Elements of antimicrobial stewardship
A coordinated strategy to optimize the use of antimicrobials with the goal of improving patient outcomes, reducing microbial resistance, and decreasing the spread of infections.
What is "Antimicrobial Stewardship"?
Alexander Fleming discovered this antibiotic upon returning from a holiday in Suffolk in 1928, when he noticed that a fungus had contaminated a culture plate of Staphylococcus bacteria he had accidentally left uncovered. The fungus had created a bacteria-free zone where it grew on the plate.
What is penicillin?
This term describes the lowest concentration of an antibiotic that completely inhibits the growth of a microorganism in vitro.
What is minimum inhibitory concentration (MIC)?
This term describes the red, diffuse rash appearing on the trunk during or after rapid infusion of vancomycin.
What is "Red Man Syndrome"?
OR "vancomycin infusion syndrome"
Zemdri
This new aminoglycoside (plazomicin) was FDA approved in June 2018 to treat serious bacterial infection due to multi-drug resistant Enterobacteriaceae, including CRE in patients with limited or no alternative options.
The process of narrowing the spectrum and/or number of antimicrobial agents based on clinical and microbiological data to limit adverse events, emergence of resistance, and preserve effectiveness of antimicrobial agents.
What is antimicrobial de-escalation?
In 1943 at Rutgers University, Nobel Prize winning biochemist Selman Waksman and his graduate student isolated this antibiotic, which was the first agent found to be active against tuberculosis.
What is Streptomycin?
This term describes the time course of antimicrobial concentrations in the body, and includes absorption, distribution, metabolism, or excretion.
What is pharmacokinetics?
Concomitant administration of vancomycin and piperacillin/tazobactam increases this risk for this adverse effect.
What is nephrotoxicity?
Vabomere
This new carbapenem, which is a combination of meropenem and vaborbactam, was approved in August 2017. If Vabomere were a Pokemon it would be evolved from Merrem, which is the brand name for meropenem without vaborbactam.
The process of evaluating the continuing need and choice of antimicrobial therapy after 48-72 hours when the clinical picture is clearer and more diagnostic information is available.
What is an "Antimicrobial Time Out"?
This antibiotic was first isolated in 1953 by Edmun Kornfeld (working at Eli Lilly) from a soil sample collected from the interior jungles of Borneo and was initially referred to as “Mississippi Mud”.
What is vancomycin?
Aminoglycosides, fluoroquinolones, and azithromycin are examples of antibiotic classes that exhibit this type of killing behavior, where the goal is to maximize serum concentrations relative to MIC
What is concentration-dependent killing?
Use of antibiotics, in particular clindamycin, fluoroquinolones, and broad spectrum penicillins, is the number one risk factor for this infection.
What is Clostridioides difficile infection?
Staravia
This new flying-type Pokemon looks like a bird with an Elvis haircut.
An overall profile of antimicrobial susceptibility of local bacterial isolates to help guide appropriate empiric therapy.
What is an antibiogram?
Penicillin was initially effective to this microorganism, but resistant strains that produce penicillinase surfaced in the 1950s.
What is Staphylococcus aureus?
Although historically monitored using trough levels, recent studies have demonstrated that targeting an AUC greater than 400 significantly reduces mortality when this antibiotic is used to treat susceptible infections.
What is vancomycin?
Administering a SSRI with linezolid increases the risk for this adverse effect.
What is Serotonin Syndrome?
Luxio
Did the X get you? Lots of new antimicrobials have a V, X, Y, or Z in their names lately. This electric-type Pokemon looks like a cute fox or monkey.
Prescribing behavior is a complex process, including adherence to local culture and etiquette. ASP teams rely on several strategies to change behavior...Name one technique used by ASP teams
What is education, audit and feedback, formulary restrictions, OR prior approvals?
Traces of this antibiotic, which is a strong chelator and incorporated into the mineral portion of bones as well as tooth enamel, have been found in human skeletal remains from ancient Sudanese Nubia dating back to 350-550 AD, likely as a result of exposure in the diet of these ancient people.
What is tetracycline?
Time above MIC is the best predictor of bacterial eradication for this class of antibiotic.
What are beta-lactams?
This class of antimicrobial should be generally avoided in children due to discoloration of the teeth.
What are tetracyclines?
Xofluza
This new antiviral agent (baloxavir) was approved in October 2018 for the treatment of acute uncomplicated influenza in patients 12 years of age and older who have been symptomatic for no more than 48 hours.