The ASHE Podcast

In this episode of The ASHE Podcast, hosts Dr. Gonzalo Bearman speaks with Dr. Meghan Jeffres from the University of Colorado School of Medicine and Health System. Dr. Jeffres is the lead author of the research brief published in ASHE titled “Seven days, seven quests: gamification to enhance engagement with antimicrobial stewardship resources during Antibiotic Awareness Week.”

Dr. Jeffres discusses how gamification can make antimicrobial stewardship education more engaging and accessible for healthcare professionals. She describes the development of seven short, interactive games designed to encourage clinicians to explore antimicrobial stewardship resources during Antibiotic Awareness Week. The initiative attracted 75 participants and resulted in a 45% increase in stewardship webpage views. The conversation explores lessons learned, plans to expand the initiative, and the potential for incorporating gamification into clinical apps and other educational tools.

References:

• Jeffres MN, McCann T, Salam ME, Brade KD. Seven days, seven quests: gamification to enhance engagement with antimicrobial stewardship resources during Antibiotic Awareness Week. Antimicrobial Stewardship & Healthcare Epidemiology. 2026;6(1):e72. doi:10.1017/ash.2026.10320

This week, we're sharing an episode of Breakpoints in the ASHE Podcast feed!

Join host Dr. Whitney Buckel and guests Dr. Priya Nori, co-host of The ASHE Podcast, and Dr. Brad Langford, an associate editor for Antimicrobial Stewardship & Healthcare Epidemiology (ASHE), as they highlight recent publications from ASHE. This episode explores antimicrobial stewardship workforce trends, leadership competencies, innovative educational strategies, and environmental sustainability, with practical takeaways to help stewardship professionals strengthen programs and advance patient care.

References:

1. Breakpoints: The SIDP Podcast. Episode 133: Trash Talk: Earth Day Special on Healthcare Sustainability and Stewardship. Released on April 16, 2026. Available at:Breakpoints website
2. CASCADES website: CASCADES – Creating a Sustainable Canadian Health System in a Climate Crisis
3. Hirsch EB, Mott DA, Gilson AM, Aitken SL, Basalyga V, Bergman SJ, Buckel WR, DeSear KE, Farber M, Gaither CA, Gross AE. A national survey of the infectious diseases and antimicrobial stewardship pharmacist workforce in the United States: work settings, characteristics, employment activities, resources and needs. Antimicrobial Stewardship & Healthcare Epidemiology. 2026 Jan;6(1):e76.
4. Holubar M, Bhowmick T, Buckel WR, Cosgrove SE, Evans C, File Jr TM, Fitzpatrick M, Leung E, Malani AN, Rios A, Preusker J, Nori P. Guidance for the Knowledge and Skills required for Antimicrobial Stewardship Leaders: an update from the Society for Healthcare Epidemiology of America, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Antimicrobial Stewardship & Healthcare Epidemiology. 2026 Jan;6(1):e130.
5. Jeffres MN, McCann T, Salam ME, Brade KD. Seven days, seven quests: gamification to enhance engagement with antimicrobial stewardship resources during Antibiotic Awareness Week. Antimicrobial Stewardship & Healthcare Epidemiology. 2026 Jan;6(1):e72.
6. Langford BJ, Baily P, Livorsi DJ, et al. Five steps to high quality antimicrobial stewardship research. Antimicrob Steward Healthc Epidemiol. 2024 May 9;4(1):e82.
7. Lee PS, Gordon H, Ferguson T, Dinh T, Vu M, Nguyen M, Hsiao C, Fong G. EcoRxChoice.com- an SIDP-funded calculator integrating environmental metrics with antimicrobial stewardship. Antimicrob Steward Healthc Epidemiol. 2026 Jul 6;6(1):e199.
8. Sustainabil-ID website: Sustainabil-ID
9. The ASHE Podcast. Episode 32: A Survey of the Infectious Diseases and Antimicrobial Stewardship Pharmacist Workforce in the United States. Released on June 25, 2026. Available via Apple Podcasts or Spotify.
10. The ASHE Podcast. Episode 35: Guidance for the Knowledge and Skills required for Antimicrobial Stewardship Leaders. Released August 19, 2026. Available via Apple Podcasts or Spotify.

In this episode of The ASHE Podcast, hosts Dr. Gonzalo Bearman and Dr. Priya Nori speak with Dr. Elizabeth Scruggs-Wodkowski and Dr. Rachel Croxton, authors of “Ongoing guidance for infectious disease care for migrants and immigrants: a case-based narrative review.” Through clinical cases involving HIV, measles, and Ebola, they discuss the challenges of providing infectious disease care to migrant and immigrant populations amid changing policies and healthcare access. The conversation explores practical approaches to patient care and opportunities for advocacy to build more equitable and responsive healthcare systems.

