Antimicrobial Stewardship: The Premier Health Experience

Size: px
Start display at page:

Download "Antimicrobial Stewardship: The Premier Health Experience"

Transcription

1 Antimicrobial Stewardship: The Premier Health Experience Steve Burdette, MD, FIDSA Professor of Medicine Wright State University Boonshoft School of Medicine Director of Antimicrobial Stewardship Miami Valley Hospital and Premier Health Dayton, Oh

2 The time has come to close the book on infectious diseases. We have basically wiped out infection in the United States. William Stewart United States Surgeon General 1967

3 What is Antimicrobial Stewardship? We are the antibiotic police according to some, but really we are just monitoring and advising on antimicrobial therapies De-escalation or at times escalation Duration of therapy!!! Appropriateness of therapy Dose optimization** Why is ASP required clinically Minimal new antibiotic therapeutic classes in the horizon Increasing drug resistance Lab conduit for better testing (PCT, rapid diagnostics, etc) Provider education on key ID issues / policies / procedures Review and update order sets / develop treatment guidelines for select infections Ensure that antibiotics are being given when desired / required Physician documentation leaves a lot to be desired

4 New Agents 2018 and beyond Available Delafloxacin Quinolone with activity against MRSA and Pseudomonas Meropenem / vaborbactam CRE Ceftazidime / avibactam CRE, ESBL, +/- MDR Pseudomonas Ceftolozane / tazobactam MDR Pseudomonas Pending FDA approval Plazomicin (aminoglycoside) CRE Cefiderocol Acinetobacter CRE Lefamulin CAP and MRSA Imipenem / relabactam CRE

5 Consequences of Antimicrobial Misuse Unnecessary exposure to antimicrobials results in risk to patients with no clinical benefit Adverse drug effects 25% of reported ADEs involve antimicrobials Drug-drug interactions Hypersensitivity reactions Organ dysfunction Antimicrobial resistance Clostridium difficile Increasing incidence and severity Bates DW et al. JAMA 1995;274:29-34

6 Why is ASP required politically Upcoming requirement for participation for CMS Indications for use 48 hour review of antibiotics Mandated by the Joint Commission as of 1/1/17 8 core principles that we have to meet Insurance carriers are using ASP as part of their score cards for reimbursement

7 Goals of stewardship Optimize Safety Reduce Resistance Decrease/ Control Health care $$

8 Stewardship

9 CDC elements

10 Leadership skills of stewards

11 What is the low hanging fruit in ASP? Duration, duration, duration De-escalation Stopping when MRSA testing is negative Using cefazolin instead of ceftriaxone Education Text books and practice patterns are out of date Microbiology reporting Cascading of cephalosporin's Reporting of certain drugs for certain cultures

12 Miami Valley Hospital Level 1 Trauma Center ~800 beds Typically have patients per day on systemic abx NICU 80+ ICU beds (surgical, neuro, medical, CT, burn) 3 ID groups 1 Private 1 Hospital Owned 1 Academic

13 How do we do stewardship inside the hospital? Pharmacist reviews patients based on various criteria Physician and pharmacist review the patients together Recommendations are past along via secure texting to the providers Recommendations are suggestions, they are not required to follow

14 ASP focus ICU patients Surgical and medical ICU's are teaching services Triple antibiotics Unless in septic shock or MDR pathogens, we try and stop all triples Select units (pulmonary, surgical units) Hospitalists Easiest communication High point scores High cost antibiotics Cellulitis (broad spectrum agents when Gram + coverage will suffice) Stay away from diabetic foot infections Duration of therapy > 7 days (levaquin >5 days)

15 Detailed records

16 AMS review

17 Our basic approach to ASP.. Expensive drugs are at times the best option..other times they are overkill Still lots of confusion between ceftolozane/tazobactam and ceftazidime/avibactam We are not cost cops But if an expensive drug is not needed, we will push to get it stopped Daptomycin for cellulitis (use linezolid if not responding to vancomycin) We will do what we think is best for the patient Cut costs by decreasing duration of therapy and deescalating to appropriate therapy

18 Antibiotic de-escalation Going from cefepime to ceftriaxone for a pansensitive E coli is NOT deescalating Using cefazolin in the ICU for a pan-sensitive E. coli sepsis is de-escalating We love giving amoxicillin or cephalexin / cefazolin in the ICU!!!

