7. Antimicrobial Stewardship MT2

Question 1

this is coordinated interventions designed to improve and measure the appropriate use of antimicrobial agents by promoting the selection of optimal antimicrobial regimen, including: dosing, duration of therapy and route of administration

Answer 1

antimicrobial stewardship

Question 2

this is a prospective audit of antimicrobial use with intervention and feedback. review antimicrobial regimens for:
- appropriate indication
- local resistance patterns
- dose optimization
- preferred route of administration
- duration of therapy
- duplication of therapy
- drug interactions
review culture and sensitivity reports of selected patients for potential adjustments to antimicrobial regimen; consider
- IV to PO conversions
- pharmacokinetics monitoring
- renal dosing adjustment

Answer 2

streamlining or de-escalation therapy

Question 3

this is a part of the antimicrobial stewardship program that involves education to prescribers and other relevant staff regarding evidence-based guidelines or best practices

Answer 3

education activates

Question 4

this is part of the antimicrobial stewardship program that involves evidence based protocols and guidelines that incorporate local microbiology and resistance patterns. the antimicrobial stewardship program should be involved in the development when produced by other departments

Answer 4

facility-specific clinical practice guidelines

Question 5

this part of the antimicrobial stewardship program facilitates capturing and reviewing patients on redundant antimicrobial coverage
- metronidazole + pip/tazo or carbapenem
- FQ + macrolide or doxycycline
- dual beta-lactams

Answer 5

surveillance monitoring

Question 6

this part of the antimicrobial stewardship program produces a list of restricted antimicrobials available to healthcare providers; its use is limited to physicians trained in infectious diseases. some restricted antimicrobials include
- aztreonam (SAP)
- daptomycin
- linezolid IV/PO

Answer 6

formulary restrictions

Question 7

preventing infections reduces antibiotic use therefore reducing the liklihood resistance will develop to therapy. what are some ways drug resistant infections can be prevented?

Answer 7

• immunization
• safe food preparation
• hand washing
• using antibiotics as directed (finish all) and only when needed

Question 8

what is the most important action of improving antibiotic prescribing/stewardship

Answer 8

to slow development and spread of antibiotic-resistant infections by changing how antibiotics are used. for example:
- only use when needed to tx disease
- choose right antibiotic
- administer antibiotics in the right way (right dose with shortest duration)

Question 9

this part of the antimicrobial stewardship program is recommended for ahminoglycosides, suggested for vancomycin and should be integrated into routine pharmacy practice

Answer 9

pharmacokinetic monitoring and adjustment