Antimicrobial Stewardship Flashcards

Which antibiotic class is most strongly associated with the development of Clostridioides difficile infection (CDI)?

Answer: Fluoroquinolones, clindamycin, and cephalosporins

Fluoroquinolones, clindamycin, and cephalosporins are most strongly linked to CDI because they disrupt gut flora and create an environment permissive for C. difficile colonization and toxin production.

What does the term 'antibiotic timeout' refer to in stewardship practice?

Answer: A scheduled reassessment of antibiotic therapy at 48-72 hours to determine continued need

An antibiotic timeout is a deliberate reassessment at 48-72 hours, when preliminary culture data are available, to confirm the indication, spectrum, dose, and duration are still appropriate.

When evaluating urine cultures, stewardship programs emphasize distinguishing asymptomatic bacteriuria (ASB) from UTI primarily because:

Answer: Treating ASB does not improve outcomes in most patients and drives resistance

Treating ASB in most patient populations confers no clinical benefit, exposes patients to antibiotic side effects, and selects for resistant organisms, making diagnosis stewardship critical.

Which of the following best describes the role of a clinical pharmacist in an antimicrobial stewardship program?

Answer: Pharmacists conduct prospective audit and feedback, optimize dosing, and educate prescribers

Clinical pharmacists are core ASP members who perform prospective audit and feedback, pharmacokinetic/pharmacodynamic dosing optimization, IV-to-oral conversions, and prescriber education.

A hospital notices rising rates of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. Which stewardship action directly addresses this trend?

Answer: Restricting carbapenems to ESBL-confirmed infections only

Restricting carbapenems to confirmed ESBL infections preserves these last-resort agents and reduces selection pressure that drives carbapenem-resistant organism emergence.

Which of the following is a core element of hospital antimicrobial stewardship programs according to CDC?

Answer: Leadership commitment with dedicated human, financial, and IT resources

CDC identifies leadership commitment with dedicated resources as a foundational element, as sustainable stewardship requires institutional support, not just individual efforts.

Pharmacokinetic/pharmacodynamic (PK/PD) optimization in stewardship refers to:

Answer: Tailoring dosing regimens to maximize pathogen killing while minimizing toxicity

PK/PD optimization applies principles like time-dependent vs. concentration-dependent killing to design regimens that maximize efficacy against the target pathogen while limiting adverse effects.