19 Medication management

20 Critical Access Hospital

21 CAH Core Elements

22 Indications for use Make them work for you!!

23 Check points

24 Risk analysis

25 Detailed log

26 CAH protocols

27 Antibiotic restrictions at MVH Ceftaroline Daptomycin Tedizolid Fidaxomicin (GI and ID) Isavuconazole (by select indications / conditions) Tigecycline

28 Out of Date

29 Clostridium difficile and antibiotic exposure

30 Antibiotic choice

31 ICU Respiratory Cultures And the role of triple antibiotics (i.e. MRSA + dual gram negative coverage)

32 Pseudomonas aeruginosa % susceptible n=36 Add Levoflox Add tobramycin Pip Tazo 78% 80.5% 88.9% Cefepime Add intermediate 66.7% 88.9% 66.7% 88.9% 72.2% 94.4% Meropenem 94.4% 94.4% 97.2% Aztreonam Add intermediate 61.1% 77.8% 69.4% 83.3% 77.8% 94.4%

33 All gram negative HCAP and HAP isolates N=135 Add levoflox Add tobramycin Pip tazo 87.7% 91.4% 90.8% Cefepime 86.6% 88.8% 89.6% Meropenem 95.5% 96.3% 97%

34 Data to action

35 Track something!!!

36 Antimicrobial Days of Therapy Definition: any dose of any antibiotic on a given day = one day of therapy (DOT) Normalize to 1000 pt days Antimicrobials monitored since program started aztreonam, ceftriaxone, cefepime, piperacillin/tazobactam, ertapenem, meropenem, levofloxacin, tigecycline, vancomycin, linezolid, ceftaroline, daptomycin

37 1.1 MVH all ICU days of therapy, as % of baseline MVH All ICU Days of Therapy as a % of Baseline baseline 4q14 1q15 2q15 3q15 4q15 1q16 2q16 3q16 MICU SICU NSIC All ICUs

38 Acute care settings

39 Recommended FTE

40 Predicted effectiveness, staffing levels

41 Rates over 1,000 patient days 850 MVH ICU Rolling 12 Month Average DOT / 1000 Pt Days

42 Total view

43 MVH Days of Therapy Baseline (3/14-8/14) 4 qtr % % % 2017 Cumulative Decrease in DOT / 1000 Patient Days of 15.2% 3.4%

44 Total ICU Days of Therapy Baseline 4 qtr % % % % Cumulative Decrease in DOT / 1000 Patient Days of 21.2%

45 2017 Metrics Compliance with CMS / TJC Patient education Physician credentialing 48 hour review Website development Decrease DOT by 3% Site specific metric C diff review Review for antibiotic de-escalation, treatment congruent with guidelines, and concurrent PPI use Cellulitis; use of broad spectrum antimicrobials

46 2018 Metrics Maintain our days of therapy without increase Minimize metronidazole use for Clostridium difficile to less than 20% of the patients Improve antibiotic compliance with sepsis measure to >90% Intervene on all bacteremic patients Education of the medical staff 8x per year

47 Our experience. Big dollar savings initially But that is likely over No impact on C diff (yet) PPI stewardship Cutting antibiotics will not help if there is a hand hygiene compliance issue No impact on LOS in the ICU despite cutting antibiotics by 20-30% But it did not go up When big brother stops watching all your work goes up in smoke! You have to keep working!

48 How can you make a difference in your facility

49 Low hanging inpatient conditions Asymptomatic bacteriuria Duration of antibiotics for CAP Triple Antibiotics for PNA De-escalation Avoiding gram negative agents for cellulitis These impact Infection Control issues greatly!!!

50 ASP literature to minimize antibiotic use JAMA study days for CAP HAP/VAP guidelines 7 days is enough unless slow clinical response UTI Treatment of asymptomatic bacteriuria actually leads to more UTI s Culture of culturing for foley catheters STOP-IT study 4 days for intra-abdominal infections after source control I am not a believer of this study!

51 IDSA guidelines for asymptomatic bacteriuria in adults

52 Gender factors

53 Culture of culturing Obtain urine cultures in hospitalized patients with urinary catheter only when one of the following criteria are met: Local signs and symptoms of infection (supra-pubic tenderness, CVA tenderness etc.) Fever and neutropenia Fever and kidney transplant Fever and recent uro-genital procedure Fever and obstructed catheter Other: document rationale for ordering the culture (EMR will force provider to document reasons in EPIC and/or progress note) Mullin KM, Kovacs CS, Fatica C et al. A Multifaceted Approach to Reduction of Catheter-Associated Urinary Tract Infections in the Intensive Care Unit with an Emphasis on "Stewardship of Culturing". Infect Control Hosp Epidemiol 2017 Feb;38(2):

54 Blood cultures Culture of culturing, cont d Peripheral only Confirming they have a fever before cultures Role of procalcitonin

55 Diagnostic stewardship

56 C diff stewardship Considered tests to be truly positive if tested patients met the following criteria: 3 episodes of diarrhea within 24 hours in the absence of administration of a laxative and at least 1 of the following symptoms: (1) temperature 38 C, (2) abdominal pain, (3) abdominal tenderness documented on exam, (4) white blood cell count >12,000/µL. Positive tests that did not meet these criteria were deemed falsely positive.

