Antimicrobial Stewardship Flashcards

Which antibiotic class is associated with the highest risk of selecting for extended-spectrum beta-lactamase (ESBL)-producing organisms?

Answer: Third-generation cephalosporins

Third-generation cephalosporins exert strong selective pressure for ESBL-producing Enterobacterales, particularly in healthcare settings.

An ASP intervention that requires infectious disease approval before dispensing certain restricted antibiotics is called:

Answer: Formulary restriction with prior authorization

Formulary restriction with prior authorization requires approval from an ID physician or pharmacist before restricted antibiotics can be dispensed.

What is the recommended duration of antibiotic therapy for uncomplicated community-acquired pneumonia (CAP) in a hospitalized patient per current IDSA guidelines?

Answer: 5 days if clinical improvement is achieved

Current IDSA guidelines support 5-day courses for CAP when the patient achieves clinical stability, reducing unnecessary antibiotic exposure.

Which of the following is a key pharmacokinetic/pharmacodynamic (PK/PD) concept important to antimicrobial stewardship?

Answer: Time-dependent killing means beta-lactam efficacy depends on time above the MIC, not peak concentration

Beta-lactams exhibit time-dependent killing; their efficacy is maximized when drug concentration exceeds the MIC for a sufficient percentage of the dosing interval.

Which of the following interventions is an example of an IV-to-oral (IV-to-PO) switch program within ASP?

Answer: Transitioning stable patients from IV vancomycin to oral linezolid when oral bioavailability is adequate

IV-to-PO switch programs reduce costs, catheter-related complications, and length of stay by transitioning clinically stable patients to oral agents with adequate bioavailability.

What is the purpose of an 'antibiotic time-out' in stewardship practice?

Answer: A structured reassessment of antibiotic therapy at 48-72 hours to determine if continuation, modification, or discontinuation is warranted

An antibiotic time-out at 48-72 hours allows clinicians to reassess necessity and appropriateness once initial culture and clinical response data are available.

Which of the following antibiograms is most useful for guiding empiric antibiotic therapy in a specific patient care unit?

Answer: A unit-specific or location-specific antibiogram showing local resistance patterns

Unit-specific antibiograms reflect local resistance patterns in a particular care setting (e.g., ICU vs. general ward), making them most actionable for empiric prescribing.