Antimicrobial stewardship program: Difference between revisions

Revision as of 17:41, 31 July 2022

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

Preauthorization
Prospective audit and feedback
Didactic educational activities, including lectures and pamphlets
Facility-specific clinical practice guidelines for common syndromes
Reducing use of antibiotics with increased risk of C. difficile infection
Prescriber-led review, including antibiotics time-outs and stop orders
Computerized clinical decision-making support at the time of prescribing
PK monitoring and adjustment of aminoglycosides and vancomycin
Alternative dosing of β-lactams
Interventions to increase the use of oral antibiotics for initial therapy as well as timely transition from IV to oral antibiotics
Interventions to reduce the duration of antibiotics to shortest effective duration
Allergy assessments and penicillin skin testing for patients with reported β-lactam allergy
Development of stratified antibiograms (e.g. by location or age)
Selective and cascade reporting of antimicrobial susceptibility
Rapid viral testing for respiratory pathogens to reduce the use of inappropriate antibiotics
Rapid diagnostic testing on blood specimens
Serial procalcitonin in ICU patients

@@ Line 12: / Line 12: @@
 * Monitoring and surveillance
 * Reporting and feedback
+== Possible Interventions ==
+* Preauthorization
+* Prospective audit and feedback
+* Didactic educational activities, including lectures and pamphlets
+* Facility-specific clinical practice guidelines for common syndromes
+* Reducing use of antibiotics with increased risk of [[C. difficile infection]]
+* Prescriber-led review, including antibiotics time-outs and stop orders
+* Computerized clinical decision-making support at the time of prescribing
+* PK monitoring and adjustment of [[aminoglycosides]] and [[vancomycin]]
+* Alternative dosing of β-lactams
+* Interventions to increase the use of oral antibiotics for initial therapy as well as timely transition from IV to oral antibiotics
+* Interventions to reduce the duration of antibiotics to shortest effective duration
+* Allergy assessments and penicillin skin testing for patients with reported [[β-lactam allergy]]
+* Development of stratified antibiograms (e.g. by location or age)
+* Selective and cascade reporting of antimicrobial susceptibility
+* Rapid viral testing for respiratory pathogens to reduce the use of inappropriate antibiotics
+* Rapid diagnostic testing on blood specimens
+* Serial [[procalcitonin]] in ICU patients
+=== Recommended Against ===
+* Cycling antibiotics
 == Further Reading ==