect. 2016;36(7):1,3-4,8.
4. CDC. Core elements of hospital antibiotic stewardship programs. CDC website. cdc.gov/antibiotic-use/healthcare/implementation/core-elements.html. Updated February 23, 2017. Accessed May 23, 2018.
5. National Quality Partners Playbook: Antimicrobial Stewardship in Acute Care. National Quality Forum website. qualityforum.org/Publications/2016/05/National_Quality_Partners_Playbook__Antibiotic_Stewardship_in_Acute_Care.aspx. Published May 2016. Accessed May 23, 2018.
6. Bush LM, Kaye D. Optimizing antimicrobial utilization: job of a steward, or time for a pilot? Clin Infect Dis. 2017;65(9):1595. doi: 10.1093/cid/cix530.
7. Pollack LA, van Santen KL, Weiner LM, Dudeck MA, Edwards JR, Srinivasan A. Antibiotic stewardship programs in U.S. acute care hospitals: findings from the 2014 National Healthcare Safety Network Annual Hospital Survey. Clin Infect Dis. 2016;63(4): 443-449. doi: 10.1093/cid/ciw323.
8. Morgan JR, Barlam TF, Drainoni M. A qualitative study of the real world experiences of infectious diseases fellows regarding antimicrobial stewardship [published online May 3, 2018]. Open Forum Infect Dis. doi: 10.1093/ofid/ofy102.