Antimicrobial Stewardship-way forward. Dr. Sonal Saxena Professor Lady Hardinge Medical College New Delhi

Size: px
Start display at page:

Download "Antimicrobial Stewardship-way forward. Dr. Sonal Saxena Professor Lady Hardinge Medical College New Delhi"

Transcription

1 Antimicrobial Stewardship-way forward Dr. Sonal Saxena Professor Lady Hardinge Medical College New Delhi

2

3

4 Lets save what we have!

5 What is Antibiotic stewardship? Optimal selection, dose and duration of an antibiotic resulting in the cure or prevention of infection with minimal unintended consequences to the patient including emergence of resistance, adverse drug events, and cost

6 Goals of Antibiotic stewardship Optimize patient safety:4ds Control costs Improve clinical outcome Reduce morbidity/mortality/hospital stay/adverse effects Dellit TH, et. al. Clin Infect Dis. 2007;44:

7 Core Elements of Hospital Antibiotic Stewardship Programs Leadership Commitment: Dedicating necessary human, financial and information technology resources. Accountability: Appointing a single leader responsible for program outcomes. Drug Expertise: Appointing a single pharmacist leader responsible for working to improve antibiotic use. Action: Implementing at least one recommended action, such as systemic evaluation of ongoing treatment need after a set period of initial treatment (i.e. a ti ioti ti e out after 48 hours).

8 Tracking: Monitoring antibiotic prescribing and resistance patterns. Reporting: Regular reporting information on antibiotic use and resistance to doctors, nurses and relevant staff. Education: Educating clinicians about resistance and optimal prescribing.

9 Stewardship approaches Front end approach Physician without authority writes order for restricted drug Order arrives in pharmacy Pharmacist informs physician that the drug is restricted/non formulary Approval or alternative antibiotic selected Back end approach Physician writes order Antibiotic is dispensed Review of antibiotic Prescriber contacted and explained Antibiotic changed/continued

10 Strategies of Antibiotic stewardship Core Strategies Supplemental Strategies Formulary restrictions and preauthorization* Prospective audit with intervention and feedback* Multidisciplinary stewardship team* Streamlining / timely de-escalation of therapy* Dose optimization* Parenteral to oral conversion* Guidelines and clinical pathways* Antimicrobial order forms Education Computerized decision support surveillance Laboratory surveillance and feedback Combination therapies Antimicrobial cycling * Strategies with strongest evidence and support by IDSA. Dellit et al. Clinical Infectious Diseases 2007;44:159-77

11 Key Support in stewardship program Clinicians and department heads: As the prescribers of antibiotics Infection preventionists and hospital epidemiologists: coordinate facility-wide monitoring and prevention of healthcare-associated infections and can readily bring their skills to auditing, analyzing and reporting data. Assist with monitoring and reporting of resistance educating staff and implementing strategies

12 Quality improvement staff Information technology staff : are critical to integrating stewardship protocols into existing workflow. Nurses: Can assure that cultures are performed before starting antibiotics. Can review medications as part of their routine duties and can prompt discussions of antibiotic treatment, indication, and duration.

13 Implementing antimicrobial stewardship program Local flora and resistance patterns Estimate resources available Determine priority & planning interventions Engage decision makers and antibiotic prescribers Engage hospital administration Generate working plan Implement program

14 Other considerations Size of the hospital and identify the clear authority for the program. Also, before institutional interventions are made, it is important to discuss the scope of authority and obtain administrative approval. Infectious diseases pharmacists need oversight with physi ia s i ol e e t in the program, so when interventions are made, they are evidencebased and supported by the medical staff.

15 Convincing seniors/administration to implement ASP. Recruiting staff or adding extra work on existing staff. Creating more communication networks via net (IT) or personal Education and motivation to be made ongoing tool

16 Implement Policies Implement policies that support optimal antibiotic use. Avoid implementing too many policies and interventions simultaneously; always prioritize interventions based on the needs of the hospital as defined by measures of overall use and other tracking and reporting metrics.

17 Components of AMSP Written document Team Data Infection control Data analysis Strategies Prescription guidelines Prescription audit/feedback Implementation outcomes Prescription autonomy

18 AMSP document Clarity is the key programme to be understood/implemented by all hospital personnel Co er all aspe ts of the hospital s AMSP programme. ie, infectious conditions, prescriptions required for antimicrobials hospital drug formulary/essential antibiotic list

19 AMSP team Large hospitals separate teams for each of the major clinical departments, to push the programme Chaired respective HODs

20 Building ASP team ID consultant preferably with ID training Pharmacist Microbiologist Epidemiologist Infection control team member Administration representative

21 Role of microbiologist Evolving antibiotic policy Can guide the proper use of tests and the flow of results. Availability of rapid, accurate quality assured antibiotic test results. Creating readily usable and coherent antibiotic resistant data Can also guide empiric therapy by creating and interpreting a facility cumulative antibiotic resistance report (antibiogram). Creating communication network with ASP team and prescribers to ensure that lab reports present data in a way that supports optimal antibiotic use.

22 Using Rapid Diagnostic Tests to Optimize Antimicrobial Selection in Antimicrobial Stewardship Programs

23 Antimicrobial prescription guidelines Department wise for various conditions Involved the HOD and respective department member Regular review/update most current developments Treatment alogrithms

24 Prescription Autonomy Surveys at regular intervals Address issues effectively

25 Strategies to follo CustomizedLocal requirements Antimicrobial Resistance Data Cost/Efficacy Drug formulary

26 Antimicrobial resistance data analysis Frequency performed monthly, communicated half- yearly & annually Data analysed as per OPD/IPD/ICU CAI(?catheter),HCAI,ICU(and sub- units), Site of infection (or subsite) Ex: Urinary tract Specific pathogen(not groups like Gram+ve, Gram ve)sentinel drug/bug

27 Let data be at the heart of your learning/communication

28 Antimicrobial usage data analysis Sales data Dispensing data either comprehensive or sampled. Actual drug administered New adverse effects identified added to formulary if statistically significant DDD/DOT

29 Antimicrobial prescription audit/feedback Separate audit teams each major clinical department Chaired by the HOD Should target AMA compliance as per specific conditions Adverse drug effects identified Suggested improvements Recognition significant achievements by a dept.