57 C diff stewardship, cont d Major education regarding prior data Two diagnostic stewardship measures were implemented via the microbiology laboratory in January C. difficile NAAT orders were canceled via the Laboratory Information System (LIS) if a stool sample was not received within 24 hours of order placement. Second, the laboratory initiated a stick test on nonliquid samples such that stool samples viscous enough to support a stick s upright position were rejected for testing.

58 Four core measures

59 Pneumonia trial

60 Increasing evidence to support short treatment courses Disease Short course Long course Community Acquired PNA Hospital acquired PNA Pyelonephritis COPD exacerbation <5 >7 Bacterial sinusitis 5 10 Cellulitis 6 10 Adapted from: Spellberg B. JAMA Intern Med 2016;176(9):1254-5

61 Nasal screening options

62 MRSA pneumonia

63 Pneumonia Hospital-Acquired Pneumonia Ventilator Associated Pneumonia Community-acquired Pneumonia MDR Risk Factors Present No MDR Risk Factors

64 Increased ED resources ASP wish list to make a bigger Resources for DC medication reconciliation / evaluation of duration of therapy Area of antibiotic overuse and prolonged courses of therapy More EHR tools to trigger de-escalation impact An easy fix for 48 hour antibiotic time out

65 Questions?

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

Best Practices: Goals of Antimicrobial Stewardship

Best Practices: Goals of Antimicrobial Stewardship Best Practices: Goals of Antimicrobial Stewardship Gail Scully, M.D, M.P.H. and Elizabeth Radigan, PharmD, BCPS UMass Memorial Medical Center Division of Infectious Disease Department of Medicine September

More information

Antibiotic Updates: Part II

Antibiotic Updates: Part II Antibiotic Updates: Part II Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures

More information

Northwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16

Northwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16 Northwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16 These criteria are based on national and local susceptibility data as well as Infectious Disease Society of America

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

Antimicrobial stewardship in managing septic patients

Antimicrobial stewardship in managing septic patients Antimicrobial stewardship in managing septic patients November 11, 2017 Samuel L. Aitken, PharmD, BCPS (AQ-ID) Clinical Pharmacy Specialist, Infectious Diseases slaitken@mdanderson.org Conflict of interest

More information

21 st Expert Committee on Selection and Use of Essential Medicines Peer Review Report Antibiotics Review

21 st Expert Committee on Selection and Use of Essential Medicines Peer Review Report Antibiotics Review (1) Have all important studies/evidence of which you are aware been included in the application? Yes No Please provide brief comments on any relevant studies that have not been included: (2) For each of

More information

4/3/2017 CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA DISCLOSURE LEARNING OBJECTIVES

4/3/2017 CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA DISCLOSURE LEARNING OBJECTIVES CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA BILLIE BARTEL, PHARMD, BCCCP APRIL 7 TH, 2017 DISCLOSURE I have had no financial relationship over the past 12 months with any commercial

More information

Appropriate antimicrobial therapy in HAP: What does this mean?

Appropriate antimicrobial therapy in HAP: What does this mean? Appropriate antimicrobial therapy in HAP: What does this mean? Jaehee Lee, M.D. Kyungpook National University Hospital, Korea KNUH since 1907 Presentation outline Empiric antimicrobial choice: right spectrum,

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

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

SHC Clinical Pathway: HAP/VAP Flowchart

SHC Clinical Pathway: HAP/VAP Flowchart SHC Clinical Pathway: Hospital-Acquired and Ventilator-Associated Pneumonia SHC Clinical Pathway: HAP/VAP Flowchart v.08-29-2017 Diagnosis Hospitalization (HAP) Pneumonia develops 48 hours following: Endotracheal

More information

Measurement of Antimicrobial Drug Use. Elizabeth Dodds Ashley, PharmD, MHS, FCCP, BCPS DASON Liaison Pharmacist

Measurement of Antimicrobial Drug Use. Elizabeth Dodds Ashley, PharmD, MHS, FCCP, BCPS DASON Liaison Pharmacist Measurement of Antimicrobial Drug Use Elizabeth Dodds Ashley, PharmD, MHS, FCCP, BCPS DASON Liaison Pharmacist Defined Daily Dose Target Audience: Administrators and Epidemiologists Standardized definition

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

Infectious Disease 101: Helping the Consultant Pharmacist with Stewardship Principles

Infectious Disease 101: Helping the Consultant Pharmacist with Stewardship Principles Infectious Disease 101: Helping the Consultant Pharmacist with Stewardship Principles Conflicts of Interest None at this time May be discussing off-label indications KALIN M. CLIFFORD, PHARM.D., BCPS,

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

Why Antimicrobial Stewardship?

