Antimicrobial Stewardship

Question 1

Which CLSI document provides guidance in creating an antibiogram?

Answer 1

M-39 document

Question 2

Which isolates should be used to develop an antibiogram per CLSI?

Answer 2

First isolate per patient per year

Question 3

What is the minimum isolates needed to be included into an antibiogram?

Answer 3

At least 30 isolates

Question 4

How would you choose antibiotics for an antibiogram?

Answer 4

Use antibiotics routinely tested (ex: do not include linezolid if only tested once or twice for Staph lugdunensis)

Question 5

What 2 IDSA/SHEA stewardship interventions show strong evidence for recommendation?

Answer 5

1. Preauthorization or Prospective audit and feedback

2. Reduce of of high-risk C. diff antibiotics

Question 6

Which 3 IDSA/SHEA stewardship methods associated with antimicrobial optimization are considered to have strong evidence of recommendation?

Answer 6

1. PK monitoring of aminoglycosides
2. IV to PO
3. Promote appropriate duration of therapy

Question 7

What stewardship-microbiology collaboration is a strongly recommended stewardship intervention?

Answer 7

Develop antibiogram

Question 8

Which organizations develop core elements of an antibiotic stewardship program that facilitate compliance with accreditation requirements?

Answer 8

Centers of Disease Prevention

Question 9

What are the 2020 goals of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria?

Answer 9

1. 50% reduction in Cdiff infection
2. 60% reduction in CRE infections
3. 35% reduction in HA MDR PSA infections
4. 50% reduction in MRSA bloodstream infections
5. 25% reduction in MDR non-typhoidal Salmonella infections
6. 15% reduction in number of MDR TB infections
7. 25% reduction in antibiotic resistant invasive pneumococcal disease among < 5 yo
8. 25% reduction in rate of antibiotic resistant invasive pneumococcal disease among >65 yo

Question 10

What are the CDC core elements for acute care hospitals?

Answer 10

1. Leadership Commitment
2. Accountability
3. Drug Expertise
4. Action plan
5. Track stewardship metrics
6. Reporting
7. Prescriber and Patient education

Question 11

What are examples of pharmacy-driven interventions under the action plan in CDC’s core elements?

Answer 11

1. IV to PO
2. Dose Adjustment
3. Dose Optimization
4. Automatic stop orders (D/c abx at a specific time point)
5. Alerts for DDIs and duplication therapy

Question 12

What are the IDSA/SHEA recommended stewardship metrics?

Answer 12

1. Monitor days of antimicrobial therapy
2. Measure expenditures based on administration data
3. Measure syndrome specific goals

Question 13

What infections are required to be reported to CDC’s National Healthcare Safety Network?

Answer 13

1. Catheter associated UTI
2. Catheter associated blood stream infections
3. Healthcare acquired C. difficile infection
4. Select surgical site infections
5. MRSA bacteremia

Question 14

What are all the common diseases that require droplet precautions?

Answer 14

Rubella
Pertussis
Meningococcal
Meningitis
Influenza
RSV
HMV

Question 15

What are the common disease that need respiratory precautions?

Answer 15

Chickenpox
Measles
Tuberculosis

Question 16

What are the common diseases that require contact precautions?

Answer 16

Scabies
Lice
VRE
MDRO GNR

Question 17

What the common disease that require contact-diarrhe?

Answer 17

Cdiff
Rotavirus
Noravirus
Hepatitis A

Question 18

What PPE is required for respiratory precautions?

Answer 18

Private room
Mask
Hand hygiene

Question 19

What PPE is required for droplet precautions?

Answer 19

Hand hygiene
Mask
Gown
Gloves

Question 20

What PPE is required for contact precautions?

Answer 20

Hand hygiene
Gloves
Gown