30 AMSP Implementation Outcomes Pre/Post implementation Efficacy of AMSP activities Report to be made available to all hospital personnel

31 Education Engage: Make the problem real (e.g. harm caused by CLABSI), HCW ideas for improvement Educate: Present the evidence Execute: Deploy the tool kit, regular meetings Evaluate: Measurement and feedback, Recognition and visibility, Celebrate success, Assess reasons for failure

32 Limitations and pitfalls Staff: Infection preventionists Hospital epidemiologists Quality improvement staff Pharmacist Facilities Latest/rapid tests IT Resistant data Communication Motivation (nurses, prescribers, administrative staff) Education COST

33 Pitfalls Demonstrating a clear causal association between implementation and of ASPs and detection of resistance Decrease use of one increase use of another: squeezing the balloon Most studies observational so correlation over time at your center more appropriate

34 Pitfalls Inadequate lab resources Physician push back related to monitoring and restricting antibiotic use No a tago is Perceived loss of physician autonomy Lack of updated guidelines Obligation to referred physician or hospital

35 Practical approach

36 Resources Duguid M and Cruickshank M (eds.) (2011). Antimicrobial stewardship in Australian hospitals, Australian Commission on Safety and Quality in health Care, Sydney. Dellit TH et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. Clinical Infectious Diseases 2007;44: CDC Get Smart for Healthcare : Department of Health Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) ANTIMICROBIAL STEWARDSHIP: START SMART -THEN FOCUS. ments/digitalasset/dh_ pdf

37 Conclusion Each stakeholder needs to be involved & made to feel responsible Whole society to be involved if stewardship needs to succeed Health professionals need to lead by example in health facilities and take leadership in communities Feasibility, cost and effectiveness of interventions to be judged Multipronged approach may reap the maximum benefit Resistance upon us Up to us to act and act fast.

38 The way forward>>>> Appropriate antibiotic use is a patient safety priority Antibiotics are a shared resource and becoming a scarce resource. Inappropriate antibiotic use and resistant infections = Billions of $$ in excess healthcare costs To combat resistance: Think globally, act locally The Future of Stewardship = YOU

39 Strategies for reversing resistance trends and examples of successes How to implement or improve your antimicrobial stewardship program Antimicrobial stewardship strategies that will work for your facility How to measure the success of your stewardship program

40 Be the change that you wish to see in the world -Mahatma Gandhi THANK YOU

UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM

UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM Diane Rhee, Pharm.D. Associate Professor of Pharmacy Practice Roseman University of Health Sciences Chair, Valley Health

More information

Antimicrobial Stewardship

Antimicrobial Stewardship Antimicrobial Stewardship Preventing the Spread of Antibiotic Resistance and Improving Patient Care (Adapted from the Centers for Disease Control and Prevention) What is Stewardship? Antimicrobial stewardship

More information

Optimizing Antimicrobial Stewardship Activities Based on Institutional Resources

Optimizing Antimicrobial Stewardship Activities Based on Institutional Resources Optimizing Antimicrobial Stewardship Activities Based on Institutional Resources Andrew Hunter, PharmD, BCPS Infectious Diseases Clinical Pharmacy Specialist Michael E. DeBakey VA Medical Center Andrew.hunter@va.gov

More information

Commonwealth of Kentucky Antibiotic Stewardship Practice Assessment For Long-Term Care Facilities

Commonwealth of Kentucky Antibiotic Stewardship Practice Assessment For Long-Term Care Facilities Commonwealth of Kentucky Antibiotic Stewardship Practice Assessment For Long-Term Care Facilities Introduction As the problem of antibiotic resistance continues to worsen in all healthcare setting, we

More information

11/22/2016. Antimicrobial Stewardship Update Disclosures. Outline. No conflicts of interest to disclose

11/22/2016. Antimicrobial Stewardship Update Disclosures. Outline. No conflicts of interest to disclose Antimicrobial Stewardship Update 2016 APIC-CI Conference November 17 th, 2016 Jay R. McDonald, MD Chief, ID Section VA St. Louis Health Care System Assistant Professor of medicine Washington University

More information

Antimicrobial Stewardship in the Hospital Setting

Antimicrobial Stewardship in the Hospital Setting GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 12 Antimicrobial Stewardship in the Hospital Setting Authors Dan Markley, DO, MPH, Amy L. Pakyz, PharmD, PhD, Michael Stevens, MD, MPH Chapter Editor

More information

Jump Starting Antimicrobial Stewardship

Jump Starting Antimicrobial Stewardship Jump Starting Antimicrobial Stewardship Amanda C. Hansen, PharmD Pharmacy Operations Manager Carilion Roanoke Memorial Hospital Roanoke, Virginia March 16, 2011 Objectives Discuss guidelines for developing

More information

Updates in Antimicrobial Stewardship

Updates in Antimicrobial Stewardship Updates in Antimicrobial Stewardship Andrew Hunter, Pharm.D., BCPS Infectious Diseases Clinical Pharmacy Specialist Michael E. DeBakey VA Medical Center andrew.hunter@va.gov Disclosures No disclosures

More information

ASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies

ASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies ASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies Theresa Jaso, PharmD, BCPS (AQ-ID) Network Clinical Pharmacy Specialist Infectious Diseases Seton Healthcare Family Ascension

More information

Using Data to Track Antibiotic Use and Outcomes

Using Data to Track Antibiotic Use and Outcomes Using Data to Track Antibiotic Use and Outcomes Michelle Nemec, PharmD Thrifty White Drug Pharmacy Objectives Describe the Antibiotic Stewardship Core Element of tracking and the specific interventions

More information

Hot Topics in Antimicrobial Stewardship. Meghan Brett, MD Medical Director, Antimicrobial Stewardship University of New Mexico Hospital