Why Antimicrobial Stewardship? Antimicrobial Stewardship: Why and How CAPT Arjun Srinivasan, MD Associate Director for Healthcare Associated Infection Prevention Programs Division of Healthcare Quality Promotion Why Antimicrobial Stewardship?

More information

Antimicrobial stewardship: Quick, don t just do something! Stand there!

Antimicrobial stewardship: Quick, don t just do something! Stand there! Antimicrobial stewardship: Quick, don t just do something! Stand there! Stanley I. Martin, MD, FACP, FIDSA Director, Division of Infectious Diseases Director, Antimicrobial Stewardship Program Geisinger

More information

Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship Report

Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship Report H e a l i n g t h e B o d y E n r i c h i n g t h e M i n d N u r t u r i n g t h e S o u l Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship Report to 214 Table of Contents I. Introduction..

More information

Infection Prevention Highlights for the Medical Staff. Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention

Infection Prevention Highlights for the Medical Staff. Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention Highlights for the Medical Staff Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention Standard Precautions every patient every time a. Hand Hygiene b. Use of Personal Protective Equipment (PPE)

More information

The Rise of Antibiotic Resistance: Is It Too Late?

The Rise of Antibiotic Resistance: Is It Too Late? The Rise of Antibiotic Resistance: Is It Too Late? Paul D. Holtom, MD Professor of Medicine and Orthopaedics USC Keck School of Medicine None DISCLOSURES THE PROBLEM Antibiotic resistance is one of the

More information

Antibiotic stewardship in long term care

Antibiotic stewardship in long term care Antibiotic stewardship in long term care Shira Doron, MD Associate Professor of Medicine Division of Geographic Medicine and Infectious Diseases Tufts Medical Center Boston, MA Consultant to Massachusetts

More information

1. List three activities pharmacists can implement to support. 2. Identify potential barriers to implementing antimicrobial

1. List three activities pharmacists can implement to support. 2. Identify potential barriers to implementing antimicrobial OPTIMIZING ANTIMICROBIAL STEWARDSHIP: IT STARTS IN THE EMERGENCY DEPARTMENT! 1 2 Objectives 1. List three activities pharmacists can implement to support health-system antimicrobial stewardship programs

More information

New Drugs for Bad Bugs- Statewide Antibiogram

New Drugs for Bad Bugs- Statewide Antibiogram New Drugs for Bad Bugs- Statewide Antibiogram Felicia Matthews, Pharm.D., BCPS Senior Consultant, Pharmacy Specialty BE MedMined Services Disclosures Employee of BD Corporation MedMined Services Agenda

More information

St. Joseph s General Hospital Vegreville. and. Mary Immaculate Care Centre. Antimicrobial Stewardship Report

St. Joseph s General Hospital Vegreville. and. Mary Immaculate Care Centre. Antimicrobial Stewardship Report St. Joseph s General Hospital Vegreville and Mary Immaculate Care Centre Antimicrobial Stewardship Report January to June 217 Introduction Antibiotics are among the most commonly prescribed medications

More information

Disclosures. Nothing Medically I own FiPhysician LLC, a financial planning and investment company (FiPhysician.com)

Disclosures. Nothing Medically I own FiPhysician LLC, a financial planning and investment company (FiPhysician.com) "How to work around (with) administration to build an Antimicrobial Stewardship Program AND how to get dumb (oops reluctant) doctors to do the right thing" David Graham, MD Disclosures Nothing Medically

More information

PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE

PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE Global Alliance for Infection in Surgery World Society of Emergency Surgery (WSES) and not only!! Aims - 1 Rationalize the risk of antibiotics overuse

More information

Antimicrobial Stewardship

Antimicrobial Stewardship Antimicrobial Stewardship Antimicrobial Stewardship Studies have estimated that 30 50% of antibiotics prescribed in acutecare hospitals are unnecessary or inappropriate 1 Antimicrobial stewardship definition:

More information

Antibiotics in the trenches: An ER Doc s Perspective

Antibiotics in the trenches: An ER Doc s Perspective Antibiotics in the trenches: An ER Doc s Perspective Peter Currie, MD Medical Director for Quality Emergency Physicians Professional Association (EPPA) Agenda Emergency Medicine Specific Disease Processes

More information

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

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

An Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings?

An Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings? An Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings? Dr. Andrew Morris Antimicrobial Stewardship ProgramMt. Sinai Hospital University Health Network amorris@mtsinai.on.ca andrew.morris@uhn.ca

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

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines Antibiotic Abyss Fredrick M. Abrahamian, D.O., FACEP, FIDSA Professor of Medicine UCLA School of Medicine Director of Education Department of Emergency Medicine Olive View-UCLA Medical Center Sylmar, California

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

Effectiv. q3) Purpose of Policy. Pharmacy: Antimicrobial subcommp&tittee of

Effectiv. q3) Purpose of Policy. Pharmacy: Antimicrobial subcommp&tittee of Name ofpolicynupolicy:mber: Department: Approving Officer: Responsible Agent: Scope: Protected Antimicrobials 3364-133-106 Pharmacy: Antimicrobial subcommp&tittee of Chief Executive Officer Director of

More information

Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report. July December 2013 Second and Third Quarters 2014

Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report. July December 2013 Second and Third Quarters 2014 H e a l i n g t h e B o d y E n r i c h i n g t h e M i n d N u r t u r i n g t h e S o u l Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report July December 213 Second and Third Quarters

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

Rational management of community acquired infections

Rational management of community acquired infections Rational management of community acquired infections Dr Tanu Singhal MD, MSc Consultant Pediatrics and Infectious Disease Kokilaben Dhirubhai Ambani Hospital, Mumbai Why is rational management needed?

More information

Antibiotic Stewardship Program (ASP) CHRISTUS SETX

Antibiotic Stewardship Program (ASP) CHRISTUS SETX Antibiotic Stewardship Program (ASP) CHRISTUS SETX Program Goals I. Judicious use of antibiotics Decrease use of broad spectrum antibiotics and deescalate use based on clinical symptoms Therapeutic duplication:

More information

Perichondritis: Source: UpToDate Ciprofloxacin 10 mg/kg/dose PO (max 500 mg/dose) BID Inpatient: Ceftazidime 50 mg/kg/dose q8 hours IV

Perichondritis: Source: UpToDate Ciprofloxacin 10 mg/kg/dose PO (max 500 mg/dose) BID Inpatient: Ceftazidime 50 mg/kg/dose q8 hours IV Empiric Antibiotics for Pediatric Infections Seen in ED NOTE: Choice of empiric antibiotic therapy must take into account local pathogen frequency and resistance patterns, individual patient characteristics,

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

DATA COLLECTION SECTION BY FRONTLINE TEAM. Patient Identifier/ Medical Record number (for facility use only)

DATA COLLECTION SECTION BY FRONTLINE TEAM. Patient Identifier/ Medical Record number (for facility use only) Assessment of Appropriateness of ICU Antibiotics (Patient Level Sheet) **Note this is intended for internal purposes only. Please do not return to PQC.** For this assessment, inappropriate antibiotic use

More information

PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS

PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS The current supply of piperacillin- tazobactam should be reserved f Microbiology / Infectious Diseases approval and f neutropenic sepsis, severe sepsis

More information

Collecting and Interpreting Stewardship Data: Breakout Session

Collecting and Interpreting Stewardship Data: Breakout Session Collecting and Interpreting Stewardship Data: Breakout Session Michael S. Calderwood, MD, MPH Regional Hospital Epidemiologist, Dartmouth-Hitchcock Medical Center March 20, 2019 None Disclosures Outline

More information

Dr Eleri Davies. Consultant Microbiologist and Infection Control Doctor, Public Health Wales NHS Trust

Dr Eleri Davies. Consultant Microbiologist and Infection Control Doctor, Public Health Wales NHS Trust Dr Eleri Davies Consultant Microbiologist and Infection Control Doctor, Public Health Wales NHS Trust Antimicrobial stewardship What is it? Why is it important? Treatment and management of catheter-associated

More information

Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report

Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report July December 216 Table of Contents I. Introduction... 3 II. Executive Summary... 5 III. MCH Antimicrobial Utilization Reports...

More information

2016/LSIF/FOR/007 Improving Antimicrobial Use and Awareness in Korea

2016/LSIF/FOR/007 Improving Antimicrobial Use and Awareness in Korea 2016/LSIF/FOR/007 Improving Antimicrobial Use and Awareness in Korea Submitted by: Asia Pacific Foundation for Infectious Diseases Policy Forum on Strengthening Surveillance and Laboratory Capacity to

More information

Antimicrobial Update. Alison MacDonald Area Antimicrobial Pharmacist NHS Highland April 2018

Antimicrobial Update. Alison MacDonald Area Antimicrobial Pharmacist NHS Highland April 2018 Antimicrobial Update Alison MacDonald Area Antimicrobial Pharmacist NHS Highland alisonc.macdonald@nhs.net April 2018 Starter Questions Setting the scene... What if antibiotics were no longer effective?

