Stewies Burned by COVID-19

Reviewed by: Cynthia T. Nguyen, PharmD, University of Chicago Medicine

During the COVID-19 pandemic, antimicrobial stewardship programs have increased workload related to COVID-19, less time available for traditional antimicrobial stewardship activities, and are exhibiting increased signs of burnout. In December 2020, Vaughn and colleagues surveyed 51 Michigan Hospital Medicine Safety Consortium (HMS) hospitals to assess 5 domains related to COVID-19 and antibiotic stewardship: (1) additional COVID-19–related duties for stewards, (2) FTE changes for stewardship, (3) the impact of COVID-19 on traditional stewardship activities, (4) new COVID-19 or telestewardship initiatives, and (5) stewardship clinician burnout.

The overall survey response rate was 100%, with lower response rates (75%–80%) for questions specifically related to burnout. Surveyed hospitals had a median of 310 beds (IQR, 189–422) and 88% were academic. Prior to the pandemic, a median of 1.2 FTEs (IQR, 0.7–3.5) were dedicated for antibiotic stewardship.

During the pandemic, antibiotic stewardship leaders reported a median of 5 new duties (IQR, 3–8), including the development and maintenance of COVID-19 treatment guidelines, remdesivir and antibody allocations, and COVID-19 related education. Despite the increased workload, only 8% of respondents reported increased FTEs and 18% of respondents reported a reduction in FTEs. 82% of respondents reported they work on average 9-11 more hours per week than before the pandemic. Much of this time is being spent on COVID-19-related activities, as almost all respondents reported that the pandemic somewhat or strongly decreased their team’s ability to perform stewardship.

Among respondents of burnout questions, 45% reported feeling emotionally drained from their work a few times per week and 15% reported feeling emotionally drained from their work daily. Overall, 71% of the responses corresponded to potential burnout and nearly all respondents indicated that burnout symptoms were higher than before the pandemic.

These findings are not surprising to many of us, but it can be cathartic to see the challenges we have faced and the emotional toll quantified in terms of actual data. Remember that you are not alone! Take care of yourself, your family, and your colleagues, stewies.


Vaughn VM, Dunn GE, Horowitz JK, McLaughlin ES, Gandhi TN. Duties, resources, and burnout of antibiotic stewards during the coronavirus disease 2019 (COVID-19) pandemic. Antimicrobial Stewardship & Healthcare Epidemiology. Cambridge University Press; 2021;1(1):e39.

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