Staying current on literature related to antimicrobial stewardship can be challenging given the ever-increasing number of published articles. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship–related peer-reviewed literature that detailed an actionable intervention for 2019. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the actionable intervention used by antimicrobial stewardship programs to provide key stewardship literature for teaching and training and to identify potential intervention opportunities within one’s institution.

With an increasing number of antimicrobial stewardship-related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an "actionable" intervention for 2017. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the "actionable" intervention used by antimicrobial stewardship programs to provide key stewardship literature for training and teaching and identify potential intervention opportunities within their institutions.

Objectives: There is debate on whether the use of third-generation cephalosporins (3GC) increases the risk of clinical failure in bloodstream infections (BSIs) caused by chromosomally-mediated AmpC-producing Enterobacterales (CAE). This study evaluates the impact of definitive 3GC therapy versus other antibiotics on clinical outcomes in BSIs due to Enterobacter, Serratia, or Citrobacter species. Methods: This multicenter, retrospective cohort study evaluated adult hospitalized patients with BSIs secondary to Enterobacter, Serratia, or Citrobacter species from 1 January 2006 to 1 September 2014. Definitive 3GC therapy was compared to definitive therapy with other non-3GC antibiotics. Multivariable Cox proportional hazards regression evaluated the impact of definitive 3GC on overall treatment failure (OTF) as a composite of in-hospital mortality, 30-day hospital readmission, or 90-day reinfection. Results: A total of 381 patients from 18 institutions in the southeastern United States were enrolled. Common sources of BSIs were the urinary tract and central venous catheters (78 (20.5%) patients each). Definitive 3GC therapy was utilized in 65 (17.1%) patients. OTF occurred in 22/65 patients (33.9%) in the definitive 3GC group vs. 94/316 (29.8%) in the non-3GC group (p = 0.51). Individual components of OTF were comparable between groups. Risk of OTF was comparable with definitive 3GC therapy vs. definitive non-3GC therapy (aHR 0.93, 95% CI 0.51–1.72) in multivariable Cox proportional hazards regression analysis. Conclusions: These outcomes suggest definitive 3GC therapy does not significantly alter the risk of poor clinical outcomes in the treatment of BSIs secondary to Enterobacter, Serratia, or Citrobacter species compared to other antimicrobial agents.

Objective: This pilot study sets out to discover the consumer's attitudes and perceptions about herbal therapy-both before and after viewing student pharmacists' posters that included information on various supplements and herbal therapies. Methods: An eleven-question survey was distributed among 61 attendees. In addition to demographic information, questions were asked about opinions of safety and efficacy of natural supplements and herbal therapies. Additionally, respondents were asked about their intended future use of herbal therapies. Results: Twenty-four percent of the survey respondents changed their perception regarding the safety of natural and herbal therapies, (p = 0.23), while 45fc changed their perception of efficacy (p = 0.012). Overall, there was not an anticipated change in the use of natural and herbal therapies among the respondents. Prior use of or familiarity with natural or herbal products did not influence future anticipated use. Conclusion: Student pharmacists' poster presentations significantly changed the perception regarding the efficacy of dietary supplements, but not the perception of safety.

Objective: To measure the impact of an automated outbound telephone messaging system on herpes zoster (HZ) vaccinations among older adults in the community pharmacy setting. Design: Randomized controlled trial. Setting: 16 grocery store chain community pharmacies in Georgia and Tennessee, between December 2006 and May 2007. Patients: Adults 60 years or older who filled at least one prescription at a participating study pharmacy. Intervention: A 30-second automated outbound telephone message was delivered to patient households monthly during the first week of March through May 2007. The message advertised that older adults should speak with their pharmacist about the risk for HZ and the availability of a new vaccine. Main outcome measure: HZ vaccinations based on pharmacy profile records. Results: After 3 months, 146 and 46 vaccinations were administered to older adults among the study cohort populations, translating into HZ vaccination rates of 2.60% and 0.72% at intervention and control pharmacies, respectively (odds ratio 3.69 [95% CI 2.64-5.15], P < 0.001). Conclusion: Use of an automated outbound telephone messaging tool to inform older adults about their risk for HZ and the availability of a vaccine significantly improved vaccination rates in the community pharmacy setting.

