Antimicrobial stewardship

Question 1

Define antimicrobial stewardship

Answer 1

Coordinated interventions designed to improve and measure the appropriate use of anitmicrobials.

Question 2

How is antimicrobial use improved?

Answer 2

Promoting selection of most optimal drug, regime, dose and duration of therapy.

Question 3

What do antimicrobial stewards seek to achieve?

Answer 3

Optimal clinical outcomes
Minimise toxicity
Reduce costs
Limit selection for antimicrobial resistant strains

Question 4

Levels of resistance

Answer 4

MDR (multidrug resistance)
XDR (extensively drug resistant)
PDR (pan-drug resistant)

Question 5

MDR

Answer 5

Non suceptability to at least 1 agent in 3 or more antimicrobial catagories

Question 6

XDR

Answer 6

Non suceptability to at least one agent in all but 2 or less antimicrobial categories

Question 7

PDR

Answer 7

Completely resistant

Question 8

Outcome measures

Answer 8

Patient outcomes
Emergence of resistance
Clostridum difficile infection

Question 9

questions to ask

Answer 9

Does the patient need antibiotics?
Can we switch from IV to oral?
Can we change broad to narrow spectrum?
Do you need authorisation from microbiology?