May 22 is Infectious Diseases Pharmacists Day intended to recognize ID pharmacists and their impact on patient care and contributions to the health care team. This year’s theme for ID Pharmacists Day is deprescribing antibiotics amid COVID-19. To understand the role of ID pharmacists and what patients can do to protect their health, we speak to our very own infectious diseases expert and assistant professor at the college, Dana Bowers.
What does an infectious diseases (ID) pharmacist do and how do they differ from other pharmacists?
ID pharmacists focus on the appropriate use of antibiotics. We make sure that when patients are prescribed an antibiotic, that it is the correct one for their infection. We help select antibiotics that will treat the infection safely and effectively. Most ID pharmacists are located in hospitals, but we are moving more into clinics and other outpatient settings. ID pharmacists have specialized training in infectious diseases and antibiotics that is above what a general pharmacist receives.
How did you become interested in becoming an ID pharmacist and what is your experience?
I have been interested in ID ever since pharmacy school. After graduation, I completed a one-year general pharmacy residency in a hospital, then I completed a two-year clinical research fellowship in infectious diseases. During my fellowship, I took care of hospitalized patients and did research in a lab investigating novel combinations of antibiotics to treat multi-drug resistant bacteria or “super bugs.” Currently, I teach infectious diseases to pharmacy students during their third year. Students are taught common infectious diseases that they will encounter like bladder, lung and skin infections and the most appropriate treatment for these diseases.
What is antimicrobial stewardship in laymen’s terms and why is it the focus of ID pharmacists?
Antimicrobial stewardship is ensuring that antibiotics are used appropriately. This includes starting the correct antibiotic for the most likely bacteria causing the infection, while minimizing patient harm. Additionally, this includes stopping antibiotics when they are unlikely to benefit the patient, such as in viral infections. This is the focus of ID pharmacists, because antibiotics are frequently prescribed inappropriately which can result in patient harm and contribute to the development of antibiotic resistance. When resistance occurs, we are left with limited treatment options or there aren’t any antibiotics left that can kill the bacteria.
Can you tell us about the 2022 theme (Deprescribing antibiotics in COVID-19) and why it is important?
Antibiotics are not helpful for treating viral infections. As COVID is the most prominent viral infection in recent history, various treatment options have been suggested that are not supported by evidence-based medicine. Some of these medications have not been shown to be effective and can harm patients. As an ID pharmacist, is it important to me that patients use antibiotics when they are safe and effective. Part of the role of an ID pharmacist is to help provide reliable, evidence-based education to both patients and other health care professionals.
What sort of questions can a patient ask their pharmacist and physician to ensure that they are receiving the right treatment/ not being overprescribed antibiotics?
I think that it is important for patients to be actively involved in their care. We call this “shared clinical decision making.” If patients would like to have a discussion with their health care provider about the appropriate use of antibiotics, here are some questions to ask a health care provider:
- Are antibiotics necessary for this condition?
There have been studies done that if a health care provider thinks that a patient wants antibiotics (regardless of whether the patient actually does) they are more likely to prescribe antibiotics. By patients asking this question, it opens up a dialogue if the provider was prescribing an antibiotic because that is what they thought the patient wanted or they were unsure of the diagnosis. Some infections can be caused by both viruses and bacteria, like upper respiratory tract infections – it is most likely a virus, but sometimes antibiotics are prescribed just in case (which is not appropriate).
- What are some other things, besides antibiotics, that I can do to help me feel better?
I think that this empowers patients to participate in their own health care. Some typical responses to this question include non-pharmacological treatments (rest, fluids, etc.) and over-the-counter medications (Tylenol or ibuprofen) that can help treat the symptoms.
- What I can I do to prevent this from occurring the in future?
This also engages patients/providers into good hygiene practices or vaccines if available.