Objective: This pilot study sets out to discover the consumer's attitudes and perceptions about herbal therapy-both before and after viewing student pharmacists' posters that included information on various supplements and herbal therapies. Methods: An eleven-question survey was distributed among 61 attendees. In addition to demographic information, questions were asked about opinions of safety and efficacy of natural supplements and herbal therapies. Additionally, respondents were asked about their intended future use of herbal therapies. Results: Twenty-four percent of the survey respondents changed their perception regarding the safety of natural and herbal therapies, (p = 0.23), while 45fc changed their perception of efficacy (p = 0.012). Overall, there was not an anticipated change in the use of natural and herbal therapies among the respondents. Prior use of or familiarity with natural or herbal products did not influence future anticipated use. Conclusion: Student pharmacists' poster presentations significantly changed the perception regarding the efficacy of dietary supplements, but not the perception of safety.

Objective: To measure the impact of an automated outbound telephone messaging system on herpes zoster (HZ) vaccinations among older adults in the community pharmacy setting. Design: Randomized controlled trial. Setting: 16 grocery store chain community pharmacies in Georgia and Tennessee, between December 2006 and May 2007. Patients: Adults 60 years or older who filled at least one prescription at a participating study pharmacy. Intervention: A 30-second automated outbound telephone message was delivered to patient households monthly during the first week of March through May 2007. The message advertised that older adults should speak with their pharmacist about the risk for HZ and the availability of a new vaccine. Main outcome measure: HZ vaccinations based on pharmacy profile records. Results: After 3 months, 146 and 46 vaccinations were administered to older adults among the study cohort populations, translating into HZ vaccination rates of 2.60% and 0.72% at intervention and control pharmacies, respectively (odds ratio 3.69 [95% CI 2.64-5.15], P < 0.001). Conclusion: Use of an automated outbound telephone messaging tool to inform older adults about their risk for HZ and the availability of a vaccine significantly improved vaccination rates in the community pharmacy setting.

Objective To identify inter-rater reliability and accuracy of pharmacy faculty members' classification of exam questions based on Bloom's Taxonomy. Methods Faculty at a college of pharmacy was given six example exam questions to assign to the appropriate Bloom's level. Results Inter-rater reliability and accuracy were both low at 0.25 and 46.0%, respectively. Accuracy increased to 81.8% when the six Bloom's levels collapsed to three. Conclusions Both inter-rater reliability and accuracy were low. Faculty members' misclassifications suggested a three-tier combination of the Bloom's levels that would optimally improve accuracy: Knowledge, Comprehension/Application, and Analysis/Synthesis/Evaluation. Faculty development should also be considered in improving accuracy and reliability.

With the beginning of the Human Genome Project, an emerging field of science was brought to the forefront of the pharmaceutical community. Pharmacogenetics facilitates optimization of the current patient-centered care model and pharmacotherapy as a whole. Utilizing these ever-expanding branches of science to nonsteroidal anti-inflammatory drugs (NSAIDs) can provide novel opportunities to affect patient care. With a wide range of NSAID choices available as treatment options for relieving pain and/or reducing inflammation or fever, a more systematic way of selecting the ideal agent for the patients based upon their genetic information could spare them from a potentially permanent health-care condition. Furthermore, if a patient possesses or lacks certain alleles, serious adverse events can be anticipated and avoided. The tailoring of drug therapy can be achieved using the published data and cutting-edge genetic testing to attain a higher standard of care for patients.

Many dietary supplements being promoted for weight loss contain caffeine-or ephedra-related alkaloids to increase energy and suppress appetite. People may be unaware that supplements can contain caffeine, even if caffeine is not listed as an ingredient. Commonly used herbal dietary supplement ingredients, such as guarana, are natural sources of caffeine. Additions of these natural sources of caffeine to dietary supplements have increased in recent years. We describe a case of possible caffeine-induced seizure in a patient taking an over-the-counter weight loss supplement. A previously healthy 38-year-old female experienced blurring of vision and a new onset grand mal seizure. The patient had a 2-month history of taking the dietary supplement, Zantrex-3™. Zantrex-3™ is advertised as a weight loss supplement, which may provide rapid weight loss and extreme energy in one "power packed pill." Zantrex-3™ is a proprietary blend containing niacin, caffeine, and various herbs. After presenting to the hospital emergency room, the patient's chemistry panel, with the exception of potassium (2.9 mEq/L), was within normal limits. An electroencephalogram (EEG) was unremarkable. The magnetic resonance imaging (MRI) showed possible atrophy in the right frontal lobe. Findings from follow-up MRI and EEG ordered as an outpatient were within normal limits. After discontinuation of Zantrex-3™, the patient has experienced no further seizure activity.