Links and Recommendations:

• Ongoing guidance for infectious disease care for migrants and immigrants: a case-based narrative review: https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/ongoing-guidance-for-infectious-disease-care-for-migrants-and-immigrants-a-casebased-narrative-review/E031972D4352C9BD97DFF538F525A26D

Antimicrobial stewardship has traditionally focused on optimizing antibiotic use to improve patient care, but growing attention to environmental sustainability is expanding how stewardship teams think about resource use. From the plastic waste generated during medication preparation and administration to opportunities to incorporate environmental considerations into antibiotic selection, stewardship offers a natural opportunity to address both clinical and environmental priorities.

Dr. Pam Lee and Dr. Gary Fong developed EcoRxChoice.com, a free calculator designed to integrate environmental metrics into antimicrobial stewardship. The calculator estimates the amount of plastic waste associated with different antimicrobial regimens by accounting for materials used in medication preparation and administration. In their paper published in ASHE, "EcoRxChoice.com— an SIDP-funded calculator integrating environmental metrics with antimicrobial stewardship," the authors describe how they developed the calculator, including physically weighing items ranging from IV bags and tubing to needle hubs and medication packaging.

In this episode, Dr. Lee and Dr. Fong discuss the origins of EcoRxChoice.com, the surprising amount of plastic waste generated through routine medication preparation, and how environmental impact can be incorporated into antimicrobial decision-making. They also explore the role of IV-to-oral conversion, the challenges of integrating sustainability into pharmacy and medical education and electronic medical records, and future opportunities to expand the calculator to other areas of stewardship and infection prevention.

Links and Recommendations:

• EcoRxChoice.com— an SIDP-funded calculator integrating environmental metrics with antimicrobial stewardship: https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/ecorxchoicecom-an-sidpfunded-calculator-integrating-environmental-metrics-with-antimicrobial-stewardship/83C55C51C9C446C4728FF1980CD2EC14
• https://ecorxchoice.com/?page=plasticWasteCalculator
• Development of a Novel Carbon Emissions Estimation Tool for Disposable Waste Associated With Antimicrobial Packaging, Preparation, and Administration in the Hospital Setting: https://academic.oup.com/ofid/article/12/10/ofaf308/8183152

Antimicrobial stewardship has evolved dramatically over the past decade, driven by expanding regulatory requirements, broader implementation across healthcare settings, advances in diagnostic stewardship, and growing opportunities to leverage technology. As stewardship programs continue to mature, leaders must develop skills in leadership, change management, collaboration, quality improvement, and strategic planning.

Dr. Sarah Cosgrove, Dr. Whitney Buckel, and a multidisciplinary group of experts from the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) developed an updated guidance document outlining the knowledge and skills required for antimicrobial stewardship leaders. Building on the original 2014 publication, the guidance provides a framework for stewardship programs across acute care, ambulatory care, and long-term care settings, with competencies spanning basic, intermediate, and advanced levels.

In this episode, the authors discuss how antimicrobial stewardship has changed since the original guidance was published, the growing role of diagnostic stewardship and collaboration, and the opportunities and challenges of artificial intelligence. They also share practical advice for using the guidance to strengthen stewardship programs, build future leaders, and prepare for the next decade of antimicrobial stewardship.

Links and Recommendations:

• Guidance for the Knowledge and Skills required for Antimicrobial Stewardship Leaders: https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/guidance-for-the-knowledge-and-skills-required-for-antimicrobial-stewardship-leaders-an-update-from-the-society-for-healthcare-epidemiology-of-america-infectious-diseases-society-of-america-pediatric-infectious-diseases-society-and-the-society-of-infectious-diseases-pharmacists/3B710B07D042BDF0A2B3D2090E1B9665

Candida auris has emerged as a major healthcare-associated pathogen due to its multidrug resistance, environmental persistence, and ability to spread between patients and healthcare facilities. Until now, infection prevention guidance has focused almost entirely on adults.

Dr. Thomas Murray, Dr. Natalie Neu, and an international multidisciplinary panel developed the first comprehensive pediatric-specific infection prevention and control recommendations for Candida auris using a rigorous Delphi consensus process. The guidance addresses children's hospitals, outpatient clinics, long-term pediatric care settings, and other congregate environments, balancing transmission prevention with family-centered care.

The recommendations cover screening, Contact Precautions, room placement, caregiver involvement, breastfeeding, shared play spaces, environmental cleaning, equipment management, and coordination with public health agencies, while also providing expert consensus where evidence is limited.

In this episode, the authors discuss why pediatric-specific guidance was needed, how the recommendations were developed, and what healthcare facilities can do to prepare for the continued emergence of Candida auris.

