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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

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Antimicrobial stewardship programs: how to start and steer a successful program.

Richard H Drew¹

¹Campbell University School of Pharmacy, Duke Medical Center, Durham, NC 27710, USA. richard.drew@duke.edu

Journal of Managed Care Pharmacy : JMCP

|February 25, 2009

Summary

This summary is machine-generated.

Antimicrobial stewardship programs (ASPs) optimize antimicrobial use to improve patient outcomes and reduce resistance. Key strategies include formulary restrictions and prospective audits, requiring multidisciplinary support for successful implementation.

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Area of Science:

Infectious Diseases
Health Services Research
Pharmacology

Background:

Antimicrobial stewardship programs (ASPs) are crucial for optimizing antimicrobial use, impacting efficacy, cost, and resistance.
Appropriate antimicrobial selection involves dose, duration, and route, aiming to enhance patient outcomes and minimize adverse events.

Purpose of the Study:

To outline effective antimicrobial stewardship program (ASP) tactics for hospital settings.
To identify strategies for multidisciplinary support and overcoming implementation barriers.

Main Methods:

Summarizing evidence-based practices for antimicrobial stewardship.
Highlighting key proactive strategies: formulary restriction/pre-authorization and prospective audit/feedback.
Identifying supplemental strategies: education, guidelines, order forms, de-escalation, IV-to-PO switch, and dose optimization.

Main Results:

Multidisciplinary teams, including infectious diseases physicians and pharmacists, are essential for ASP implementation.
Proactive strategies like formulary restriction and prospective audits are recommended.
Barriers include administrative support, compensation, and physician acceptance.

Conclusions:

ASPs can significantly reduce antimicrobial resistance, healthcare costs, and adverse drug events.
Improved clinical outcomes and substantial patient/hospital benefits justify ASP investment.
Successful ASPs require a collaborative, multidisciplinary approach to overcome identified challenges.