Antimicrobial Stewardship Flashcards

A patient is diagnosed with asymptomatic bacteriuria. Which ASP recommendation is appropriate for most patients?

Answer: No antibiotic treatment is warranted unless the patient is pregnant or undergoing urologic procedures

Treating asymptomatic bacteriuria in non-pregnant, non-surgical patients provides no clinical benefit and increases resistance and adverse effects.

Which of the following best describes the concept of 'antibiotic stewardship' as defined by the CDC?

Answer: The coordinated interventions designed to improve and measure the appropriate use of antimicrobials by promoting selection of the optimal regimen

The CDC defines antibiotic stewardship as coordinated efforts to optimize antibiotic use, including the right drug, dose, route, and duration for each patient.

Which biomarker is most useful for guiding antibiotic discontinuation in patients with suspected sepsis?

Answer: Procalcitonin (PCT)

Procalcitonin rises rapidly in bacterial infections and falls quickly with effective treatment, making serial PCT measurements useful for guiding antibiotic de-escalation and stopping decisions.

Which of the following infections typically requires the shortest antibiotic course according to current evidence-based guidelines?

Answer: Uncomplicated lower urinary tract infection in women (3 days)

Uncomplicated cystitis in women is effectively treated with 3-day courses of trimethoprim-sulfamethoxazole or 5-day nitrofurantoin, one of the shortest validated antibiotic durations.

In long-term care facilities (LTCFs), which of the following represents a common stewardship challenge?

Answer: High rates of antibiotic prescribing for asymptomatic bacteriuria based on urine dipstick results alone

LTCFs commonly over-treat asymptomatic bacteriuria detected incidentally on dipstick, contributing significantly to antibiotic overuse and resistance in this population.

What is 'cascade reporting' in the context of microbiology and ASP?

Answer: Reporting susceptibility to broader-spectrum antibiotics only when the organism is resistant to narrower agents, to promote use of narrower therapy

Cascade reporting withholds susceptibility data for broader agents unless resistance to narrower agents is confirmed, nudging prescribers toward narrower-spectrum therapy.

Which of the following represents an appropriate outcome metric for evaluating an antimicrobial stewardship program?

Answer: Rate of Clostridioides difficile infections per 10,000 patient-days

C. difficile infection rates are a key clinical outcome metric for ASPs because they reflect the downstream harm of unnecessary broad-spectrum antibiotic use.