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Background: It is unknown whether ChatGPT provides quality responses to infectious diseases (ID) pharmacotherapy questions. This study surveyed ID pharmacist subject matter experts (SMEs) to assess the quality of ChatGPT version 3.5 (GPT-3.5) responses., Methods: The primary outcome was the percentage of GPT-3.5 responses considered useful by SME rating. Secondary outcomes were SMEs' ratings of correctness, completeness, and safety. Rating definitions were based on literature review. One hundred ID pharmacotherapy questions were entered into GPT-3.5 without custom instructions or additional prompts, and responses were recorded. A 0-10 rating scale for correctness, completeness, and safety was developed and validated for interrater reliability. Continuous and categorical variables were assessed for interrater reliability via average measures intraclass correlation coefficient and Fleiss multirater kappa, respectively. SMEs' responses were compared by the Kruskal-Wallis test and chi-square test for continuous and categorical variables., Results: SMEs considered 41.8% of responses useful. Median (IQR) ratings for correctness, completeness, and safety were 7 (4-9), 5 (3-8), and 8 (4-10), respectively. The Fleiss multirater kappa for usefulness was 0.379 (95% CI, .317-.441) indicating fair agreement, and intraclass correlation coefficients were 0.820 (95% CI, .758-.870), 0.745 (95% CI, .656-.816), and 0.833 (95% CI, .775-.880) for correctness, completeness, and safety, indicating at least substantial agreement. No significant difference was observed among SME responses for percentage of responses considered useful., Conclusions: Fewer than 50% of GPT-3.5 responses were considered useful by SMEs. Responses were mostly considered correct and safe but were often incomplete, suggesting that GPT-3.5 responses may not replace an ID pharmacist's responses., Competing Interests: Potential conflicts of interest. J. M. S. served on an advisory board for Paratek Pharmaceuticals. E. B. C. served on an advisory board and speakers bureau for Seqirus. W. D. K. received research grants from Melinta, Merck & Co, and Shionogi, Inc and served on an advisory board for Theratechnologies, Inc. All other authors report no potential conflicts., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Background: Outpatient parenteral antimicrobial therapy (OPAT) allows for long-course intravenous treatment of infections without lengthy hospital stays. Upon discharge, antimicrobial therapy may be broadened for "ease" of once-daily administration (EOA). Patients requiring subsequent readmission can be tailored to pre-OPAT regimens to minimize adverse effects. This study assessed continuation of EOA regimens upon hospital readmission during or immediately after OPAT., Methods: This was a retrospective review of adults enrolled in OPAT and discharged on ertapenem or daptomycin for EOA, defined by the terms "convenience" or "EOA" in OPAT notes or by switching to ertapenem or daptomycin upon OPAT enrollment despite adequate therapy with narrower-spectrum agents. The primary outcome was the percentage of patients readmitted during or after their OPAT course and maintained on an EOA regimen. Secondary outcomes included inpatient therapy cost, rates of Clostridioides difficile infection, and adverse events., Results: Of 188 patients receiving an OPAT EOA regimen, 71 were readmitted, representing 113 unique readmissions. Patients were mostly males (81%) aged 57 years. The EOA regimens were continued in 27% of hospital readmissions. The Infectious Diseases (ID) team was consulted in 48% of readmissions, and the Antimicrobial Stewardship Program (ASP) intervened in 26%. Combined, this resulted in de-escalation in 28% of cases. Clostridioides difficile infections and adverse events occurred in 7% and 12% of readmissions, respectively. The median acquisition cost of inpatient EOA regimens was $150 per readmission., Conclusions: The OPAT EOA regimens were continued in 27% of hospital readmissions indicating a role for improved indication documentation and collaboration between ID services, ASPs, and OPAT teams., (© The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)