Antimicrobial stewardship program - Revision history

Aidan: /* Antimicrobial Use */ typo

2022-09-21T10:51:20Z

Antimicrobial Use: typo

← Older revision		Revision as of 10:51, 21 September 2022
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	* Days of therapy (DOTs) or defined daily doses (DDDs)		* Days of therapy (DOTs) or defined daily doses (DDDs)
	* ~~Stadardized~~ antimicrobial administration ratio (SAAR), which compares actual use to expected use based on a statistical model		* Standardized antimicrobial administration ratio (SAAR), which compares actual use to expected use based on a statistical model

	==== Outcome Measures ====		==== Outcome Measures ====

Aidan: /* Microbiology- and Laboratory-Based Interventions */

2022-09-04T01:20:11Z

Microbiology- and Laboratory-Based Interventions

← Older revision		Revision as of 01:20, 4 September 2022
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	==== Nursing-Based Interventions ====		==== Nursing-Based Interventions ====
	* Optimizing microbiology culture collection		* Optimizing microbiology culture collection (see also [[Diagnostic stewardship of urine cultures]])
	* IV to oral transitions		* IV to oral transitions
	* Prompting antibiotic timeouts		* Prompting antibiotic timeouts

Aidan: /* Further Reading */ added CDC

2022-08-10T18:39:17Z

Aidan at 18:38, 10 August 2022

2022-08-10T18:38:08Z

← Older revision		Revision as of 18:38, 10 August 2022
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	** May involve nurses for the assessments		** May involve nurses for the assessments

	* Pharmacy-~~based~~ ~~interventions~~ ~~include:~~		==== Pharmacy-Based Interventions ====
	** Documentation of indication for antibiotics can improve antibiotic use		* Documentation of indication for antibiotics can improve antibiotic use
	** Automatic substitutions from IV to oral therapy		* Automatic substitutions from IV to oral therapy
	** Interventions to reduce the duration of antibiotics to shortest effective duration		* Interventions to reduce the duration of antibiotics to shortest effective duration
	** Dose adjustments and optimization		* Dose adjustments and optimization
	*** PK monitoring and adjustment of [[aminoglycosides]] and [[vancomycin]]		** PK monitoring and adjustment of [[aminoglycosides]] and [[vancomycin]]
	*** Alternative dosing of β-lactams		** Alternative dosing of β-lactams
	** Duplicative therapy alerts		* Duplicative therapy alerts
	** Time-sensitive automatic stop orders		* Time-sensitive automatic stop orders
	** Detection and prevention of [[drug-drug interactions]]		* Detection and prevention of [[drug-drug interactions]]
	** Reducing use of antibiotics with increased risk of [[Clostridioides difficile]] infection		* Reducing use of antibiotics with increased risk of [[Clostridioides difficile]] infection

	* Microbiology- and laboratory-based interventions include:
			==== Microbiology- and Laboratory-Based Interventions ====
	** Selective reporting of susceptibility testing		* Selective reporting of susceptibility testing
	** Comments in microbiology reports		* Comments in microbiology reports
	** Development of stratified antibiograms (e.g. by location or age)		* Development of stratified antibiograms (e.g. by location or age)
	** Rapid viral testing for respiratory pathogens to reduce the use of inappropriate antibiotics		* Rapid viral testing for respiratory pathogens to reduce the use of inappropriate antibiotics
	** Rapid diagnostic testing on blood specimens		* Rapid diagnostic testing on blood specimens
	** Serial procalcitonin in ICU patients		* Serial procalcitonin in ICU patients
	* Nursing-based interventions include:

⚫	** Optimizing microbiology culture collection
			==== Nursing-Based Interventions ====
⚫	** IV to oral transitions
		⚫	* Optimizing microbiology culture collection
⚫	** Prompting antibiotic timeouts
		⚫	* IV to oral transitions
		⚫	* Prompting antibiotic timeouts

	=== Tracking ===		=== Tracking ===

Aidan at 18:37, 10 August 2022

2022-08-10T18:37:26Z

@@ Line 21: / Line 21: @@
 === Action ===
 * Choose interventions that will best improve outcomes
-** Prospective audit and feedback, which can be made more effective with face-to-face meetings with prescribers ("handshake stewardship")
+* Prospective audit and feedback, which can be made more effective with face-to-face meetings with prescribers ("handshake stewardship")
-** Preauthorization
+* Preauthorization
 * Pharmacy-based interventions include:
 ** Documentation of indication for antibiotics can improve antibiotic use

