Established in 2003, ASP is one of the most comprehensive programs in the country. It has successfully reversed resistance patterns, decreased inappropriate antimicrobial usage and lowered pharmacy costs.
Tufts MC's ASP closely works with the Massachusetts Department of Public Health, and its members, including ID fellows, regularly participate in statewide initiatives. These include a recent statewide educational program for hospitals interested in implementing antimicrobial stewardship and an initiative to improve the management of asymptomatic bacteriuria in the elderly.
Led by Shira Doron, MD, a graduate of the Tufts Infectious Diseases fellowship training program, and Maureen Campion, PharmD, a pharmacist with advanced training in infectious diseases and antimicrobials, the program offers opportunities for fellows to gain hands-on learning experience with close supervision. Maureen also rounds with fellows on the inpatient consult teams, providing the fellows with extra training in pharmacokinetics, pharmacodynamics and pharmacology.
All fellows participate in Antimicrobial Stewardship during their ID fellowship as a core training competency. Every fellow will have a closely supervised experience in approving restricted antimicrobials with feedback from the antimicrobial stewardship staff on this activity.
Fellows choosing this concentration will have a more intensive experience. In the end, they can implement and lead similar programs, making them highly desirable in the present infectious disease employment market. Many of our trainees have gone on to jobs where this skill has been well-utilized.
Educational experience
- We are developing educational materials for hospital staff and trainees on specific antimicrobial stewardship issues.
- Internal and external speaking opportunities promoting prudent antimicrobial use.
- They were prospectively evaluating and authorizing restricted antimicrobials on a routine basis.
- You are contributing to the annual revision of the Tufts MC "Antimicrobial Treatment and Dosing Guide" by developing clinical algorithms and treatment pathways.
- Leadership roles in hospital quality improvement task forces, allow fellows to have important input and to experience working in a multidisciplinary hospital team.
- Integral involvement in the Tufts Antimicrobial Stewardship Team, where key processes and execution of policies and practices are developed and implemented.
- Weekly journal club reviewing guidelines, articles and news at the forefront of antimicrobial stewardship.
- I participate in the Antimicrobial subcommittee of the Pharmacy and Therapeutics Committee at Tufts MC, a multidisciplinary group that discusses essential antimicrobial use.
- Participation in quarterly infection prevention meetings
- Participation in microbiology rounds
Research
For 2-year fellows and those interested and eligible for our 3-year Physician-Investigator track, many opportunities exist in antimicrobial stewardship-related research. Examples of recent projects include the effect of empiric therapy for neutropenic fever on C. difficile rates, implementation of an antimicrobial stewardship program in long-term care facilities and effect of mini-BAL results on de-escalation of antimicrobials for ventilator-associated pneumonia.
Antimicrobial stewardship is an exceptionally fertile area for QI/QA projects, and our fellows often choose projects from this area, even if not specifically enrolled in this concentration.
Teaching opportunities
Fellows in this track will have specific opportunities to develop their expertise as clinician educators. Teaching opportunities include leading small group discussions with pre-clinical medical students and lecturing to medical students on clinical rotations and housestaff.
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