CBIC Antimicrobial Stewardship 5

Question 1

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

Accepted Answer

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

Answer

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

Question 2

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

Accepted Answer

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

Answer

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

Question 3

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

Accepted Answer

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

Answer

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

Question 4

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

Accepted Answer

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

Answer

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

Question 5

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

Accepted Answer

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

Answer

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

CBIC - Certification Board of Infection Control Practice Test

CBIC - Certification Board of Infection Control Practice Test

CBIC Antimicrobial Stewardship 5