Hot Topics in Antimicrobial Stewardship. Meghan Brett, MD Medical Director, Antimicrobial Stewardship University of New Mexico Hospital Hot Topics in Antimicrobial Stewardship Meghan Brett, MD Medical Director, Antimicrobial Stewardship University of New Mexico Hospital Antimicrobial Stewardship Goals Primary Goal Optimize clinical outcomes

More information

Healthcare Facilities and Healthcare Professionals. Public

Healthcare Facilities and Healthcare Professionals. Public Document Title: DOH Guidelines for Antimicrobial Stewardship Programs Document Ref. Number: DOH/ASP/GL/1.0 Version: 1.0 Approval Date: 13/12/2017 Effective Date: 14/12/2017 Document Owner: Applies to:

More information

Hospital Antimicrobial Stewardship Program Assessment Checklist

Hospital Antimicrobial Stewardship Program Assessment Checklist Hospital Antimicrobial Stewardship Program Assessment Checklist This checklist should be used to determine which aspects of antimicrobial stewarship (AMS) programs are already in place to ensure optimal

More information

Hospital - Leaders establish antimicrobial stewardship as an

Hospital - Leaders establish antimicrobial stewardship as an Below please find the IDSA response to the Joint Commission s Proposed Standard for Antimicrobial Stewardship in various types of facilities, (AHC, CAH,HAP, NCC, and OBS). Comments are broken out by the

More information

Jump Start Stewardship

Jump Start Stewardship Jump Start Stewardship Webinar 2: Building your Stewardship Team and Selecting Interventions and Targets for your Implementation Welcome Thank you for your time today This webinar will be recorded for

More information

Antimicrobial Stewardship 101

Antimicrobial Stewardship 101 Antimicrobial Stewardship 101 Betty P. Lee, Pharm.D. Pediatric Infectious Disease/Antimicrobial Stewardship Pharmacist Lucile Packard Children s Hospital Stanford Disclosure I have no actual or potential

More information

Antimicrobial Stewardship Programs The Same, but Different. Sara Nausheen, MD Kevin Kern, PharmD

Antimicrobial Stewardship Programs The Same, but Different. Sara Nausheen, MD Kevin Kern, PharmD Antimicrobial Stewardship Programs The Same, but Different Sara Nausheen, MD Kevin Kern, PharmD Antimicrobial Stewardship Programs The Same, but Different Objectives: Outline the overall function of an

More information

ANTIBIOTIC STEWARDSHIP

ANTIBIOTIC STEWARDSHIP ANTIBIOTIC STEWARDSHIP S.A. Dehghan Manshadi M.D. Assistant Professor of Infectious Diseases and Tropical Medicine Tehran University of Medical Sciences Issues associated with use of antibiotics were recognized

More information

It s Time to Regulate Antimicrobial Stewardship Standards in Acute Care Settings. Emily Heil, PharmD, BCPS-AQ ID, AAHIVP

It s Time to Regulate Antimicrobial Stewardship Standards in Acute Care Settings. Emily Heil, PharmD, BCPS-AQ ID, AAHIVP It s Time to Regulate Antimicrobial Stewardship Standards in Acute Care Settings Emily Heil, PharmD, BCPS-AQ ID, AAHIVP Conflict of Interest I have no conflicts of interest to disclose related to the content

More information

CHAPTER 9 ANTIMICROBIAL STEWARDSHIP PROGRAM (ASP)

CHAPTER 9 ANTIMICROBIAL STEWARDSHIP PROGRAM (ASP) DEPARTMENT OF THE ARMY HEADQUARTERS, UNITED STATES ARMY MEDICAL DEPARTMENT ACTIVITY FORT POLK, LOUISIANA 71459-5110 MEDDAC Regulation 29 August 2017 Number 500a-59 CHAPTER 9 ANTIMICROBIAL STEWARDSHIP PROGRAM

More information

Antimicrobial Stewardship

Antimicrobial Stewardship Antimicrobial Stewardship Background Why Antimicrobial Stewardship 30-50% of antibiotic use in hospitals are unnecessary or inappropriate Appropriate antimicrobial use is a medication-safety and patient-safety

More information

What is an Antibiotic Stewardship Program?

What is an Antibiotic Stewardship Program? What is an Antibiotic Stewardship Program? Jane Rogers, R.N. Anne Messer, MPH Learning Session #4 August 15, 2017 National Nursing Home Quality Care Collaborative Change Package Change Bundle: To prevent

More information

Define evidence based practices for selection and duration of antibiotics to treat suspected or confirmed neonatal sepsis

Define evidence based practices for selection and duration of antibiotics to treat suspected or confirmed neonatal sepsis GLOBAL AIM: Antibiotic Stewardship Perinatal Quality Improvement Teams (PQITs) will share strategies and lessons learned to develop potentially better practices and employ QI methodologies to establish

More information

Antimicrobial stewardship

Antimicrobial stewardship Antimicrobial stewardship Magali Dodemont, Pharm. with the support of Wallonie-Bruxelles International WHY IMPLEMENT ANTIMICROBIAL STEWARDSHIP IN HOSPITALS? Optimization of antimicrobial use To limit the

More information

STANDARD FOR ANTIMICROBIAL STEWARDSHIP IN HAP, CAH, AND NCC OR ANTIBIOTIC STEWARDSHIP AND YOU

STANDARD FOR ANTIMICROBIAL STEWARDSHIP IN HAP, CAH, AND NCC OR ANTIBIOTIC STEWARDSHIP AND YOU STANDARD FOR ANTIMICROBIAL STEWARDSHIP IN HAP, CAH, AND NCC OR ANTIBIOTIC STEWARDSHIP AND YOU CLINT ROHNER, PHARMD EIRMC CLINICAL COORDINATOR, FORMER AMP LEAD OCTOBER 28, 2016 TYPES OF FACILITY AFFECTED:

More information

Antibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE

Antibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE Antibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE Crisis: Antibiotic Resistance Success Strategy WWW.optimistic-care.org

More information

Antibiotic stewardship in North Carolina hospitals

Antibiotic stewardship in North Carolina hospitals Introduction Antibiotic stewardship in North Carolina hospitals Ralph Raasch a, Laini Jarrett-Echols b, Carol Koeble c, Christine Pittman d The benefits of hospital-based antibiotic stewardship programs

