Academic journal article American Journal of Pharmaceutical Education

An Introductory Review Module for an Anti-Infectives Therapeutics Course

Academic journal article American Journal of Pharmaceutical Education

An Introductory Review Module for an Anti-Infectives Therapeutics Course

Article excerpt

INTRODUCTION

The dearth of new antimicrobial agents being developed and approved for use may lead to a public health crisis. Many pharmaceutical companies have withdrawn from antibiotic development because of low return on investment. (1) This is illustrated by the precipitous drop in antibiotic approvals over the last 30 years from 16 in the 5-year period from 1983 to 1987 to just 4 in the 5-year period from 2003 to 2007. (2) The decline has continued, with only 2 new antibiotics being approved in the 4-year period from 2008 to 2011. Simultaneously, during this period the rate of antibiotic resistance has significantly increased. (1-3) There are 2 main efforts underway to delay this public health disaster: major advocacy campaigns largely driven by the Infectious Diseases Society of America's 10 x '20 initiative (10 new antibiotics by 2020, endorsed by 36 medical societies) (4) and antimicrobial stewardship programs. (5)

Antimicrobial stewardship programs are an effort to improve and promote the appropriate use of antibiotics through selection of optimal regimens including agent selection, dosing, duration of administration, and route of administration. (5) Pharmacists are considered a core member of the multidisciplinary team that implements such programs and frequently are the primary ones responsible for day-to-day stewardship activities. (5,6) This responsibility has created a need for pharmacists who are highly knowledgeable of the basic principles of antimicrobial therapy such that they are able to implement these stewardship policies effectively in any given clinical scenario.

The Northeastern University School of Pharmacy offers a 6-year doctor of pharmacy (PharmD) program, which the majority of incoming students enter directly out of high school. We identified a need in our students to bolster these basic principles of antimicrobial therapy. Because of the time that elapses between the microbiology course and the pharmacology and medicinal chemistry courses taught in the second preprofessional year and first professional year, respectively, and the therapeutics of infectious diseases course taught in the third year, students have difficulty remembering and applying the foundational material. Feedback from students on course evaluations and exit survey instruments has highlighted the poor sequence of these courses. This paper describes the development and implementation of an introductory review module in the infectious diseases portion of the therapeutics course during the P3 year to bolster students' knowledge using a hybrid-learning approach, and an evaluation of the effectiveness of this module on student learning.

DESIGN

The introductory module was designed to enable students to learn and better understand the management of specific infectious diseases taught later in the course, including respiratory infections, endocarditis, meningitis, urinary tract infections, skin/soft tissue/bone infections, and several others. The module maximized class time spent on review and application of previously taught material. An online 1-hour lecture was recorded to review common pathogens, drug classes, drug mechanisms of action, drug spectrum of activity, adverse effects, pharmacokinetic properties of drugs, and drug interactions. Students were asked to listen to the online module between late August and early September, prior to the first class, and to complete a table with pharmacological characteristics of commonly used anti-infectives. For each class of drugs and/or generation, students were asked to describe the mechanism of action, any notable side effects, potential for drug interactions, and route of administration. Once complete, students were asked to upload their charts to the Blackboard course site (Blackboard, Inc., Washington, DC), where course instructors were able to track which students completed this required pre-class assignment.

In addition to the online component, the introductory module included 2 traditional lectures and 1 case-based lecture. …

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