More information

Appropriate Management of Common Pediatric Infections. Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases

Appropriate Management of Common Pediatric Infections. Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases Appropriate Management of Common Pediatric Infections Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases It s all about the microorganism The common pathogens Viruses

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

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

Understanding the Hospital Antibiogram

Understanding the Hospital Antibiogram Understanding the Hospital Antibiogram Sharon Erdman, PharmD Clinical Professor Purdue University College of Pharmacy Infectious Diseases Clinical Pharmacist Eskenazi Health 5 Understanding the Hospital

More information

Creating an EHR-based Antimicrobial Stewardship Program Session #257, March 8, 2018 David Ratto M.D., Chief Medical Information Officer, Methodist

Creating an EHR-based Antimicrobial Stewardship Program Session #257, March 8, 2018 David Ratto M.D., Chief Medical Information Officer, Methodist Creating an EHR-based Antimicrobial Stewardship Program Session #257, March 8, 2018 David Ratto M.D., Chief Medical Information Officer, Methodist Hospital of Southern California 1 Conflict of Interest

More information

Methicillin-Resistant Staphylococcus aureus Nasal Swabs as a Tool in Antimicrobial Stewardship

Methicillin-Resistant Staphylococcus aureus Nasal Swabs as a Tool in Antimicrobial Stewardship Methicillin-Resistant Staphylococcus aureus Nasal Swabs as a Tool in Antimicrobial Stewardship Natalie R. Tucker, PharmD Antimicrobial Stewardship Pharmacist Tyson E. Dietrich, PharmD PGY2 Infectious Diseases

More information

Inappropriate Use of Antibiotics and Clostridium difficile Infection. Jocelyn Srigley, MD, FRCPC November 1, 2012

Inappropriate Use of Antibiotics and Clostridium difficile Infection. Jocelyn Srigley, MD, FRCPC November 1, 2012 Inappropriate Use of Antibiotics and Clostridium difficile Infection Jocelyn Srigley, MD, FRCPC November 1, 2012 Financial Disclosures } No conflicts of interest } The study was supported by a Hamilton

More information

Evaluating the Role of MRSA Nasal Swabs

Evaluating the Role of MRSA Nasal Swabs Evaluating the Role of MRSA Nasal Swabs Josh Arnold, PharmD PGY1 Pharmacy Resident Pharmacy Grand Rounds February 28, 2017 2016 MFMER slide-1 Objectives Identify the pathophysiology of MRSA nasal colonization

More information

Disclosures. Principles of Antimicrobial Therapy. Obtaining an Accurate Diagnosis Obtain specimens PRIOR to initiating antimicrobials

Disclosures. Principles of Antimicrobial Therapy. Obtaining an Accurate Diagnosis Obtain specimens PRIOR to initiating antimicrobials Disclosures Principles of Antimicrobial Therapy None Lori A. Cox MSN, ACNP-BC, ACNPC, FCCM Penn State Hershey Medical Center Neuroscience Critical Care Unit Obtaining an Accurate Diagnosis Determine site

More information

Dr. Shaiful Azam Sazzad. MD Student (Thesis Part) Critical Care Medicine Dhaka Medical College

Dr. Shaiful Azam Sazzad. MD Student (Thesis Part) Critical Care Medicine Dhaka Medical College Dr. Shaiful Azam Sazzad MD Student (Thesis Part) Critical Care Medicine Dhaka Medical College INTRODUCTION ICU acquired infection account for substantial morbidity, mortality and expense. Infection and

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

Thank You for Joining!

Thank You for Joining! Thank You for Joining! Session 4 Antibiotic Selection, De-Escalation, and Duration Webinar Will Begin Shortly. Call-In Number: (888) 895-6448 Access Code: 5196001 Antibiotic Selection, De- Escalation,

More information

1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient

1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient 1 Chapter 79, Self-Assessment Questions 1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient with normal renal function is: A. Trimethoprim-sulfamethoxazole B. Cefuroxime

More information

Preventing Multi-Drug Resistant Organism (MDRO) Infections. For National Patient Safety Goal

Preventing Multi-Drug Resistant Organism (MDRO) Infections. For National Patient Safety Goal Preventing Multi-Drug Resistant Organism (MDRO) Infections For National Patient Safety Goal 07.03.01 2009 Methicillin Resistant Staphlococcus aureus (MRSA) About 3-8% of the population at large is a carrier

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

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

Presenter: Marc Meyer, BPharm, RPh, CIC, FAPIC Clinical Pharmacists, Infection Preventionist, Antibiotic Stewardship Pharmacist Southwest Health

