Putting Patients First to Drive Antimicrobial Stewardship Improvements

Laura Gillespie, PharmD, has built a career at the intersection of patient care and evidence-based practice as an antimicrobial stewardship (AMS) pharmacist. Driven by a commitment to solving real-world clinical problems—from reducing multidrug-resistant organisms to tackling Clostridioides difficile infections—she has become a leading voice in pharmacy-driven research and regional collaboration. As cofounder of North Central Indiana's Regional AMS Program and a key contributor during the COVID-19 pandemic, Gillespie has demonstrated how pharmacists can drive meaningful, measurable change in patient outcomes. In the following Q&A, she shares her journey, her proudest accomplishments, and her perspective on what it means to be a pharmacist researcher.

This interview was lightly edited for clarity.

Pharmacy Times: What brought you to research as a pharmacist, and how has research shaped your work in the field?

Gillespie: Interestingly, I have never really considered myself a “researcher.” In my job as an AMS pharmacist, I first take note of patient care problems that arise, then develop initiatives to improve them. I have learned over time [that] it is essential to then track and report results of these initiatives. This allows everyone to see the effectiveness of changes made, which builds an exciting momentum in further making improvements and can encourage others to, in turn, make these changes.

Helping patients always comes first in my practice, but unless the data and results are reported, improvements in the care of patients cannot grow. Thus, my desire to help patients actually shapes the projects and research I perform as opposed to the research shaping my work.

Pharmacy Times: Traditionally, what is your role within the research team, and how often are you involved in pharmacist-led research?

Gillespie: I often refer to myself in my job as an investigator, and I either happen upon problems warranting [investigation] myself or have others come to me with issues needing a fix. Example problems range from overtreatment of certain disease states to troubleshooting alarmingly rising rates of multidrug-resistant organisms. In each case, I investigate the root cause of the problem, then establish an action plan together with a multidisciplinary team. Although I don’t necessarily always look at what I do as research, one might say that is technically what I’m doing each and every day. I may not publish everything I’m working on and their respective results, but I do track all initiatives’ progress and results, and I report these to our hospital teams.

Pharmacy Times: When getting involved with a research team, are you most frequently connected through your institution, or have associations or other groups provided opportunities for research collaboration?

Gillespie: Research teams I have been a part of, and specifically published work in, have been through my institution. However, many initiatives I have worked on to improve patient care [have] been in collaboration with other regional hospitals. In 2017, I became the cofounder and leader of North Central Indiana’s Regional AMS Program. It is extremely rewarding to know that we are making improvements in treatment efficacy and safety for patients across a region rather than [being] isolated to a single health care facility.

Pharmacy Times: What are some of your greatest accomplishments as a pharmacy researcher?

Gillespie: One of my biggest goals I set for myself when I became our institution’s AMS pharmacist was to reduce the untoward effects of antimicrobials. Our hospital has since reduced inappropriate fluoroquinolone and clindamycin utilization, removed inappropriately labeled β-lactam allergies, and reduced overall C difficile rates. A somewhat recent and unexpected accomplishment came during the COVID-19 pandemic. I cofounded our hospital’s COVID-19 Coagulation Committee and later published multiple papers describing our work on COVID[-19]’s coagulopathic nature. Knowing that we were able to improve patient care and potentially save lives during such a scary time was greatly rewarding.

Pharmacy Times: What is a recent publication showcasing your research that you are proud of?

Gillespie: My most recent publication, “Impact of Pharmacist-Led Initiatives on Health Care–Associated Clostridioides difficile Rates,” was published in the March 2024 issue of Pharmacy Practice in Focus: Health Systems. The moment I was granted a devoted position as the AMS pharmacist at my health care system, I moved full steam ahead with the reduction of C difficile infections. I knew the approach we had to take as a health care system would need to be multifaceted and require multidisciplinary teamwork. I am so proud to report our health care facility- and community-onset health care facility–associated C difficile rates decreased by approximately 80% and 81%, respectively, in 2 years’ time.