High prevalence of clinical MRSA strains with elevated vancomycin MIC (2 microg/mL) requires aggressive empirical vancomycin dosing to achieve a trough greater than 15 microg/mL. Combination or alternative therapy should be considered for invasive infections caused by these strains.

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Objectives. To assess the association of pharmacy students' personal characteristics with absenteeism and academic performance. Methods. A survey instrument was distributed to first-(P1) and second-year (P2) pharmacy students to gather characteristics including employment status, travel time to school, and primary source of educational funding. In addition, absences from specific courses and reasons for not attending classes were assessed. Participants were divided into "high" and "low" performers based on grade point average. Results. One hundred sixty survey instruments were completed and 135 (84.3%) were included in the study analysis. Low performers were significantly more likely than high performers to have missed more than 8 hours in therapeutics courses. Low performers were significantly more likely than high performers to miss class when the class was held before or after an examination and low performers were significantly more likely to believe that participating in class did not benefit them.Conclusions. There was a negative association between the number of hours students' missed and their performance in specific courses. These findings provide further insight into the reasons for students' absenteeism in a college or school of pharmacy setting.

The antibiogram is an essential resource for institutions to track changes in antimicrobial resistance and to guide empirical antimicrobial therapy. In this Viewpoint, data and examples from literature are presented that suggest institutions have not completely adopted the standardized approach in developing antibiograms, as variations in the development methodologies of antibiograms exist despite consensus guidelines (M39) published by CLSI. We emphasize developing antibiograms in line with the M39 recommendations will help ensure that they are accurate, reliable and valid, and highlight that understanding the limitations of antibiogram data is critical to ensuring appropriate interpretation and application to clinical decision-making. We also stress the importance of easy accessibility and education on antibiogram use, to allow for prescribers to select the most optimal empirical treatment regimens and propose the creation of an abbreviated antibiogram for frontline users. Multidisciplinary antimicrobial stewardship programmes are vital to accomplishing these goals.

The rapid evolution of resistance, particularly among Gram-negative bacteria, requires appropriate identification of patients at risk followed by administration of appropriate empiric antibiotic therapy. A primary tenet of antimicrobial stewardship programs (ASPs) is the establishment of empiric antibiotic recommendations for commonly encountered infections. An important tool in providing empiric antibiotic therapy recommendations is the use of an antibiogram. While the majority of institutions use a traditional antibiogram, ASPs have an opportunity to enhance antibiogram data. The authors provide the rationale for why ASPs should implement alternative antibiograms, and the importance of incorporating an antibiogram into clinical decision support systems with the goal of providing effective empiric antibiotic therapy.