In the spring of 2020, New York City quickly became a hotspot for the COVID-19 pandemic in the United States, putting a strain on local healthcare systems. Antimicrobial stewardship programs faced diagnostic and therapeutic uncertainties as well as healthcare resource challenges. With the lack of effective antivirals, antibiotic use in critically ill patients was difficult to avoid. Uncertainty drove antimicrobial use and thus antimicrobial stewardship principles were paramount. The dramatic influx of patients, drug and equipment shortages, and the need for prescribers to practice in alternative roles only compounded the situation.
The early response to the COVID-19 pandemic did not change our antimicrobial stewardship principles but instead changed our antimicrobial stewardship practices. As the COVID-19 pandemic continues, there is a strong need to study the impact of antimicrobial decision-making on outcomes, particularly antimicrobial resistance. In a study published in the American Journal of Health-System Pharmacy, these were the key take-aways:
- The COVID-19 pandemic has strained healthcare systems, including pharmacy departments and antimicrobial stewardship programs.
- Rapid changes in patient volume, shifts in diagnostics, therapeutic uncertainty, and practice changes have challenged antimicrobial stewardship programs.
- Pharmacists working as part of antimicrobial stewardship programs can prepare for these emergency situations by establishing enhanced communication channels, exploring optimal ways to disseminate information and educational material, developing antimicrobial stewardship alerts that are specific to the type of emergency, or using existing alerts to prioritize workflow, and leveraging the electronic medical record when possible.
It can be difficult to focus on anything but the pandemic, even now as things are quieting down, we are all on guard. That said, antibiotic stewardship is a must, we can’t let our guard down and allow overuse of these medications without expecting a negative impact in the future. We utilized the resources we thought would be helpful during the pandemic and now we need to refocus on the task at hand, preventing antibiotic-resistant organisms from multiplying and affecting our residents. The study is interesting and a worthwhile read! Stay well, roll up your sleeves and stay tuned!