S43(2) Antimicrobial Stewardship Program

Question 1

CDC’s Antibiotic Resistance Threats 2019

Watch List NEW

Answer 1

Azole-resistant Aspergillus fumigatus (A. fumigatus)
Drug-resistant Mycoplasma genitalium (M. genitalium)
Drug-resistant Bordetella pertussis (B. pertussis)

Question 2

CDC’s Antibiotic Resistance Threats 2019

Concerning Threats

Answer 2

Vancomycin-resistant Staphylococcus aureus (VRSA)

removed from the list in 2019

Question 3

ASP Core Team Players: A Multidisciplinary Approach

Two primary players:

Answer 3

Infectious Diseases Physician Champion (Director)
Main responsibility is to oversee the overall functioning of the ASP

Infectious Diseases trained/Antimicrobial Stewardship clinical pharmacist (Co-Director)
Responsible for day-day monitoring of the functions of the ASP and discusses cases with the ID physician champion

Question 4

Components of the ASP

Two Primary:

Answer 4

Prospective audit with the intervention and feedback

Formulary restriction and preauthorization requirement for specific agents

Question 5

We recommend ________________ and/or __________ _____ and feedback over no such intervention (strong recommendation, moderate-quality evidence).

Answer 5

preauthorization

prospective audit

Question 6

We recommend antibiotic stewardship interventions designed to ______ the use of antibiotics associated with a high risk CDI compared with no such intervention (strong recommendation, moderate-quality evidence)

Answer 6

reduce

Question 7

We recommend that hospitals implement PK monitoring and adjustment programs for _______________ and __________ (strong recommendation, moderate-quality evidence).

Answer 7

aminoglycosides

vancomycin

Question 8

We recommend ASPs implement programs to ________ both the appropriate use of oral antibiotics for initial therapy and the timely transition of patients from IV to oral antibiotics (strong recommendation, moderate-quality evidence). Continuation

Answer 8

increase

Question 9

We recommend that ASPs implement guidelines and strategies to reduce antibiotic therapy to the ________ ________ ________ (strong recommendation, moderate-quality evidence).

Answer 9

shortest effective duration

Question 10

We suggest the use of rapid viral testing for __________ _________ to reduce the use of inappropriate antibiotics (weak recommendation, low-quality evidence)

Answer 10

respiratory pathogens

Question 11

In adults in the ICUs with suspected infection, we suggest the use of serial _____________ measurements as an ASP intervention to decrease antibiotic use (weak recommendation, moderate-quality evidence)

Answer 11

procalcitonin