Presenter: Marc Meyer, BPharm, RPh, CIC, FAPIC Clinical Pharmacists, Infection Preventionist, Antibiotic Stewardship Pharmacist Southwest Health Presenter: Marc Meyer, BPharm, RPh, CIC, FAPIC Clinical Pharmacists, Infection Preventionist, Antibiotic Stewardship Pharmacist Southwest Health System, Cortez, Colorado None How do AU vendors and NHSN

More information

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016 Mercy Medical Center Des Moines, Iowa Department of Pathology Microbiology Department Antibiotic Susceptibility January December 2016 These statistics are intended solely as a GUIDE to choosing appropriate

More information

Intrinsic, implied and default resistance

Intrinsic, implied and default resistance Appendix A Intrinsic, implied and default resistance Magiorakos et al. [1] and CLSI [2] are our primary sources of information on intrinsic resistance. Sanford et al. [3] and Gilbert et al. [4] have been

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

Concise Antibiogram Toolkit Background

Concise Antibiogram Toolkit Background Background This toolkit is designed to guide nursing homes in creating their own antibiograms, an important tool for guiding empiric antimicrobial therapy. Information about antibiograms and instructions

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

Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship July December 2017

Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship July December 2017 Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship July December 217 Table of Contents Table of Contents... 2 I. Executive Summary... 3 II. GNCH Total Antimicrobial Utilization... 4 III. GNCH

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

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

Current Regulatory Landscape in Antibiotic Stewardship

Current Regulatory Landscape in Antibiotic Stewardship Current Regulatory Landscape in Antibiotic Stewardship Elizabeth Dodds Ashley, PharmD, MHS March 4, 2014 CDC Vital Signs Report 2 1 Core Elements of Stewardship Accountability Drug expertise Appointing

More information

Pharmacist-Driven ASP. Jessica Holt, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Coordinator October 24 th, 2013

Pharmacist-Driven ASP. Jessica Holt, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Coordinator October 24 th, 2013 Pharmacist-Driven ASP Jessica Holt, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Coordinator October 24 th, 2013 Abbott Northwestern Hospital Largest not-for-profit hospital in the Twin Cities area

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

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

8/17/2016 ABOUT US REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM

8/17/2016 ABOUT US REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM Mary Moore, MS CIC MT (ASCP) Infection Prevention Coordinator Great River Medical Center, West Burlington REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM ABOUT

More information

Today s webinar will begin in a few minutes.

Today s webinar will begin in a few minutes. Today s webinar will begin in a few minutes. Please press *6 to mute your line or use the mute button on your phone. If you have questions for the presenter or need to contact TCPS staff, type your comments

More information

OPTIMIZATION OF PK/PD OF ANTIBIOTICS FOR RESISTANT GRAM-NEGATIVE ORGANISMS

OPTIMIZATION OF PK/PD OF ANTIBIOTICS FOR RESISTANT GRAM-NEGATIVE ORGANISMS HTIDE CONFERENCE 2018 OPTIMIZATION OF PK/PD OF ANTIBIOTICS FOR RESISTANT GRAM-NEGATIVE ORGANISMS FEDERICO PEA INSTITUTE OF CLINICAL PHARMACOLOGY DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, ITALY SANTA

More information

Ready to Launch: Antimicrobial Stewardship for All!

Ready to Launch: Antimicrobial Stewardship for All! Ready to Launch: Antimicrobial Stewardship for All! Lucas Schulz, PharmD, BCPS AQ ID Clinical Coordinator Infectious Diseases PGY2 Infectious Diseases Residency Program Director Disclosures Consultant

More information

Preserve the Power of Antibiotics

Preserve the Power of Antibiotics PROVIDERInsight News for providers in Northeast Nebraska April 2016 Preserve the Power of Antibiotics Antimicrobial stewardship interventions have been proven to improve individual patient outcomes, reduce

More information

Overview of C. difficile infections. Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases

Overview of C. difficile infections. Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases Overview of C. difficile infections Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases Conflicts of Interest I have no financial conflicts of interest related to this topic and presentation.

