Miranda So, BScPhm, PharmDWieczorkiewicz SM, Sincak CA. ASHP Publications, Bethesda, Maryland, 2016. ISBN 978-1-58528-519-8. Softcover, 228 pages. US$26 for ASHP members ($33 for nonmembers).
The Pharmacist’s Guide to Antimicrobial Therapy and Stewardship is a user-focused reference. Coauthored by an infectious diseases pharmacist and a professor of pharmacy practice at Midwestern University Chicago College of Pharmacy, it provides foundational knowledge on infectious diseases management, antimicrobial therapy, and stewardship interventions. This book will be a welcome resource for practising pharmacists, given the urgent need to use antimicrobials judiciously.
The book is divided into the following 5 parts: (I) How to evaluate a potentially infected patient; (II) What is the suspected source of infection and what organisms are typically associated with infection at this site? (III) What anti-infectives provide adequate coverage for the suspected infection? (IV) What patient-or disease state-specific factors affect your decision? and (V) What antimicrobial stewardship interventions can be made on reassessment and what needs to be monitored?
Part I provides a general approach to the patient, based on physical assessment, laboratory results, and imaging studies. It reviews colonization, infection, and contamination, as well as noninfectious causes of signs and symptoms bearing similarities to an infection. The overview of clinically significant organisms, with recommended antimicrobials, interpretation of antibiograms, and microbiology susceptibility, is particularly helpful. Part II focuses on the management of commonly encountered infections, with recommendations on dosing and duration and “clinical pearls”. Part III is a concise but detailed overview of antimicrobial pharmacology. Part IV presents miscellaneous topics that will affect the selection of antimicrobial regimens, including β-lactam allergy, renal dosing adjustment, and pharmacokinetic and pharmacodynamic concepts. Part V is dedicated to implementation of antimicrobial stewardship clinical interventions.
Wieczorkiewicz and Sincak have created a practical guide targeting a wide spectrum of readers, expertly balancing a broad scope with concise but pertinent details. New practitioners, pharmacy trainees, clinical pharmacists wishing to refresh their knowledge of infectious diseases management, and those practising in antimicrobial stewardship will find it beneficial. For me, the authors’ recommended patient care approach to infectious diseases management (Part I) is the key “take-away” of this book. Conversely, the evolving nature of both infectious diseases and antimicrobial therapy means there is a risk that many of the book’s recommendations will soon become outdated, as new practice-changing evidence continues to emerge. Nonetheless, the reader can supplement this book’s foundational material with regularly updated point-of-care references.
One minor criticism is that materials on the leadership skills of the antimicrobial stewardship pharmacist are scant: contributions from the pharmacist are focused on clinical interventions and provision of pharmacy data. Program development, implementation, and quality improvement methodology are briefly mentioned, but not with the pharmacist as a leader. Although there is a small section on performance measurements, it does not educate the reader to interpret and utilize the data to improve, sustain, or further develop an antimicrobial stewardship program.
I would recommend this reference to readers who wish to learn or refresh their knowledge of infectious diseases and antimicrobial therapy. Pharmacists pursuing antimicrobial stewardship will find it to be an excellent launching pad for further exploration.
Competing interests: None declared. ( Return to Text )
The Pharmacist’s Guide to Antimicrobial Therapy and Stewardship and other ASHP and Pharmaceutical Press products and publications are available to CSHP members at a reduced rate through CSHP’s website, www.cshp.ca/. A password is needed, which can be accessed by selecting the “Products and Publications” tab on the CSHP homepage. From there, please scroll down to “Products and Other Publications” and select “ASHP/Pharmaceutical Press”. Members will be asked to log in before being allowed to proceed to CSHP’s virtual bookstore. ( Return to Text )
Canadian Journal of Hospital Pharmacy, VOLUME 70, NUMBER 2, March-April 2017