Incorporating physical manipulatives into an integrated pharmacotherapy course to reinforce antimicrobial spectrum of activity.

BACKGROUND AND PURPOSE: Teaching and learning the spectrum of activity (SOA) of antimicrobial agents can be a challenge in pharmacy education. This study describes the implementation and assessment of a novel tool to aid in the instruction of SOA. Physical manipulatives were used as an active-learning technique to model bacterial pathogens for antimicrobial SOA in an infectious diseases (ID) integrated medication therapy management course. EDUCATIONAL ACTIVITY AND SETTING: Pharmacy students enrolled in two consecutive years of the ID course were provided the opportunity to utilize a set of manipulatives for in-class activities and out-of-class practice. The manipulatives were small, colored building blocks that could be used to model bacterial pathogens for antimicrobial SOA. A key was included with each set of blocks, color-coding each block to represent a different bacterial pathogen or pathogen group. Blocks were used during classroom instruction to model the SOA of antimicrobial agents, compare/contrast SOA between medications, and model bacterial pathogens requiring empiric coverage for various infections, allowing students to produce "bug-drug" matches. Course data from the previous year was utilized to compare pre-implementation aggregate performance with post-implementation data. Performance on SOA-related questions was assessed during the course, using an independent samples t-test. FINDINGS: The intervention group exhibited a statistically significant increased mean score on test questions relating to SOA as compared to the control group. SUMMARY: The use of manipulatives was associated with improved performance on SOA-related questions in an integrated ID course of pharmacy students.

Evaluation of Antibiotic Utilization in a Rural, Outpatient Clinic: An Antimicrobial Stewardship Initiative.

BACKGROUND: Antibiotics are commonly prescribed for uncomplicated urinary tract infection (UTI) and acute otitis media (AOM) and may be unnecessary at times. The aim of this study was to evaluate prescribing practices for UTIs and AOM in a rural ambulatory care setting and to identify areas for improvement. METHODS: In a single-center, retrospective review conducted at a rural clinic, patients diagnosed with uncomplicated UTI and AOM were included. Patients were identified by International Classification of Diseases, Tenth (ICD-10) codes, and data were collected for visits between January 1, 2017, and December 31, 2017. The primary outcome was to assess adherence of antimicrobial prescribing to current treatment guidelines. RESULTS: Of the 76 patients identified, 28 met inclusion criteria. Of the 28 patients, 75% received an agent recommended first line in the treatment guidelines, and 18 of the 21 received a recommended dose. Only 17% of patients were prescribed an appropriate duration of treatment. CONCLUSION: Opportunities exist for antimicrobial stewardship interventions for uncomplicated UTIs and AOM. Prescribers are not consistently adhering to guidelines in regard to antibiotic choice, dose, or duration. Additional education and stewardship interventions are crucial considering the increased prevalence of antimicrobial resistance.