Links and Recommendations:

• Infection prevention and control of Candida auris in pediatric settings: https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/infection-prevention-and-control-of-candida-auris-in-pediatric-settings/D1012137F51BF268BC89FE5DBCC1DA8A

“We should not be practicing medicine in a way that contributes to the pollution and emissions that harm the health of those we have pledged to serve.”

The U.S. healthcare sector is responsible for approximately 8.5% of the nation's greenhouse gas emissions, contributing to an estimated 388,000 disability-adjusted life years (DALYs) lost in 2018. While non-sterile gloves are essential for reducing the transmission of pathogens, an estimated 100 billion exam gloves are used annually in the United States, generating approximately 400,000 tons of medical plastic waste each year.

Evidence suggests that gloves are used inappropriately in up to 50% of clinical encounters. Beyond creating avoidable plastic waste, inappropriate glove use can compromise patient safety and infection prevention efforts by reducing hand hygiene compliance. These practices have downstream environmental and public health consequences that extend well beyond the clinical setting.

Fortunately, a growing body of evidence supports the safety and effectiveness of glove stewardship initiatives. Educational campaigns that promote evidence-based, appropriate glove use have reduced glove consumption by 15% to 50% across a variety of healthcare settings without compromising patient care.

In this episode of the ASHE Podcast, hosts Dr. Priya Nori and Dr. Elizabeth Monsees are joined by Dr. Laurie Lalakea and Dr. Radhika Sheth to discuss their recent publication, Using Gloves Wisely: Rethinking Glove Use for Health, Safety, and Environmental Sustainability. Together, they explore the far-reaching public health and environmental impacts of non-sterile glove overuse and share practical strategies for implementing a successful glove stewardship program.

Links and Recommendations:

• Read Dr. Lalakea and Dr. Sheth’s article in ASHE: https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/using-gloves-wisely-rethinking-glove-use-for-health-safety-and-environmental-sustainability/EB82A26AE6E05E298688F4005AB6F0CB?utm_campaign=shareaholic&utm_medium=copy_link&utm_source=bookmark
• Sustainabil-ID: https://sustainabil-id.com/
• What If We Get It Right? by Ayana Elizabeth Johnson: https://www.getitright.earth/

In this episode of The ASHE Podcast, hosts Dr. Gonzalo Bearman and Dr. Priya Nori speak with Elizabeth Hirsch, PharmD and David Mott, PhD about their national survey of infectious diseases and antimicrobial stewardship pharmacists in the United States. They discuss the workforce's diverse responsibilities, training and resource challenges, and key findings that have implications for workforce development, retention, and the future of antimicrobial stewardship programs.

Read the full article: Hirsch EB, Mott DA, Gilson AM, et al. A national survey of the infectious diseases and antimicrobial stewardship pharmacist workforce in the United States: work settings, characteristics, employment activities, resources and needs. Antimicrobial Stewardship & Healthcare Epidemiology. 2026;6(1):e76. doi:10.1017/ash.2026.10312

In this episode of The ASHE Podcast, host Dr. Gonzalo Bearman and Dr. Priya Nori speak with the authors of “Sports fever! Getting the ball rolling to prevent infections at the World Cup™ and beyond,” Dr. Preeti Mehrotra and Dr. Trini Mathew.

Sporting events provide athletes with an opportunity to compete on the world stage and bring together millions of fans in celebration. However, mass gatherings and mega sporting events also present unique public health challenges, including the risk of communicable disease transmission and the need for extensive preparedness planning.

As the world looks ahead to the 2026 FIFA World Cup™, which will feature 48 teams competing across three host countries, Drs. Mehrotra and Mathew discuss the infectious disease risks associated with large-scale sporting events, including commonly encountered infections and high-consequence pathogens. They explore practical preparedness strategies for healthcare personnel, infection prevention and control teams, emergency departments, and disaster preparedness leaders, while emphasizing the importance of closed-loop communication, multidisciplinary collaboration, and innovative technology solutions.

Tune in to learn how healthcare systems and public health agencies can prepare for one of the largest sporting events in history—and how the lessons learned can serve as a blueprint for future mass gatherings worldwide.

Read “Sports fever! Getting the ball rolling to prevent infections at the World Cup™ and beyond”: https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/sports-fever-getting-the-ball-rolling-to-prevent-infections-at-the-world-cup-and-beyond/DA92F515F40CE1C201E7D89456850DED#article

In this episode of The ASHE Podcast, hosts Dr. Gonzalo Bearman and Dr. Priya Nori sit down with Antoinette Acbo, PharmD, BCIDP and Karan Raja, PharmD to discuss their recent publication on pharmacy benefit manager practices and their impacts on infectious diseases patients.

https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/what-should-infectious-diseases-clinicians-know-about-pharmacy-benefit-managers-and-their-impact-on-our-patients/37A2F39BEADB2E8BF1D0302709279DA3

In this episode of The ASHE Podcast, hosts Dr. Gonzalo Bearman and Dr. Priya Nori sit down with Dr. Lindsey Childs-Kean and Dr. Alexandra Yamshchikov to discuss their recent publication highlighting a curated bundle of the top 10 OPAT-related studies from 2024.

