Learning Experiences Within Infectious Diseases Pharmacy Residency Programs in the United States: A Cross-Sectional Survey

Abstract

Background Pharmacists with residency training in infectious diseases (ID) optimize antimicrobial therapy outcomes in patients and support antimicrobial stewardship (AS) programs. Although most ID residencies are accredited and assessed by certain standards, the degree to which these programs are similar is not known. Methods A 19-item, cross-sectional, multicentered, electronic survey was distributed via e-mail to pharmacy residency program directors (RPDs) of all 101 second-year postgraduate (PGY-2) ID residency programs in the United States. Results Survey responses were collected from 71 RPDs (70.3%); 64.8% were associated with an academic medical center and 97.2% focused primarily in adult ID. Rotations in the microbiology laboratory, adult AS, and adult ID consult were required in 98.6% of residency programs. Only 28.2% of responding programs required pediatric AS and pediatric ID consult rotations. Programs at academic medical centers were more likely to offer immunocompromised host ID consult (P = .003), pediatric ID consult (P = .006), and hospital epidemiology (P = .047) rotations but less frequently offered outpatient AS (P = .003), viral hepatitis clinics (P = .001), and travel medicine clinics (P = .007) rotations compared to programs at nonacademic medical centers. Residents were frequently involved in AS committees (97.2%), pharmacokinetic dosing of antimicrobials (83.1%), precepting pharmacy trainees (80.3%), and performing research projects (91.5%). Conclusions The PGY-2 ID pharmacy residency programs demonstrated consistency in required adult ID consult, antimicrobial management activities, committee service, and teaching and research opportunities. Pediatric experiences were less common. The PGY-2 ID residency programs prepare pharmacists to become antimicrobial stewards for adult patients.

Role of infectious diseases pharmacists in outpatient intravenous and complex oral antimicrobial therapy: Society of Infectious Diseases Pharmacists insights

“…23,26,27 Most postgraduate year 2 (PGY2) ID residencies require a stewardship rotation and standalone stewardship programs are offered for pharmacists without specialized residency training. [28][29][30] OPAT/COpAT does not represent an exception from the practice of appropriate antimicrobial stewardship, and pharmacists are perfectly poised to implement elements of antimicrobial stewardship in this setting. Examples of how pharmacists can apply principles of antimicrobial stewardship within OPAT/COpAT include utilization of narrow-spectrum agents by continuous infusion to facilitate both ease of administration and optimization of pharmacodynamics targets, careful monitoring, and subsequent dosing adjustment of narrow spectrum agents which require therapeutic drug monitoring, or, when applicable, design of IV regimens that may be administered with hemodialysis in order to minimize the need for additional IV access and/or further health care exposure.…”

“…Currently, 47% of PGY2 residencies offer an OPAT experience and with a recently published blueprint for OPAT rotations, this is expected to increase. 28,31 Focus areas for OPAT training include inpatient, transitions of care, and outpatient patient experiences. In addition to the cognitive, clinical ID skills (the right drug, dose, duration, and route), communication and administrative skills are also enhanced.…”

“…Pharmacists are uniquely trained and play an integral role in the establishment and maintenance of antimicrobial stewardship programs (ASPs) in all settings 23,26,27 . Most postgraduate year 2 (PGY2) ID residencies require a stewardship rotation and standalone stewardship programs are offered for pharmacists without specialized residency training 28‐30 . OPAT/COpAT does not represent an exception from the practice of appropriate antimicrobial stewardship, and pharmacists are perfectly poised to implement elements of antimicrobial stewardship in this setting.…”

“…Compared with ID physician training programs, PGY2 ID residencies and fellowships offer unique OPAT training within their curriculum. Currently, 47% of PGY2 residencies offer an OPAT experience and with a recently published blueprint for OPAT rotations, this is expected to increase 28,31 . Focus areas for OPAT training include inpatient, transitions of care, and outpatient patient experiences.…”

A prescription for an outpatient parenteral antimicrobial therapy (OPAT) rotation for pharmacy residents

“…OPAT/COpAT programs are expanding, as are the opportunities for pharmacist employment therein. However, in a recent survey of residency program directors of postgraduate year 2 (PGY2) infectious diseases (ID) programs, less than half offered an OPAT rotation 6 . As these residencies specialize in ID, it is hypothesized that even fewer postgraduate year 1 (PGY1) residency programs offer these rotations.…”