Antimicrobial Stewardship Flashcards

A stewardship program tracks 'antibiotic-associated adverse events.' Which is the most common antibiotic-related harm that stewardship programs aim to prevent?

Answer: Clostridioides difficile infection

CDI is the most common antibiotic-related harm encountered in healthcare settings, with an estimated 500,000 cases and 30,000 deaths annually in the US, making its prevention a primary stewardship goal.

Which stewardship measure specifically addresses the issue of patients receiving antibiotics longer than necessary?

Answer: Implementing automatic stop orders or defined treatment durations

Automatic stop orders or pre-defined treatment duration policies prompt prescribers to re-evaluate continued antibiotic need, preventing the common error of indefinitely extending therapy.

What is the significance of Minimum Inhibitory Concentration (MIC) creep in antimicrobial stewardship?

Answer: It describes gradual increases in MIC values that may predict future clinical treatment failures

MIC creep refers to gradual upward drift in MIC values over time, which can predict treatment failures even when organisms still test 'susceptible,' highlighting the need for ongoing resistance surveillance.

An infection preventionist is presenting stewardship data to hospital leadership. Which outcome metric would best demonstrate the clinical impact of the program?

Answer: Reduction in CDI rates and antibiotic-resistant organism infections over time

Reduction in CDI rates and resistant organism infections are patient outcome metrics that directly demonstrate the clinical value of stewardship, which is more compelling to leadership than process metrics.

Which of the following best describes the concept of 'antibiotic allergy de-labeling' in stewardship?

Answer: Evaluating and removing inaccurate penicillin allergy labels to expand prescribing options

Penicillin allergy de-labeling uses skin testing or graded challenges to identify patients with inaccurate allergy labels, restoring access to first-line beta-lactams and improving stewardship outcomes.

In stewardship, which practice specifically targets reducing redundant anaerobic coverage?

Answer: Avoiding metronidazole and beta-lactam/beta-lactamase inhibitor combinations simultaneously

Combining metronidazole with a beta-lactam/beta-lactamase inhibitor (e.g., piperacillin-tazobactam) provides redundant anaerobic coverage, a common stewardship target for streamlining therapy.

Which of the following is true about the relationship between antimicrobial stewardship and infection prevention programs?

Answer: Stewardship and infection prevention are complementary and should be integrated for maximum impact on resistance

Stewardship reduces antibiotic selection pressure that drives resistance, while infection prevention controls transmission; integrating both programs is necessary for a comprehensive strategy against resistant organisms.