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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/83C55C51C9C446C4728FF1980CD2EC14https://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

Hosted by Dr. Gonzalo Bearman and Dr. Priya Nori, this episode features Dr. Madhuri Sopirala, Dr. Werner Bischof, and Dr. David Weber discussing their recent ASHE publication, A research agenda for burn infection prevention: identifying knowledge gaps and prioritizing future directions. The conversation explores why a dedicated research agenda is needed for burn patients, highlights priority areas with near-term clinical impact, and examines key gaps in our understanding of the burn wound microbiome and biofilms. The episode also looks ahead to how evolving research could shape infection prevention practice, policy, and stewardship over the next five years.

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

In this episode of *The ASHE Podcast*, hosts Dr. Gonzalo Bearman and Dr. Priya Nori are joined by Dr. Emine Alp Meşe, author of "Prioritizing isolation precautions: a patient-centered approach to infection prevention and control," published in Antimicrobial Stewardship & Healthcare Epidemiology (Cambridge University Press, June 2025). Together, they discuss how a patient-centered framework can transform infection prevention and control by balancing the benefits and potential harms of isolation precautions. Dr. Alp Meşe outlines a risk-based approach that considers patient, pathogen, and healthcare system factors; explores how advanced tools like omics-based susceptibility analysis and machine learning can enable personalized infection prevention; and highlights the importance of environmental controls and patient engagement in improving outcomes.

In this episode, Dr. Brittany Rodriguez, Dr. Andrea Prinzi, and Dr. Denver Niles discuss their recent ASHE publication, “Uniting disciplines against antimicrobial resistance (AMR): highlights from a multidisciplinary inaugural AMR Summit.” They share key takeaways from the inaugural AMR Summit, held in November 2024, including rapid diagnostics, implementation science, next-generation sequencing, and strategies for engaging hospital leadership. The conversation closes with a call to action and priorities for advancing AMR efforts over the next two years.

In this episode of the ASHE Podcast, we are joined by guests Michael Moran and Aurora Pop-Vicas to explore new survey findings from 42 hospitals in the SHEA Research Network on implementing colorectal surgical site infection (SSI) prevention bundles. While most hospitals consistently use IV antibiotics and CHG-alcohol skin prep, practices like glove changes, separate trays, and oral antibiotics with bowel prep lag behind. The study highlights barriers such as resistant culture, clinician non-compliance, and gaps in audit and feedback—especially in high-volume centers. Our guests share practical strategies and success stories to strengthen adherence and improve SSI prevention.