Antimicrobial Stewardship Flashcards

Which metric is most commonly used to measure antibiotic consumption in antimicrobial stewardship programs?

Answer: Days of therapy (DOT) per 1,000 patient-days

Days of therapy (DOT) per 1,000 patient-days is the preferred standardized metric for tracking antibiotic consumption because it accounts for multiple agents and dose changes.

A patient is started on broad-spectrum antibiotics empirically. What is the stewardship principle that involves narrowing therapy once culture results return?

Answer: De-escalation

De-escalation is the practice of switching from broad-spectrum to narrow-spectrum antibiotics once the causative organism and its susceptibilities are identified.

Which intervention is an example of a 'front-end' stewardship strategy?

Answer: Formulary restriction with prior authorization

Formulary restriction with prior authorization is a front-end strategy that requires approval before an antibiotic is dispensed, preventing unnecessary prescriptions proactively.

Procalcitonin (PCT) guidance in antimicrobial stewardship is primarily used to:

Answer: Guide antibiotic discontinuation in respiratory infections

PCT is a biomarker that rises with bacterial infections and falls as they resolve, making it useful for guiding safe discontinuation of antibiotics in respiratory tract infections.

What is the primary goal of antimicrobial cycling (rotation) strategies?

Answer: Prevent the emergence and spread of resistance by rotating drug classes

Antimicrobial cycling rotates antibiotic classes in a scheduled manner to reduce selective pressure from any single agent and theoretically limit resistance development.

Which organism is the primary target of vancomycin stewardship efforts in healthcare settings?

Answer: Methicillin-resistant Staphylococcus aureus (MRSA)

Vancomycin is the primary treatment for MRSA infections, and inappropriate use drives vancomycin-resistant enterococci (VRE) emergence, making MRSA the central stewardship target for this agent.

An ASP team recommends switching a patient from IV to oral antibiotics on day 3 of treatment. This intervention is known as:

Answer: IV-to-oral (IVPO) conversion

IV-to-oral conversion is a key stewardship intervention that reduces costs, IV line complications, and hospital length of stay when a patient can tolerate oral medications.