More information

Antibiotic Stewardship and Critical Access Hospitals. Robert White, BA, PT, CPHQ Program Manager TMF Quality Innovation Network

Antibiotic Stewardship and Critical Access Hospitals. Robert White, BA, PT, CPHQ Program Manager TMF Quality Innovation Network Antibiotic Stewardship and Critical Access Hospitals Robert White, BA, PT, CPHQ Program Manager TMF Quality Innovation Network Antibiotic-Resistant Bacteria A serious threat to public health and the economy

More information

Antibiotic Stewardship: The Facility Role and Implementation. Tim Cozad, LPN, Lead LTC Health Facilities Surveyor

Antibiotic Stewardship: The Facility Role and Implementation. Tim Cozad, LPN, Lead LTC Health Facilities Surveyor Antibiotic Stewardship: The Facility Role and Implementation Tim Cozad, LPN, Lead LTC Health Facilities Surveyor Phase II CMS Regulatory Changes Current information available includes: New Survey Process

More information

Antibiotic Stewardship in the LTC Setting

Antibiotic Stewardship in the LTC Setting Antibiotic Stewardship in the LTC Setting Joe Litsey, Director of Consulting Services Pharm.D., Board Certified Geriatric Pharmacist Thrifty White Pharmacy Objectives Describe the Antibiotic Stewardship

More information

Antimicrobial Stewardship: Setting minimum expectations for optimizing antimicrobial use and addressing resistance

Antimicrobial Stewardship: Setting minimum expectations for optimizing antimicrobial use and addressing resistance Antimicrobial Stewardship: Setting minimum expectations for optimizing antimicrobial use and addressing resistance Loria Pollack, MD, MPH Centers for Disease Control and Prevention Division of Healthcare

More information

Disclosures. Astellas. The Medicines Company. Theravance Biopharma

Disclosures. Astellas. The Medicines Company. Theravance Biopharma Disclosures Astellas The Medicines Company Theravance Biopharma Objectives Define antimicrobial stewardship using nationally accepted criteria Identify strategies to provide antimicrobial stewardship Review

More information

Antimicrobial Stewardship: Stopping the Spread of Antibiotic Resistance

Antimicrobial Stewardship: Stopping the Spread of Antibiotic Resistance Antimicrobial Stewardship: Stopping the Spread of Antibiotic Resistance Natalie Weber, PharmD PGY2 Critical Care Pharmacy Resident September 22, 2016 The speaker has no actual or potential conflicts of

More information

Impact of Antimicrobial Stewardship Program

Impact of Antimicrobial Stewardship Program Impact of Antimicrobial Stewardship Program Ripal Joshi, Pharm.D. AAHIVP Tampa General Hospital January 28, 2016 Objectives Provide an overview on antimicrobial stewardship programs (ASP) Describe the

More information

Core Elements of Antibiotic Stewardship for Nursing Homes

Core Elements of Antibiotic Stewardship for Nursing Homes Core Elements of Antibiotic Stewardship for Nursing Homes Nimalie D. Stone, MD, MS Medical Epidemiologist for LTC Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Antimicrobial

More information

6/15/2017 PART 1: THE PROBLEM. Objectives. What is Antimicrobial Resistance? Conflicts of Interest Disclosure Statement

6/15/2017 PART 1: THE PROBLEM. Objectives. What is Antimicrobial Resistance? Conflicts of Interest Disclosure Statement Conflicts of Interest Disclosure Statement Getting a grasp on Antibiotic Use and Resistance: Principles of Antimicrobial Stewardship Speaker has nothing to disclose. Jacob M Kesner, PharmD UNMH PGY-2 Infectious

More information

Bugs, Drugs, and No More Shoulder Shrugs: The Role for Antimicrobial Stewardship in Long-term Care

Bugs, Drugs, and No More Shoulder Shrugs: The Role for Antimicrobial Stewardship in Long-term Care Bugs, Drugs, and No More Shoulder Shrugs: The Role for Antimicrobial Stewardship in Long-term Care Molly Curran, PharmD, BCPS Clinical Assistant Professor The University of Texas College of Pharmacy Clinical

More information

Antimicrobial Stewardship. October 2012

Antimicrobial Stewardship. October 2012 Antimicrobial Stewardship October 2012 Rising Antimicrobial Resistance Methicillin resistant staphylococcus aureus (MRSA) Vancomycin resistant enterococci (VRE) MDR and extremely drug resistant (XDR TB)

More information

Preventing and Responding to Antibiotic Resistant Infections in New Hampshire

Preventing and Responding to Antibiotic Resistant Infections in New Hampshire Preventing and Responding to Antibiotic Resistant Infections in New Hampshire Benjamin P. Chan, MD, MPH NH Dept. of Health & Human Services Division of Public Health Services May 23, 2017 To bring a greater

More information

Antimicrobial Stewardship:

Antimicrobial Stewardship: Antimicrobial Stewardship: Inpatient and Outpatient Elements Angela Perhac, PharmD afperhac@carilionclinic.org Disclosure I have no relevant finances to disclose. Objectives Review the core elements of

More information

Understand the application of Antibiotic Stewardship regulations in LTC. Understand past barriers to antibiotic management concepts

Understand the application of Antibiotic Stewardship regulations in LTC. Understand past barriers to antibiotic management concepts Objectives Understand the application of Antibiotic Stewardship regulations in LTC Understand past barriers to antibiotic management concepts Understand benefits of adoption of antibiotic stewardship regulations

More information

Antimicrobial Stewardship Strategy: Formulary restriction

Antimicrobial Stewardship Strategy: Formulary restriction Antimicrobial Stewardship Strategy: Formulary restriction Restricted dispensing of targeted antimicrobials on the hospital s formulary, according to approved criteria. The use of restricted antimicrobials