Aidan at 18:33, 10 August 2022

2022-08-10T18:33:50Z

@@ Line 7: / Line 7: @@
 === Hospital Leadership Commitment ===
 * Need support from senior leadership, including chief medical officer, chief nursing officer, and director of pharmacy
 * Need leaders to give time to manage the program, resource (including staffing)
-=== Recommended Against ===
+=== Education ===
 * Cycling antibiotics

Aidan at 17:03, 10 August 2022

2022-08-10T17:03:18Z

← Older revision		Revision as of 17:03, 10 August 2022
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	== Core Elements ==		== Core Elements ==

			=== Hospital Leadership Commitment ===
	* Senior hospital management leadership towards antimicrobial stewardship
			* Need support from senior leadership, including chief medical officer, chief nursing officer, and director of pharmacy
			* Need leaders to give time to manage the program, resource (including staffing)
	* Accountability and responsibilities		* Accountability and responsibilities
	* Available expertise on infection management		* Available expertise on infection management

Aidan at 17:41, 31 July 2022

2022-07-31T17:41:03Z

@@ Line 12: / Line 12: @@
 * Monitoring and surveillance
 * Reporting and feedback
 == Further Reading ==

Aidan: added Further Reading

2022-07-31T17:21:12Z

added Further Reading

← Older revision		Revision as of 17:21, 31 July 2022
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	* Monitoring and surveillance		* Monitoring and surveillance
	* Reporting and feedback		* Reporting and feedback

			== Further Reading ==

			* How to start an antimicrobial stewardship programme in a hospital. ''Clin Microbiol Infect''. 2019;26(4):447-453. doi: [https://doi.org/10.1016/j.cmi.2019.08.007 10.1016/j.cmi.2019.08.007]
			* Implementing an Antibiotic Stewardship Program: Guidelines by the IDSA and the SHEA. ''Clin Infect Dis''. 2016;62(10):e51-e77. doi: [https://doi.org/10.1093/cid/ciw118 10.1093/cid/ciw118]
			* IDSA and the SHEA Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. ''Clin Infect Dis''. 2007;44:159-77. doi: [https://doi.org/10.1086/510393 10.1086/510393]

Aidan: Created page with "== Background == * Program to ensure that antimicrobials are used appropriately, in order to improve patient outcomes == Core Elements == * Senior hospital management leadership towards antimicrobial stewardship * Accountability and responsibilities * Available expertise on infection management * Education and practical training * Other actions aiming at responsible antimicrobial use * Monitoring and surveillance * Reporting and feedback"

2022-07-28T16:47:04Z

Created page with "== Background == * Program to ensure that antimicrobials are used appropriately, in order to improve patient outcomes == Core Elements == * Senior hospital management leadership towards antimicrobial stewardship * Accountability and responsibilities * Available expertise on infection management * Education and practical training * Other actions aiming at responsible antimicrobial use * Monitoring and surveillance * Reporting and feedback"

New page

== Background ==

* Program to ensure that antimicrobials are used appropriately, in order to improve patient outcomes

== Core Elements ==

* Senior hospital management leadership towards antimicrobial stewardship
* Accountability and responsibilities
* Available expertise on infection management
* Education and practical training
* Other actions aiming at responsible antimicrobial use
* Monitoring and surveillance
* Reporting and feedback

← Older revision		Revision as of 18:39, 10 August 2022
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	* Implementing an Antibiotic Stewardship Program: Guidelines by the IDSA and the SHEA. ''Clin Infect Dis''. 2016;62(10):e51-e77. doi: [https://doi.org/10.1093/cid/ciw118 10.1093/cid/ciw118]		* Implementing an Antibiotic Stewardship Program: Guidelines by the IDSA and the SHEA. ''Clin Infect Dis''. 2016;62(10):e51-e77. doi: [https://doi.org/10.1093/cid/ciw118 10.1093/cid/ciw118]
	* IDSA and the SHEA Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. ''Clin Infect Dis''. 2007;44:159-77. doi: [https://doi.org/10.1086/510393 10.1086/510393]		* IDSA and the SHEA Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. ''Clin Infect Dis''. 2007;44:159-77. doi: [https://doi.org/10.1086/510393 10.1086/510393]
			* ''The Core Elements of Hospital Antibiotic Stewardship Programs: 2019''. Atlanta, GA: US Department of Health and Human Services, CDC; 2019. Available at https://www.cdc.gov/antibiotic-use/core-elements/hospital.html.