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Updated: May 16, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Specialist trainees on rotation cannot replace dedicated consultant clinicians for antimicrobial stewardship of
Chay Leng Yeo1, Jia En Wu, Gladys Wei-Teng Chung
1Department of Medicine, National University Health System, NUHS Tower Block Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore. liyang_hsu@yahoo.com.
Abstract:
Our prospective-audit-and-feedback antimicrobial stewardship (AS) program for hematology and oncology inpatients was switched from one led by dedicated clinicians to a rotating team of infectious diseases trainees in order to provide learning opportunities and attempt a "de-escalation" of specialist input towards a more protocol-driven implementation. However, process indicators including the number of recommendations and recommendation acceptance rates fell significantly during the year, with accompanying increases in broad-spectrum antibiotic prescription. The trends were reversed only upon reverting to the original setup. Dedicated clinicians play a crucial role in AS programs involving immunocompromised patients. Structured training and adequate succession/contingency planning is critical for sustainability.
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