More information

Antibiotic Stewardship Beyond Hospital Walls

Antibiotic Stewardship Beyond Hospital Walls Antibiotic Stewardship Beyond Hospital Walls Katie Burenheide Foster, PharmD, MS, BCPS, FCCM Pharmacy Clinical Manager & PGY1 Pharmacy Residency Director OBJECTIVES 1. Review what Antibiotic Stewardship

More information

Position Statement The Role of the ICP in Antimicrobial Stewardship

Position Statement The Role of the ICP in Antimicrobial Stewardship Position Statement The Role of the ICP in Antimicrobial Stewardship ACIPC Recommends Infection control practitioners bring specific expertise and should be part of a multidisciplinary antimicrobial stewardship

More information

Interdisciplinary Communication in Antimicrobial Stewardship. Jennifer Liao, PharmD September 29, 2017 Patient Safety Academy

Interdisciplinary Communication in Antimicrobial Stewardship. Jennifer Liao, PharmD September 29, 2017 Patient Safety Academy Interdisciplinary Communication in Antimicrobial Stewardship Jennifer Liao, PharmD September 29, 2017 Patient Safety Academy Objectives 1. Define antimicrobial stewardship (AMS) teams across various settings

More information

4/4/2018. Pathway Health 1. Antibiotics - Are they OVERUSED?? Best Practice Approach to Antibiotic Stewardship: Essential Strategies for Compliance

4/4/2018. Pathway Health 1. Antibiotics - Are they OVERUSED?? Best Practice Approach to Antibiotic Stewardship: Essential Strategies for Compliance Best Practice Approach to Antibiotic Stewardship: Essential Strategies for Compliance Laura Chambers, RN, MSN, RAC-CT, CIMT Pathway Health Objectives Upon completion of this presentation, attendees should

More information

Minnesota Guide to a Comprehensive. Antimicrobial Stewardship Program

Minnesota Guide to a Comprehensive. Antimicrobial Stewardship Program Minnesota Guide to a Comprehensive Antimicrobial Stewardship Program Getting Started Antimicrobial Stewardship Program Strategies July 2012 Draft 8.10.12 1 Table of Contents Introduction. 3 Getting Started

More information

Antimicrobial Stewardship Strategy:

Antimicrobial Stewardship Strategy: Antimicrobial Stewardship Strategy: Prospective audit with intervention and feedback Formal assessment of antimicrobial therapy by trained individuals, who make recommendations to the prescribing service

More information

Promoting Appropriate Antimicrobial Prescribing in Secondary Care

Promoting Appropriate Antimicrobial Prescribing in Secondary Care Promoting Appropriate Antimicrobial Prescribing in Secondary Care Stuart Brown Healthcare Acquired Infection and Antimicrobial Resistance Project Lead NHS England March 2015 Introduction Background ESPAUR

More information

Antimicrobial Stewardship: Guidelines for its Implementation

Antimicrobial Stewardship: Guidelines for its Implementation Antimicrobial Stewardship: Guidelines for its Implementation Loliet Gonzalez Martinez, Pharm.D. Palmetto General Hospital PGY-1 Pharmacy Resident Disclosure The author of this presentation has nothing

More information

Geriatric Mental Health Partnership

Geriatric Mental Health Partnership Geriatric Mental Health Partnership September 8, 2017 First, let s test your knowledge about antibiotics http://www.cdc.gov/getsmart/community/about/quiz.html 2 Get Smart Antibiotics Quiz Antibiotics fight

More information

MDRO s, Stewardship and Beyond. Linda R. Greene RN, MPS, CIC

MDRO s, Stewardship and Beyond. Linda R. Greene RN, MPS, CIC MDRO s, Stewardship and Beyond Linda R. Greene RN, MPS, CIC linda_greene@urmc.rochester.edu Evolving Threat of Antimicrobial Resistance Why are MDROs important? Limited treatment options Associated with:

More information

Antimicrobial Stewardship in the Long Term Care and Outpatient Settings. Carlos Reyes Sacin, MD, AAHIVS

Antimicrobial Stewardship in the Long Term Care and Outpatient Settings. Carlos Reyes Sacin, MD, AAHIVS Antimicrobial Stewardship in the Long Term Care and Outpatient Settings Carlos Reyes Sacin, MD, AAHIVS Disclosure Speaker and consultant in HIV medicine for Gilead and Jansen Pharmaceuticals Objectives

More information

MHA/OHA HIIN Antibiotic Stewardship/MDRO Collaborative

MHA/OHA HIIN Antibiotic Stewardship/MDRO Collaborative MHA/OHA HIIN Antibiotic Stewardship/MDRO Collaborative Place picture here Nov. 14, 2017 Reminders For best sound quality, dial in at 1-800-791-2345 and enter code 11076 Please use the chat box to ask questions!

More information

Stewardship tools. Dilip Nathwani Ninewells Hospital and Medical School Dundee, UK

Stewardship tools. Dilip Nathwani Ninewells Hospital and Medical School Dundee, UK Stewardship tools Dilip Nathwani Ninewells Hospital and Medical School Dundee, UK What is Antimicrobial Stewardship (AMS)? Antimicrobial stewardship has been defined as the optimal selection, dosage, and

More information

OBJECTIVES. Fast Facts 3/23/2017. Antibiotic Stewardship Beyond Hospital Walls. Antibiotics are a shared resource and becoming a scarce resource.