More information

Ghinwa Dumyati, MD Christina Felsen, MPH University of Rochester Medical Center

Ghinwa Dumyati, MD Christina Felsen, MPH University of Rochester Medical Center Ghinwa Dumyati, MD Christina Felsen, MPH University of Rochester Medical Center How do you decide where to start? Start small; core elements recommend you focus on one thing at a time Use data to help

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

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 Susceptibility Patterns

Antimicrobial Susceptibility Patterns Antimicrobial Susceptibility Patterns KNH SURGERY Department Masika M.M. Department of Medical Microbiology, UoN Medicines & Therapeutics Committee, KNH Outline Methodology Overall KNH data Surgery department

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 Advisory Committee Meeting

Antimicrobial Stewardship Advisory Committee Meeting Antimicrobial Stewardship Advisory Committee Meeting August 25, 2016 3:00 PM-4:30 PM Washington State Dept of Health Room A42 1610 NE 150th St Shoreline, WA 98155 Call in: (571) 317-3116 Access Code: 211-449-029

More information

Antimicrobial Stewardship/Statewide Antibiogram. Felicia Matthews Senior Consultant, Pharmacy Specialty BD MedMined Services

Antimicrobial Stewardship/Statewide Antibiogram. Felicia Matthews Senior Consultant, Pharmacy Specialty BD MedMined Services Antimicrobial Stewardship/Statewide Antibiogram Felicia Matthews Senior Consultant, Pharmacy Specialty BD MedMined Services Disclosures Employee of BD Corporation MedMined Services Agenda CMS and JCAHO

More information

Antibiotic Stewardship Programs: The Secret of Getting Ahead is Getting Started. HRET HIIN Antimicrobial Stewardship June 1, 2017

Antibiotic Stewardship Programs: The Secret of Getting Ahead is Getting Started. HRET HIIN Antimicrobial Stewardship June 1, 2017 Antibiotic Stewardship Programs: The Secret of Getting Ahead is Getting Started HRET HIIN Antimicrobial Stewardship June 1, 2017 1 Emily Koebnick, Program Manager, HRET WELCOME AND INTRODUCTIONS 2 Agenda

More information

ANTIMICROBIAL STEWARDSHIP IN LONG TERM CARE FACILITIES

ANTIMICROBIAL STEWARDSHIP IN LONG TERM CARE FACILITIES ANTIMICROBIAL STEWARDSHIP IN LONG TERM CARE FACILITIES ANTIMICROBIAL STEWARDSHIP COLLABORATIVE COLORADO HOSPITAL ASSOCIATION MARCH 23, 2016 Bridget Olson, RPh Infectious Disease Pharmacist, Sharp Coronado

More information

Maximizing Treatment Outcomes in an Era of Antibiotic Resistance

Maximizing Treatment Outcomes in an Era of Antibiotic Resistance Friday General Session Maximizing Treatment Outcomes in an Era of Antibiotic Resistance Edward Dominguez, MD Medical Director, Organ Transplant and Infectious Diseases Methodist Dallas Medical Center Dallas,

More information

Update on Fluoroquinolones. Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO

Update on Fluoroquinolones. Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO Update on Fluoroquinolones Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO Potential fluoroquinolone side-effects Increased risk, greater than with most other antibiotics, for

More information

* gender factor (male=1, female=0.85)

* gender factor (male=1, female=0.85) Usual Doses of Antimicrobials Typically Not Requiring Renal Adjustment Azithromycin 250 500 mg Q24 *Amphotericin B 1 3-5 mg/kg Q24 Clindamycin 600 900 mg Q8 Liposomal (Ambisome ) Doxycycline 100 mg Q12

More information

LEARNING OBJECTIVES ANTIMICROBIAL USES AND ABUSES INFECTIOUS DISEASE SCARES

LEARNING OBJECTIVES ANTIMICROBIAL USES AND ABUSES INFECTIOUS DISEASE SCARES LEARNING OBJECTIVES ANTIMICROBIAL USES AND ABUSES Goodbye to the Antibiotic Era? Glenn D. Bedsole, MD, FACP Infectious Disease Consultant 1. Be able to list 6 examples of resistant bacteria that present

More information

Antimicrobial Stewardship Program. Jason G. Newland MD, MEd Miranda Nelson, PharmD

Antimicrobial Stewardship Program. Jason G. Newland MD, MEd Miranda Nelson, PharmD Antimicrobial Stewardship Program Jason G. Newland MD, MEd Miranda Nelson, PharmD The Children's Mercy Hospital, 2015 Antibiotic Timeline Clatworthy 2007 Antibiotic Use in Freestanding Children s Hospitals

More information

ANTIMICROBIAL STEWARDSHIP: THE ROLE OF THE CLINICIAN SAM GUREVITZ PHARM D, CGP BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCES

ANTIMICROBIAL STEWARDSHIP: THE ROLE OF THE CLINICIAN SAM GUREVITZ PHARM D, CGP BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCES ANTIMICROBIAL STEWARDSHIP: THE ROLE OF THE CLINICIAN SAM GUREVITZ PHARM D, CGP BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCES 1 Crisis: Antibiotic Resistance Success Strategy 2 OBJECTIVES Discuss

More information

Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report

Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report January June 215 Table of Contents I. Introduction... 3 II. CHASC Antimicrobial Utilization Reports... 4 III. Executive Summary...

More information