Antimicrobial Stewardship Flashcards

A stewardship program wants to reduce carbapenem use. Which organism's rising prevalence would most urgently justify this intervention?

Answer: Carbapenem-resistant Enterobacteriaceae (CRE)

CRE are resistant to carbapenems and most other antibiotics, leaving very limited treatment options; stewardship to reduce carbapenem use is essential to slow CRE emergence and spread.

Which stewardship strategy involves reviewing antibiotic prescriptions after they are dispensed and providing recommendations to prescribers?

Answer: Prospective audit and feedback (PAF)

Prospective audit and feedback involves pharmacists or infectious disease physicians reviewing active antibiotic orders and providing real-time recommendations to prescribers without requiring prior approval.

What is the recommended standard duration of therapy for uncomplicated community-acquired pneumonia (CAP) in a hospitalized patient according to current guidelines?

Answer: 5-7 days

Current IDSA/ATS guidelines recommend 5-7 days for hospitalized CAP patients who respond clinically, as shorter courses are as effective as longer durations for uncomplicated cases.

In the context of stewardship, 'inappropriate antibiotic use' includes all of the following EXCEPT:

Answer: Using narrow-spectrum antibiotics for confirmed susceptible organisms

Using narrow-spectrum antibiotics for confirmed susceptible organisms is the ideal stewardship outcome — matching therapy to the pathogen appropriately is correct practice, not inappropriate use.

Which of the following best describes antimicrobial stewardship in long-term care facilities (LTCFs)?

Answer: LTCFs must implement stewardship programs and are a major reservoir for resistant organisms

LTCFs are required by CMS to have antibiotic stewardship programs and are recognized as major reservoirs for resistant organisms like MRSA, VRE, and ESBL-producers due to frequent antibiotic use.

Which clinical scenario represents appropriate antibiotic stewardship?

Answer: Discontinuing antibiotics when cultures confirm a viral etiology

Stopping antibiotics when cultures confirm a viral etiology is the correct stewardship action, as antibiotics have no efficacy against viruses and continuing them only drives resistance.

Which of the following antibiotic properties makes it suitable for IV-to-oral conversion early in therapy?

Answer: High oral bioavailability (>80%)

High oral bioavailability (>80%) means serum levels achieved orally are comparable to IV administration, making early conversion safe and effective without compromising efficacy.