OBJECTIVES. Fast Facts 3/23/2017. Antibiotic Stewardship Beyond Hospital Walls. Antibiotics are a shared resource and becoming a scarce resource. Antibiotic Stewardship Beyond Hospital Walls Katie Burenheide Foster, PharmD, MS, BCPS, FCCM Pharmacy Clinical Manager & PGY1 Pharmacy Residency Director OBJECTIVES 1. Review what Antibiotic Stewardship

More information

Overview of Antimicrobial Stewardship

Overview of Antimicrobial Stewardship Overview of Antimicrobial Stewardship Kurt B. Stevenson, MD, MPH Professor of Medicine and Epidemiology Colleges of Medicine and Public Health Medical Director, Antimicrobial Stewardship Program The Ohio

More information

Antimicrobial Stewardship Basics Why, What, Who, and How. Philip Chung, PharmD, MS, BCPS ASAP Community Network Pharmacy Coordinator October 12, 2017

Antimicrobial Stewardship Basics Why, What, Who, and How. Philip Chung, PharmD, MS, BCPS ASAP Community Network Pharmacy Coordinator October 12, 2017 Antimicrobial Stewardship Basics Why, What, Who, and How Philip Chung, PharmD, MS, BCPS ASAP Community Network Pharmacy Coordinator October 12, 2017 Objectives List reasons for developing antimicrobial

More information

EVIDENCE BASED MEDICINE: ANTIBIOTIC RESISTANCE IN THE ELDERLY CHETHANA KAMATH GERIATRIC MEDICINE WEEK

EVIDENCE BASED MEDICINE: ANTIBIOTIC RESISTANCE IN THE ELDERLY CHETHANA KAMATH GERIATRIC MEDICINE WEEK EVIDENCE BASED MEDICINE: ANTIBIOTIC RESISTANCE IN THE ELDERLY CHETHANA KAMATH GERIATRIC MEDICINE WEEK EPIDEMIOLOGY AND BACKGROUND Every year, more than 2 million people in the United States acquire antibiotic-resistant

More information

Dr. Charles Onunkwo, Infectious Disease Medicine Erika Ingram, Infectious Disease/Critical Care Clinical Pharmacy Specialist Southeastern Regional

Dr. Charles Onunkwo, Infectious Disease Medicine Erika Ingram, Infectious Disease/Critical Care Clinical Pharmacy Specialist Southeastern Regional Dr. Charles Onunkwo, Infectious Disease Medicine Erika Ingram, Infectious Disease/Critical Care Clinical Pharmacy Specialist Southeastern Regional Medical Center Cancer Treatment Centers of America May

More information

Successful Antimicrobial Stewardship in a Multihospital System: Tools You Can Use

Successful Antimicrobial Stewardship in a Multihospital System: Tools You Can Use Successful Antimicrobial Stewardship in a Multihospital System: Tools You Can Use Justin Schmetterer, PharmD Infectious Disease Specialist jschmette2@phs.org 505-724-7146 Disclosure Relevant Financial

More information

Potential Conflicts of Interest. Schematic. Reporting AST. Clinically-Oriented AST Reporting & Antimicrobial Stewardship

Potential Conflicts of Interest. Schematic. Reporting AST. Clinically-Oriented AST Reporting & Antimicrobial Stewardship Potential Conflicts of Interest Clinically-Oriented AST Reporting & Antimicrobial Stewardship Hsu Li Yang 27 th September 2013 Research Funding: Pfizer Singapore AstraZeneca Janssen-Cilag Merck, Sharpe

More information

WENDY WILLIAMS, MT(AMT) MSAH DIRECTOR LABORATORY AND PATHOLOGY SERVICES. Appalachian Regional Healthcare System apprhs.org

WENDY WILLIAMS, MT(AMT) MSAH DIRECTOR LABORATORY AND PATHOLOGY SERVICES. Appalachian Regional Healthcare System apprhs.org Incorporating Automation and Rapid Diagnostic Technologies into the Micro Lab's Lean Workflow to Boost Productivity, Shorten Length of Stay, and Improve Antibiotic Utilization WENDY WILLIAMS, MT(AMT) MSAH

More information

Nursing Home Online Training Sessions Session 2: Exploring Antibiotics and Their Role in Fighting Bacterial Infections

Nursing Home Online Training Sessions Session 2: Exploring Antibiotics and Their Role in Fighting Bacterial Infections National Nursing Home Quality Care Collaborative Nursing Home Online Training Sessions Session 2: Exploring Antibiotics and Their Role in Fighting Bacterial Infections Health Services Advisory Group (HSAG)

More information

Stewardship: Challenges & Opportunities in the Gulf Region

Stewardship: Challenges & Opportunities in the Gulf Region Stewardship: Challenges & Opportunities in the Gulf Region Mushira Enani, MBBS, FRCPE, FACP,CIC Head- Infectious Disease Section King Fahad Medical City Outline Background of Healthcare system in GCC GCC

More information

Implementing Antibiotic Stewardship in Rural and Critical Access Hospitals

Implementing Antibiotic Stewardship in Rural and Critical Access Hospitals National Center for Emerging and Zoonotic Infectious Diseases Implementing Antibiotic Stewardship in Rural and Critical Access Hospitals Denise Cardo, MD Director, Division of Healthcare Quality Promotion,

More information

Objective 1/20/2016. Expanding Antimicrobial Stewardship into the Outpatient Setting. Disclosure Statement of Financial Interest

Objective 1/20/2016. Expanding Antimicrobial Stewardship into the Outpatient Setting. Disclosure Statement of Financial Interest Expanding Antimicrobial Stewardship into the Outpatient Setting Michael E. Klepser, Pharm.D., FCCP Professor Pharmacy Practice Ferris State University College of Pharmacy Disclosure Statement of Financial

More information

Physician Rating: ( 23 Votes ) Rate This Article:

Physician Rating: ( 23 Votes ) Rate This Article: From Medscape Infectious Diseases Conquering Antibiotic Overuse An Expert Interview With the CDC Laura A. Stokowski, RN, MS Authors and Disclosures Posted: 11/30/2010 Physician Rating: ( 23 Votes ) Rate

More information

Antimicrobial Stewardship Basics Why, What, Who, and How

Antimicrobial Stewardship Basics Why, What, Who, and How Antimicrobial Stewardship Basics Why, What, Who, and How Philip Chung, PharmD, MS, BCPS ASAP Community Network Pharmacy Coordinator September 19, 2017 Objectives List reasons for developing antimicrobial

More information

Antimicrobial Stewardship Program 2 nd Quarter

Antimicrobial Stewardship Program 2 nd Quarter Antimicrobial Stewardship Program 2 nd Quarter May 19, 2016 Jill Hanson, WHA DeAnn Richards, MetaStar Objectives for Today Hospital Highlight UnityPoint Health - Meriter Status of the state Update on pilot

More information

National Action Plan development support tools

National Action Plan development support tools National Action Plan development support tools Sample Checklist This checklist was developed to be used by multidisciplinary teams in countries to assist with the development of their national action plan

More information

Antibiotic Stewardship in a Community Hospital: Building a Program from the Ground Up

Antibiotic Stewardship in a Community Hospital: Building a Program from the Ground Up Antibiotic Stewardship in a Community Hospital: Building a Program from the Ground Up Comprehensive Antimicrobial Management Program Texas Health Presbyterian Dallas September 4, 2014 Edward L. Goodman,

More information

Dr. Torsten Hoppe-Tichy, Chief Pharmacist. How to implement Antibiotic Stewardship without having the resources for that?

