W05_03 Antimicrobial Stewardship

Question 1

note: total number of antibiotic prescriptions hasn’t changed since 2014, but the cost has gone down.

Answer 1

because the antibiotics are getting cheaper with patent expiry and generics production

Question 2

how do immunocompromised patients contribute to antibiotic resistance?

Answer 2

more immunocompromised patients (old, dementia, HIV, transplantation, etc) that require higher usage of antimicrobials for prophylaxis and treatment

Question 3

note: morris says that antibiotics prescribing is usually because of emotional attachment to these meds, but not what’s scientifically correct

Answer 3

okay.

Question 4

what’s the history of antimicrobial stewardship?

Answer 4

1988 - infectious diseases society of america published guidelines for usage.
1997 - IDSA made more guidelines with society for hospital epidemiology of america for prevention of resistance.
1998 - coleman rotstein
2007 - IDSA/SHEA publishes their widely cited documents

Question 5

what are things we don’t know but should, concerning antimicrobials?

Answer 5

clinical difference between cidal and static drugs;
cost-benefit ratios of treating syndromes;
IV vs orals?;
when/duration to start antibiotics;

Question 6

how is AM stewardship performed?

Answer 6

AM formulary;
AM policing for certain AMs;
auditing;
education;
guidelines;
narrow spectrum;
iv-to-oral