A multicenter case series of 21 patients were treated with imipenem-cilastatin-relebactam. There were mixed infection sources, with pulmonary infections (11/21,52%) composing the majority. The primary pathogen was Pseudomonas aeruginosa (16/21, 76%), and 15/16 (94%) isolates were multidrug-resistant. Thirty-day survival occurred in 14/21 (67%) patients. Two patients experienced adverse effects.

The use of long-acting lipoglycopeptides (LaLGPs) in serious, deep-seated infections is of increasing interest. The purpose of this study is to evaluate the economic and clinical utility of LaLGPs in patients requiring protracted antibiotic courses who are not ideal candidates for oral transition or outpatient parenteral antibiotic therapy (OPAT). This is a retrospective, observational, matched cohort study of adult patients who received a LaLGP. Patients were matched 1:1 to those who received standard of care (SOC). Cost effectiveness was evaluated as total healthcare-related costs between groups. Clinical failure was a composite endpoint of mortality, recurrence, or need for extended antibiotics beyond planned course within 90 days of initial infection. There was no difference in clinical failure between the two cohorts (22% vs. 30%; p = 0.491). Six patients in the SOC cohort left against medical advice (AMA) prior to completing therapy. Among those who did not leave AMA, receipt of LaLGPs resulted in a decreased hospital length of stay by an average of 13.6 days. The average total healthcare-related cost of care was USD 295,589 in the LaLGP cohort compared to USD 326,089 in the SOC cohort (p = 0.282). Receipt of LaLGPs may be a beneficial treatment option for patients with deep-seated infections and socioeconomic factors who are not candidates for oral transition or OPAT.

Introduction The National Academy of Medicine (NAM; formerly the Institute of Medicine) recommends multidisciplinary authorship as a standard for developing trustworthy guideline panels. The purpose of this study is to describe pharmacist authorship on clinical practice guideline (CPG) expert panels. Methods Guidelines published between January 1, 2010 and December 31, 2016 and were available in the Agency for Healthcare Research and Quality National Guideline Clearinghouse database were eligible for study inclusion. Only guidelines with pharmacotherapeutic recommendations were included. The primary end point was the proportion of pharmacist authorship on national CPGs. Pharmacist authorship by specialty area and characteristics of pharmacist authors were described. Results Of the 143 guidelines included, 58 (40.6%) had at least one pharmacist author. Guidelines developed by the Veterans Affairs/Department of Defense (VA/DoD; n = 7) and the Clinical Pharmacogenetics Implementation Consortium (CPIC; n = 13) always included at least one pharmacist. Excluding VA/DoD and CPIC guidelines, the proportion of pharmacist authorship was 30.9% (38/123). A pharmacist served as the first, senior, and/or corresponding author on 19% (27/143) of CPGs. There were 1919 total authors with an average of 13.4 (+7.4) authors per guideline. Pharmacists represented 6.8% (130/1919) of all authors, and 83 were unique pharmacist authors. Critical care, emergency medicine, and adult internal medicine guidelines had the largest proportion of pharmacist authorship, while oncology and pediatric guidelines had the smallest. Pharmacy organizations sponsored or endorsed 5.2% (3/58) of CPGs with a pharmacist author. Conclusion The majority of CPGs in this cohort did not include a pharmacist in the authorship and when included, was often limited to a single pharmacist. It is imperative for pharmacy organizations to collaborate with sponsoring medical organizations and position clinical pharmacists to serve as expert members on CPGs consistent with NAM recommendations.

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