Dr. Torsten Hoppe-Tichy, Chief Pharmacist. How to implement Antibiotic Stewardship without having the resources for that? Dr. Torsten Hoppe-Tichy, Chief Pharmacist How to implement Antibiotic Stewardship without having the resources for that? No conflict of interests Questions to the audience (Yes/No) - Is it promising to

More information

REPORT ON THE ANTIMICROBIAL RESISTANCE (AMR) SUMMIT

REPORT ON THE ANTIMICROBIAL RESISTANCE (AMR) SUMMIT 1 REPORT ON THE ANTIMICROBIAL RESISTANCE (AMR) SUMMIT The Department of Health organised a summit on Antimicrobial Resistance (AMR) the purpose of which was to bring together all stakeholders involved

More information

ANTIMICROBIAL STEWARDSHIP IN PRIMARY CARE DR ROSEMARY IKRAM MBBS FRCPA CLINICAL MICROBIOLOGIST

ANTIMICROBIAL STEWARDSHIP IN PRIMARY CARE DR ROSEMARY IKRAM MBBS FRCPA CLINICAL MICROBIOLOGIST ANTIMICROBIAL STEWARDSHIP IN PRIMARY CARE DR ROSEMARY IKRAM MBBS FRCPA CLINICAL MICROBIOLOGIST CONFLICTS OF INTEREST NONE PRESENTATION OUTLINE. SETTING THE SCENE WORLD AND NEW ZEALAND. BARRIERS TO OVERCOME.

More information

Comments from The Pew Charitable Trusts re: Consultation on a draft global action plan to address antimicrobial resistance September 1, 2014

Comments from The Pew Charitable Trusts re: Consultation on a draft global action plan to address antimicrobial resistance September 1, 2014 Comments from The Pew Charitable Trusts re: Consultation on a draft global action plan to address antimicrobial resistance September 1, 2014 The Pew Charitable Trusts is an independent, nonprofit organization

More information

Government Initiatives to Combat Antimicrobial Resistance (AMR)

Government Initiatives to Combat Antimicrobial Resistance (AMR) Government Initiatives to Combat Antimicrobial Resistance (AMR) in the Philippines Ma. Virginia G. Ala, MD, MPH, CESO III Director IV and Program Manager National Center for Pharmaceutical Access and Management,

More information

The Core Elements of Antibiotic Stewardship for Nursing Homes

The Core Elements of Antibiotic Stewardship for Nursing Homes The Core Elements of Antibiotic Stewardship for Nursing Homes APPENDIX B: Measures of Antibiotic Prescribing, Use and Outcomes National Center for Emerging and Zoonotic Infectious Diseases Division of

More information

Advancing Antimicrobial Stewardship in Community and Rural Hospitals

Advancing Antimicrobial Stewardship in Community and Rural Hospitals Advancing Antimicrobial Stewardship in Community and Rural Hospitals Whitney Buckel, PharmD, BCPS Infectious Diseases Clinical Pharmacist Intermountain Medical Center Disclosures The SCORE study was supported

More information

Antimicrobial Use Toolkit Webinar M A R C H 1 3,

Antimicrobial Use Toolkit Webinar M A R C H 1 3, Antimicrobial Use Toolkit Webinar M A R C H 1 3, 2 0 1 8 Welcome & Housekeeping Thank you for attending! HMS data abstractors Administrators QI staff Pharmacists Hospitalists ID physicians Individuals

More information

CMS Antibiotic Stewardship Initiative

CMS Antibiotic Stewardship Initiative CMS Antibiotic Stewardship Initiative Mary Fermazin, MD, MPA Chief Medical Officer Vice President, Health Policy and Quality Measurement Health Services Advisory Group (HSAG) March 11, 2017 Disclosure

More information

4/17/2013. Antimicrobial Stewardship: pengalaman di Belanda. Henri A. Verbrugh MD PhD. number of emerging infectious diseases events per decade

4/17/2013. Antimicrobial Stewardship: pengalaman di Belanda. Henri A. Verbrugh MD PhD. number of emerging infectious diseases events per decade Antimicrobial Stewardship: pengalaman di Belanda Henri A. Verbrugh MD PhD KE Jones et al., Nature 2008 EID is disease caused by a pathogen that has recently evolved or entered the human population for

More information

ANTIBIOTIC STEWARDSHIP. Brian Mayhue, Pharm D, CGP Director of Pharmacy Palm Beach Gardens Medical Center

ANTIBIOTIC STEWARDSHIP. Brian Mayhue, Pharm D, CGP Director of Pharmacy Palm Beach Gardens Medical Center ANTIBIOTIC STEWARDSHIP Brian Mayhue, Pharm D, CGP Director of Pharmacy Palm Beach Gardens Medical Center Antibiotic Resistance It is not difficult to make microbes resistant to penicillin in the laboratory

More information

Connecting Your Audio

Connecting Your Audio Connecting Your Audio Want to ask a question over the audio? Make sure you are dialed-in. Number: 1-877-280-9413 Passcode: 54567205 Dialed-in? Check if the phone icon is next to your name. If not, connect

More information

MAGNITUDE OF ANTIMICROBIAL USE. Antimicrobial Stewardship in Acute and Long Term Healthcare Facilities: Design, Implementation and Challenges

