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Roy Goo

The University of Hawaiʻi at Hilo Daniel K. Inouye College of Pharmacy and Wilcox Hospital have formed Hawaiʻi’s first interdisciplinary antimicrobial stewardship program to help combat infectious diseases on Kauaʻi.

Antimicrobial stewardship programs are designed to improve the utilization of appropriate antibiotics with the goals of improving patient outcomes and lowering healthcare associated costs, as well as slowing the development of antimicrobial resistance.

“The management of infectious diseases is a constant arms race, and, as medication experts, pharmacists are uniquely qualified to help drive antimicrobial stewardship programs,” said Roy Goo, assistant professor in the Department of Pharmacy Practice, who is based on Kauaʻi. “As new antimicrobial agents are developed, bacterial, viral and fungal organisms evolve with new resistance mechanisms that confer immunity to even our best medications. Even with proper medication, it is estimated that 50 percent of antibiotics are used inappropriately.

“The practice of infectious diseases is the art of using only what is necessary to cure the infection and nothing more,” added Goo. “One of the basic principles of infectious diseases is the more antimicrobial agents we use, the faster resistance develops.”

With support from Wilcox Hospital’s inpatient pharmacy department and the hospital’s infectious disease physician James Yoon, students screen for patients who are on high-cost or high-risk antimicrobials. They then assess the appropriateness of the antimicrobial regimen for each patient and present their recommendations to the entire infectious disease team, who makes changes to optimize therapy.

“The Center for Disease Control strongly recommends that hospitals perform some form of antimicrobial stewardship, and it is likely that it will become mandated by the Center for Medicare/ Medicaid Services in a couple of years,” Yoon said. “At Wilcox Memorial Hospital, we like to be ahead of the curve. Right now we are lucky that we have very few resistant bacteria, and we want to keep it that way.”

This positive experience has led to other collaborative programs at Straub Hospital and Pali Momi Medical Center on Oʻahu. Pharmacist Melissa Yoneda, a DKICP alumni, is currently helping to establish a pharmacy-driven antimicrobial stewardship program at Pali Momi Medical Center.

Read the Daniel K. Inouye College of Pharmacy news release for more information.

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