Connecticut Children's has a nationally recognized Antimicrobial Stewardship Program (ASP), led by an infectious disease physician and infectious disease pharmacist. Founded in 2011, the program has led multiple initiatives to reduce inappropriate antimicrobial prescribing, and created clinical pathways and guidelines that have resulted in improved patient care and outcomes. Integral to the ASP is an accredited second-year pediatric infectious disease pharmacy residency program, creating a truly collaborative practice environment. A core goal of the fellowship program is to train infectious disease physicians to be competent in managing an antimicrobial stewardship program of their own.

As part of the team and as a co-director of the program, Dr. Jennifer Girotto earned her doctorate of pharmacy from the University of Connecticut and completed an American Society of Health-System Pharmacy accredited specialty residency in pediatrics at Children’s Hospital in Boston. She is board certified in both infectious diseases pharmacy and pediatric pharmacotherapy and is currently a Clinical Professor of Pharmacy Practice and Pediatrics and Assistant Department Head for Pharmacy Practice at the University of Connecticut. Her practice site is at Connecticut Children’s where she is the Co-Director of the Antimicrobial Stewardship Program. Her clinical and research interests are immunizations, antimicrobial stewardship and pediatric infectious diseases outcomes. Some of her current research interest includes evaluation of the impact of the antimicrobial stewardship processes including implementation and expansion of an antimicrobial app. Some of Dr. Girotto’s most recent publications include a review of the contemporary treatment of Gram-negative infections in pediatric patients, evaluation of the current status of pharmacodynamic dosing of antimicrobials for pediatric Gram-negative infections, impact of a direct from blood culture identification of pathogens with antimicrobial stewardship notification, and evaluation of the hospital’s per pharmacist vancomycin protocols on AUC achievement.

Learn by seeing

At the start of the fellowship the fellow will attend didactic lectures on the principles and practical of effective antimicrobial stewardship, including how an Antimicrobial Stewardship Program is structured and the evidence-based interventions that are typically employed. Lectures will include instruction on the pharmacokinetics and pharmacodynamics of antimicrobial agents.

Learn by doing

The fellow will participate in antimicrobial stewardship activities during inpatient clinical weeks alongside the on-call attending: they will respond to requests for restricted antimicrobials and provide recommendations and approvals as appropriate. The fellow will experience progressively increasing responsibility, and gain expertise such that by the third year they will be able to perform ASP activities without immediate attending physician oversight.

During the second and third years the fellow will undertake formal rotations working with the co-directors of the ASP; performing daily culture review and providing recommendations to clinicians, including the Infectious Diseases team on service, as regards antimicrobial stewardship.

Academic experiences

Throughout the fellowship, the fellow serves on the ASP committee meeting, and participate in the SHARPS (Sharing Antimicrobial Reports for Pediatric Stewardship) monthly webinars. The fellow will also identify and complete a research project in the area of antimicrobial stewardship. This project could be selected as the primary scholarly activity of the fellowship, but at a minimum should be suitable for submission to a national meeting as an abstract. The fellow will also be expected to join other members of the ASP at the Annual International Pediatric Antimicrobial Stewardship Meeting.