MAGNITUDE OF ANTIMICROBIAL USE. Antimicrobial Stewardship in Acute and Long Term Healthcare Facilities: Design, Implementation and Challenges Antimicrobial Stewardship in Acute and Long Term Healthcare Facilities: Design, Implementation and Challenges John A. Jernigan, MD, MS Division of Healthcare Quality Promotion Centers for Disease Control

More information

Antimicrobial Stewardship

Antimicrobial Stewardship Antimicrobial Stewardship Report: 11 th August 2016 Issue: As part of ensuring compliance with the National Safety and Quality Health Service Standards (NSQHS), Yea & District Memorial Hospital is required

More information

Antimicrobial Stewardship the State Health Department Perspective

Antimicrobial Stewardship the State Health Department Perspective Antimicrobial Stewardship the State Health Department Perspective Marion A. Kainer MD, MPH, FRACP, FSHEA Healthcare Associated Infections and Antimicrobial Resistance Program NIAA Antibiotic Stewardship:

More information

Antimicrobial Stewardship Northern Ireland

Antimicrobial Stewardship Northern Ireland Antimicrobial Stewardship Northern Ireland Dr Lorraine Doherty Assistant Director of Public Health (Health Protection) Public Health Agency 15 November 2011 Co Authors Dr Muhammad Sartaj. SpR Public Health

More information

Antibiotic Stewardship in Nursing Homes

Antibiotic Stewardship in Nursing Homes National Center for Emerging and Zoonotic Infectious Diseases Antibiotic Stewardship in Nursing Homes Greater New York Hospital Association February 15 2018 Sarah Kabbani, MD, MSc Medical Officer, Office

More information

Host, Syndrome, Bug, Drug: Introducing 2 Frameworks to Approach Infectious Diseases Cases with an Antimicrobial Stewardship Focus

Host, Syndrome, Bug, Drug: Introducing 2 Frameworks to Approach Infectious Diseases Cases with an Antimicrobial Stewardship Focus Host, Syndrome, Bug, Drug: Introducing 2 Frameworks to Approach Infectious Diseases Cases with an Antimicrobial Stewardship Focus Montana ACP Meeting 2018 September 8, 2018 Staci Lee, MD, MEHP Billings

More information

ANTIMICROBIAL STEWARDSHIP START SMART THEN FOCUS Guidance for Antimicrobial Stewardship for SHSCT

ANTIMICROBIAL STEWARDSHIP START SMART THEN FOCUS Guidance for Antimicrobial Stewardship for SHSCT ANTIMICROBIAL STEWARDSHIP START SMART THEN FOCUS Guidance for Antimicrobial Stewardship for SHSCT CLINICAL GUIDELINES ID TAG Title: Prepared by Specialty / Division: Directorate: Antimicrobial Stewardship

More information

TREAT Steward. Antimicrobial Stewardship software with personalized decision support

TREAT Steward. Antimicrobial Stewardship software with personalized decision support TREAT Steward TM Antimicrobial Stewardship software with personalized decision support ANTIMICROBIAL STEWARDSHIP - Interdisciplinary actions to improve patient care Quality Assurance The aim of antimicrobial

More information

The ABCs of Antibiotic Stewardship

The ABCs of Antibiotic Stewardship The ABCs of Antibiotic Stewardship Sarah Brinkman, MBA, MA, CPHQ Program Manager Stratis Health 2018 Flex Program Reverse Site Visit July 18, 2018 Stratis Health Independent, nonprofit, Minnesota-based

More information

Surveillance of AMR in PHE: a multidisciplinary,

Surveillance of AMR in PHE: a multidisciplinary, Surveillance of AMR in PHE: a multidisciplinary, integrated approach Professor Neil Woodford Antimicrobial Resistance & Healthcare Associated Infections (AMRHAI) Reference Unit Crown copyright International

More information

The Philippine Action Plan to Combat Antimicrobial Resistance: One Health Approach

The Philippine Action Plan to Combat Antimicrobial Resistance: One Health Approach The Philippine Action Plan to Combat Antimicrobial Resistance: One Health Approach Prese ted at the Workshop o Natio al A tio Plan on Antimicrobial Resistance for Developing Countries Focusing on Resistance

More information

Models for stewardship in Hospital - UK Models Philip Howard Consultant Antimicrobial Pharmacist

Models for stewardship in Hospital - UK Models Philip Howard Consultant Antimicrobial Pharmacist Models for stewardship in Hospital - UK Models Philip Howard Consultant Antimicrobial Pharmacist philip.howard2@nhs.net Twitter: @AntibioticLeeds United Kingdom of England, Scotland, Wales & Northern Ireland

More information

9/30/2016. Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS

9/30/2016. Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS 1 2 Untoward Effects of Antibiotics Antibiotic resistance Adverse drug events (ADEs) Hypersensitivity/allergy Drug side effects

More information

Antibiotic Stewardship in the Hospital Setting

Antibiotic Stewardship in the Hospital Setting Antibiotic Stewardship in the Hospital Setting G. Evans, MD FRCPC Medical Director, Infection Prevention & Control Kingston General Hospital & Hotel Dieu Hospital EOPIC September 26, 2012 Stewardship stew-ard-ship

More information

Antimicrobial Stewardship in the Outpatient Setting. ELAINE LADD, PHARMD, ABAAHP, FAARFM OCTOBER 28th, 2016

Antimicrobial Stewardship in the Outpatient Setting. ELAINE LADD, PHARMD, ABAAHP, FAARFM OCTOBER 28th, 2016 Antimicrobial Stewardship in the Outpatient Setting ELAINE LADD, PHARMD, ABAAHP, FAARFM OCTOBER 28th, 2016 Abbreviations AMS - Antimicrobial Stewardship Program OP - Outpatient OPS - Outpatient Setting

More information

Healthcare-associated Infections and Antimicrobial Use Prevalence Survey

Healthcare-associated Infections and Antimicrobial Use Prevalence Survey Healthcare-associated Infections and Antimicrobial Use Prevalence Survey Shamima Sharmin, M.B.B.S., MSc, MPH Emerging Infections Program New Mexico Department of Health Agenda Recognize healthcare-associated

More information