Antimicrobial Stewardship Flashcards

Which of the following is a core element of hospital antibiotic stewardship programs as recommended by The Joint Commission?

Answer: Leadership commitment demonstrated by dedicating necessary human, financial, and information technology resources

TJC's ASP standards require leadership commitment, including accountability, drug expertise, action, tracking, reporting, and education as core elements.

A patient with MRSA bacteremia is started on vancomycin. Which ASP-supported monitoring practice is most important?

Answer: Therapeutic drug monitoring using AUC/MIC-guided dosing rather than trough-only monitoring

AUC/MIC-guided vancomycin dosing (targeting AUC 400-600 mg·h/L) reduces nephrotoxicity and treatment failure compared to trough-only monitoring.

Which of the following best describes 'antibiotic heterogeneity' as a stewardship strategy?

Answer: Intentionally varying the antibiotic agents used across a unit to reduce selective pressure for resistance to any single drug

Antibiotic heterogeneity (also called mixing) aims to reduce clonal expansion of resistant organisms by diversifying drug selection pressure across patients.

When evaluating a positive respiratory culture from a ventilated patient, which scenario best represents colonization rather than infection requiring treatment?

Answer: Growth of Candida albicans in a BAL specimen from a patient with no clinical signs of pneumonia and normal oxygenation

Candida in respiratory cultures almost always represents colonization; antifungal treatment for respiratory Candida is not recommended in non-immunocompromised ventilated patients.

Which of the following is the most important reason to obtain blood cultures BEFORE starting antibiotics?

Answer: To identify the causative pathogen and guide de-escalation to targeted narrow-spectrum therapy

Pre-treatment blood cultures provide the pathogen identification and susceptibility data needed to de-escalate from empiric broad-spectrum therapy to targeted narrower agents.

Which of the following antibiotic stewardship interventions has been shown to reduce surgical site infection (SSI) rates?

Answer: Ensuring surgical prophylaxis is given within 60 minutes before incision and discontinued within 24 hours post-operatively

Timely administration (within 60 minutes pre-incision) and short duration (≤24 hours) of surgical prophylaxis are evidence-based practices that optimize SSI prevention while minimizing resistance selection.

Which of the following best describes the role of clinical decision support systems (CDSS) in antimicrobial stewardship?

Answer: Provide real-time alerts and recommendations at the point of prescribing to guide antibiotic selection, dosing, and duration based on patient-specific data

CDSS tools integrated into the EHR can flag inappropriate prescribing, suggest de-escalation, alert to drug-drug interactions, and recommend dose adjustments in real time.