Table of Contents
Credits
Host: Sara Dong
Guest: Rachel Britt
Producing/Editing/Cover Art: Sara Dong
Our Guest
Rachel Britt, PharmD, BCIDP
Rachel Britt is a Pharmacy Clinical Practice Specialist in Infectious Diseases at UTMB Health in Galveston, Texas. She received her PharmD from The University of Texas at Austin College of Pharmacy and completed her PGY1 Pharmacy Practice and PGY2 Infectious Diseases residencies at Beth Israel Deaconess Medical Center in Boston, Massachusetts. She is currently serving as Chair of the Society of Infectious Diseases Pharmacists Publications and Podcasts Committee and Chair of the American College of Clinical Pharmacy Infectious Diseases Practice and Research Network Networking Committee.
Consult Notes
This episode kicks off some collaboration episodes with the Society of Infectious Diseases Pharmacists (SIDP) and their podcast Breakpoints!
- Febrile Digest (this one!) on 10/3
- Febrile Case-based episode on 10/10
- Breakpoints FUO episode on 10/14
We discussed the process of becoming an ID pharmacy specialist:
- Pharmacy school – 4 year PharmD with or without a bachelor’s degree
- PGY1 residency – optional
- PGY2 residency in infectious diseases – optional
- Rachel mentioned clinical fellowships – more of a research focus than clinical practice – could be bench research or clinical outcomes, lots of different variations
- You can check out the Breakpoints episode “A PGY-What Now? A Primer on ID Pharmacy Fellowships” for more info
- This training prepares you for clinical practice and possibly academia
- Individuals can opt to get board certified (BCIDP) after residency graduation but it’s not required
Rachel provided some insight into the various places and roles you may find your ID pharmacist colleagues in beyond ID consult rounds
Clinical care / Hospital administration (such as committees and leadership)
- Antimicrobial stewardship programs
- Antimicrobial Advisory Subcommittees to the P&T committee – Formulary decisions, guideline/protocol development
- Other pharmacy/hospital committees – drug shortage committee, etc.
- Pharmacy residency programs – precepting and mentorship, program recruiting
- Education – lectures to NP, PA, and MD students as well as ID fellowship program and medical residency
Research
- In many clinical jobs, no protected time or funding for this – all research optional work
- Involved in pharmacy residency projects – for ASHP accredited programs, each resident is required to complete a medication use evaluation (MUE) and a full research project with a manuscript at the end
Organizational involvement outside of the hospital
- ID organizations, pharmacy organizations, giving CE talks, industry advisory boards, journal associate editors, volunteer work, etc!
This list is not totally comprehensive, but hopefully gives you a view of the wide variety of roles an individual with ID pharmacy background may consider
Calling your ID pharmacist
- Call for any questions about therapy! Drug, dose, route, or duration!
- Dosing questions – at some institutions, ID pharmacists may already be following vancomycin and aminoglycosides (and other TDM if your institution has it)
- Can look at organism/MIC patterns to recommend potential optimal agents or changes in dosing strategies
- Stewardship training!
- Transitions of care, such as stability of drugs, streamlining things for discharge/ease of administration, outpatient insurance issues, coming up with creative regimens when first line isn’t possible, patient counseling
- Allergy reconciliation +/- PCN skin testing
- OPAT/COpAT
- Drug/drug interactions; drug-lifestyle, drug-diet interactions, etc.
Other tips for working well with your ID pharmacist
- Call early if you are considering a non-formulary inpatient medication recommendation – this helps you discuss collaboratively to ensure there is no alternative that might exist since there could be substantial cost burden to the patient. Plus, you’ll need your ID pharmacists help to get the medication and there are a lot of moving pieces between multiple parties to make that happen!
- Don’t feel like you are bothering us! We are a resource and we would rather you ask
- Don’t refer to the stewardship team as the antibiotic police – everyone is on the same team and trying to do the best thing for the patient – and that might be starting/escalating therapy as much as de-escalating
- Don’t hesitate to teach us your wheelhouse – we love learning diagnostics and imaging b/c this isn’t our training perspective and we need to know your whole differential to help pick the best drug
Infographics
Disclosures
Our guest (Rachel Britt) as well as Febrile podcast and hosts report no relevant financial disclosures
Citation
Britt, R., Dong, S. “#56: Febrile Digest – Phone a [Pharmacy] Friend”. Febrile: A Cultured Podcast. https://player.captivate.fm/episode/49873dc2-e9f1-40d7-aa93-0f0f2f0db1ee