ASHP 2019 News Network: Cost Reduction and New Options for CAP Treatment

Segment Description: Lisa Dumkow, PharmD, BCPS, BCIDP, clinical pharmacist, antimicrobial stewardship, Mercy Health Saint Mary's, discusses how to reduce costs of treating pneumonia and highlights new agents in the pipeline.

Interview transcript: (modified slightly for readability)

I think, for reducing the overall cost of pneumonia, we have to go back to preventing pneumonia. So vaccination is probably one of our most important things that we can do. As stewards and as patient advocates [we can] advocate for our patients to get the pneumococcal vaccine, as well as influenza vaccine seasonally. So again, just going back to a lot of those pneumonias are caused by viruses and just making sure that our patients are at their best level of health by being fully vaccinated would be probably the best thing that we can do in terms of reducing costs.

On a treatment standpoint, again, we need to be picking the most appropriate agent for our patients, as well as appropriate durations of therapy. So the new guidelines are very solid in terms of saying that 5 days of therapy is appropriate for most patients. And so actually in Michigan, HMS has been looking at Michigan data statewide and just showing that a lot of patients are receiving, you know, 2, 3, maybe even 4 days of excess antibiotics when they're discharged. And so reducing costs that way to making sure that patients are receiving just the minimum number of days that they need, not excess days on discharge.

So in terms of new antibiotics, lefamulin did just come out in the third quarter of this past year. So it's a novel antibiotic, a novel mechanism of action, something that we haven't seen before. So that is a potential new drug that we could use as monotherapy for community-acquired pneumonia. Other than that, there aren't a ton of new oral options for community-acquired pneumonia, but we still have our tried and true beta-lactam therapy. Targeting Streptococcus pneumoniae is our No. 1 pathogen so it's exciting to have a new agent and a non-fluoroquinolone agent as well so I will just say that for us as stewards and not having to reach for fluoroquinolones is a nice option.