Federal Ministry of Health
Volume 2
Chapter 2:ANTIBIOTIC STEWARDSHIP
PROGRAMS
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Chapter Outline
• Chapter Objective
• PPP 1.1:Goals of an Antimicrobial Stewardship Program
• PPP 1.2:Core Elements of an Antibiotic Stewardship Program
• PPP 1.3:Intervention Modalities for Implementing AMS program
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Chapter Content
• Goals of an Antimicrobial Stewardship Program
• Core Elements of an Antibiotic Stewardship Program
• Intervention Modalities for Implementing AMS program
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Learning Objectives
By the end of this chapter participants will be able to:
• Describe the Goals of an Antimicrobial Stewardship Program
• Identify the core elements of an Antibiotic Stewardship Program
• Describe the Intervention Modalities for Implementing AMS program
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Overview
• Antibiotic stewardship programs are coordinated interventions at the health care
facility level intended to monitor and improve the appropriate use of antibiotics
by encouraging the selection of the optimal drug regimen, dose, duration of
therapy, and route of administration.
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Antibiotic stewardship programs are designed to:
• Achieve optimal clinical outcomes associated with antibiotic use
• Minimize adverse events
• Reduce infection-related health care costs
• Reduce antibiotic resistance
• Prevent the creation of antibiotic-resistant strains
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The goals of an antibiotic stewardship program should inclu de :
• Optimization of clinical outcomes while minimizing unintended
consequences of antibiotic use, such as toxicity and selection of
pathogenic organisms (e.g., Clostridium difficile)
• Reduction of health care costs without an adverse impact on quality of
care
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Core Elements of an Antibiotic Stewardship Program
• Leadership commitment
• Accountability and drug expertise
• Implementation of policies and interventions
• Tracking and reporting antibiotic use and outcomes
• Education
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Intervention Modalities for Implementing AMS program
• Antibiotic time-outs
• Prior authorization
• Prospective audits and feedback:
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Pharmacy-driven interventions
• Changing from parenteral (i.e., IV) to oral antibiotic therapy
• Adjusting dosage
• Optimizing dosage
• Avoiding therapeutic duplication
• Issuing time-sensitive automatic stop orders
• Detecting and preventing antibiotic-related drug interactions
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Infection- and syndrome-specific interventions
• Standard treatment guidelines for prescribing antibiotics for a given
infection help avoid the use of multiple antibiotics for managing an
infection that can be treated with a single, specific antibiotic.
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Standard treatment guidelines include those for:
• Sexually transmitted infections
• Community-acquired pneumonia
• Urinary tract infections
• Skin and soft tissue infections
• Empiric treatment of MRSA infections
• C. difficile infections
• Maternal sepsis
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General public/community-level recommendations and strategies
• Prevent the spread of infections
• Use antibiotics only when prescribed
• Take all antibiotics according to the clinician’s advice
• Do not use antibiotics left over
• Refrain from sharing antibiotics with others
• Refrain from pressuring the doctor to prescribe antibiotics
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Summary
• Antibiotic stewardship programs are coordinated interventions at the
facility level intended to improve and monitor the appropriate use of
antibiotics
• Health care managers and practitioner should encourage and participate
in efforts at implementing a facility-based stewardship programme
