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Atb steward
Antibiotic stewardship programs aim to optimize antibiotic use, improve patient outcomes, reduce antibiotic resistance and adverse events. They involve multidisciplinary teams who provide guidance and feedback on prescribing. Core elements include leadership commitment, accountability, drug expertise, tracking antibiotic use and resistance over time, and educating prescribers. Specific interventions target broad antibiotic use as well as infection-specific treatment protocols. Regular reporting and education helps ensure optimal antibiotic stewardship.
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Atb steward
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- 2. lethal infections treatable • Savelives. • Sepsis. medical advances • Cancer chemotherapy • Organ transplants
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- 17. •3 Ds •the right •drug • dose • duration.
- 18. “Antibiotic Stewardship Programs • improvethe quality of patient care • optimize the treatment of infections • correct therapy • increased cure rates • reduced failures • patient safety • reduce adverse events • reduce antibiotic resistance.
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- 20. Core Elements of Hospital Antibiotic Stewardship Programs Leadership Commitment Accountability DrugExpertise Action Tracking Reporting Education
- 21. Leadership Commitment critical • jobdescriptions • annual performance • staff • time • training and education • Financial Formal statements
- 22. Accountability identifying a lead •physicians and pharmacists • Infection control • Quality-improvement • Laboratorians • IT staff
- 23. Drug expertise • doseoptimization. • In addition, pharmacists can assist with: • Automatic alerts • automatic stop orders • Alerts -drug-drug interactions • Encouraging prescribers to document dose, duration, and indication • Development treatment recommendations.
- 24. Key points • Implementoptimal antibiotic use policies. • specific interventions • Broad • pharmacy driven • infection specific • Avoid implementing too many policies and interventions • prioritize interventions
- 25. Action •Broad Interventions •Pharmacy-Driven Interventions •Infection-Specific Interventions
- 26. Action •Broad Interventions • Antibiotictime outs • Prior authorization • Prospective audit and feedback
- 27. Action • Pharmacy-Driven Interventions •Automatic changes IV-- PO • Dose adjustments • Dose optimization • Automatic alerts • automatic stop • drug-drug interactions
- 28. Action Infection -Specific Interventions •CAP • UTIs • SSTI • Empiric coverage of (MRSA) infections • Clostridium difficile infections • Treatment of culture-proven invasive infections
- 29. Track antibiotic useand outcomes. • Process measures • Periodic assessments of the use of antibiotics or the treatment of infections to determine the quality of antibiotic use. • Assess if antibiotics are being given in a timely manner. • Assess prescribers’ compliance with the facility’s antibiotic-use policies. • Outcome measures • Track rates of hospital-onset Clostridium difficile infections. • Track antibiotic resistance. • Monitor antibiotic costs.
- 30. Reporting • to prescribersand staff • compares regional or national. • Reporting (C-diff) to the National Healthcare Safety Network (NHSN)
- 31. Education • Any antibioticstewardship program should provider regular updates and/or training on antibiotic prescribing, antibiotic resistance, and infectious disease management on updated or emerging local or national trends.
Editor's Notes
- #4 In his Nobel Prize acceptance speech, Fleming warned the world of the dangers of misusing antibiotics. He had already noted bacteria in his lab becoming resistant to penicillin, just a few years after its discovery! After decades of antibiotic misuse, today we find ourselves facing bacteria which has become resistant to most, if not all antibiotics.
- #23 identifying a lead physicians and pharmacists Infection control monitoring and prevention Auditing Analyzing reporting of data. Quality-improvement staff Laboratorians appropriate lab tests results communicated. facility’s antibiogram. IT staff point of care Prompts Data collection and reporting
- #30 Tracking the prescribing of antibiotics in the facility is important because it will help stewardship team members identify areas for improvement and to assess the impact of any improvement efforts that are implemented. Both processes and outcomes can be tracked and measured.
- #31 Tracking antibiotic use and outcomes is only beneficial if the information is reported back to the prescribers themselves, the facility's antimicrobial stewardship team, and the facility's executive leadership. By sharing this information, prescribers and staff can identify where improvements can be made or where interventions should be targeted. Reporting of both antibiotic use and antibiotic resistance in a facility can help clinicians make more informed decisions in patient care and potentially prevent misuse of antibiotics.