Outpatient parenteral antimicrobial therapy (OPAT) remains a cornerstone of infectious diseases practice, with a growing body of research shaping how clinicians deliver safe and effective care outside the hospital setting. In this conversation, the authors break down the most clinically impactful OPAT publications of the year, offering key insights, emerging trends, and practical takeaways for providers.

https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/bundle-of-the-top-10-opat-publications-in-2024/F22DABCC50AED0A66CA53840508B8BD8#article

On this episode of the ASHE Podcast, hosts Dr. Gonzalo Bearman and Dr. Priya Nori speak with Dr. Brittany Lehrer, and Dr. Sophie Katz, about their new study in ASHE, “It’s QuizTime! The impact of web-based microlearning quizzes on guideline-concordant antibiotic duration for pediatric acute otitis media.”

They explore the prescribing gap in pediatric acute otitis media that inspired their microlearning approach and discuss why brief, web-based quizzes can be a high-yield stewardship tool in busy outpatient settings. The authors highlight key design elements that drove engagement, share surprising findings from their pre/post evaluation of guideline-concordant antibiotic duration, and offer practical advice for institutions looking to replicate this low-burden, scalable intervention to improve antibiotic prescribing.

https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/its-quiztime-the-impact-of-webbased-microlearning-quizzes-on-guidelineconcordant-antibiotic-duration-for-pediatric-acute-otitis-media/C23CBF28D3DBA0985491820A5DC52382#article

Hospital discharge is a critical and often overlooked moment for antibiotic stewardship. In this episode of The ASHE Podcast, hosts Dr. Gonzalo Bearman and Dr. Priya Nori are joined by Dr. David Ha (Stanford University) and Dr. Ritika Prasad (University of California, San Francisco), authors of the recent ASHE article “Unraveling indications for discharge antibiotics: the Devil’s in the details.”

The conversation explores why discharge prescribing is so challenging, the limitations of ICD-10 codes, and how using indication-based fields like the Last Inpatient Indication can more accurately capture clinician intent and improve stewardship at transitions of care.

https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/unraveling-indications-for-discharge-antibiotics-the-devils-in-the-details/00D66BAC14D6C6B878572EB7069C7014

In this episode of The ASHE Podcast, host Dr. Priya Nori speaks with Dr. Alexia Foy-Crowder, Dr. Pam Bailey, and Dr. Grace Pazienza about their ASHE paper, “Stewardship opportunities in peripartum infections: a review of quality improvement initiatives and future directions” (September 2025).

They discuss why they focused on the peripartum population, the unique implementation challenges in obstetric care, and key findings from their study—including the high proportion of mother–baby dyads receiving antimicrobials and the striking variability across 199 identified regimens. The authors reflect on guideline discordance, the frequent presence of penicillin allergy labels, and how these issues create opportunities for stewardship intervention.

The conversation also covers practical strategies for engaging obstetric teams, metrics for improving antibiotic use, remaining research gaps, and how stewardship in obstetrics connects to maternal health disparities and global antimicrobial resistance.

https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/stewardship-opportunities-in-peripartum-infections-a-review-of-quality-improvement-initiatives-and-future-directions/BC262D79208E5215F7FF7562B579C6B2#article

Join hosts Gonzalo Bearman and Priya Nori as they dive into the critical intersection of infectious diseases and climate change with experts Dr. Shreya M. Doshi and Dr. Preeti Jaggi. This episode explores actionable steps that infectious diseases professionals can take to address the climate crisis, based on the article, "Ten Sustainable Steps Infectious Diseases Professionals Can Take to Mitigate the Climate Crisis." Our expert guests discuss how global warming exacerbates disease spread and the specific contributions of healthcare activities, from diagnostics and pharmaceutical waste, to greenhouse gas emissions. The conversation highlights strategies for reducing healthcare waste, transitioning from disposable to reusable medical supplies, and balancing infection control needs with environmental sustainability in PPE. Additional topics include optimizing pharmaceutical use to reduce waste, advocating for climate action in healthcare systems, and optimizing telehealth. The importance of tracking and reporting environmental benefits is emphasized, along with an invitation to join a new sustainability interest group. Listeners should note that this submission is part of an ongoing Call for Papers in ASHE on Environmental Sustainability.

Links:
- https://sustainabil-id.com/