Antibiotic Stewardship

Antibiotic stewardship is most critical in the hospital because there are a concentrated number of patients shedding bacterial DNA that can then be transferred to other patients. At the end of the anti-infectives slide, I have a case study. Not all of these patients need an antibiotic. Of the ones that do, how can we hope to have the least amount of potential resistance?

It is presented here, too.

Here are 4 urinalyses and 9 culture reports. Urine Culture Examples

I want each of you to choose 1 urinalysis and 1 culture.

For your urinalysis, tell me:

­Was the patient catheterized for did s/he void.

­Is there evidence of host infection? If so, tell me 3 pieces of evidence and how that proves infection (instead of colonization)

­Is there evidence of colonization without infection?

For your culture, tell me:

What kind of bacteria is the patient colonizing (gram +/-, cocci, rod, spiral)?

Which drug will be best for the patient why? What about for a patient with multiple bacteria?

What is the advantage of a drug with sensitivity of <1 v. a sensitivity <20.

Demonstrate understanding of minimum inhibitory concentration and whether your antibiotic is bacterial-cidal, bacterio-static, or both. Refer to a guide for interpreting minimum inhibitory concentration (MIC)