Antimicrobial Stewardship – ACSQHC Clinical Care Standard

CPD Hours: 2
Current as at 27 October 2021
The session explores the importance of antimicrobial stewardship, to know when to consult infectious disease specialists for guidance.


“Review ACSQHC clinical standards for antimicrobial stewardship”

Course Content

Antimicrobial agents are some of the most widely, and often injudiciously, used therapeutic drugs worldwide.

Important considerations when prescribing antimicrobial therapy include

  • obtaining an accurate diagnosis of infection;
  • understanding the difference between empiric and definitive therapy;
  • identifying opportunities to switch to narrow-spectrum, cost-effective oral agents for the shortest duration necessary;
  • understanding drug characteristics that are peculiar to antimicrobial agents (such as pharmacodynamics and efficacy at the site of infection);
  • accounting for host characteristics that influence antimicrobial activity; and in turn,
  • recognizing the adverse effects of antimicrobial agents on the host.

It is also important to understand the importance of antimicrobial stewardship, to know when to consult infectious disease specialists for guidance, and to be able to identify situations when antimicrobial therapy is not needed.

By following these general principles, all practising physicians should be able to use antimicrobial agents in a responsible manner that benefits both the individual patient and the community.

An infectious disease diagnosis is reached by determining the site of infection, defining the host (eg, immunocompromised, diabetic, of advanced age), and establishing, when possible, a microbiological diagnosis. It is critical to isolate the specific pathogen in many serious, life-threatening infections, especially for situations that are likely to require prolonged therapy (i.e. endocarditis, septic arthritis, disk space infection, and meningitis).

Antimicrobial stewardship is pivotal to improving patient outcomes, reducing adverse events, decreasing healthcare costs, and preventing further emergence of antimicrobial resistance. In an era in which antimicrobial resistance is increasing, judicious antimicrobial use is the responsibility of every healthcare provider. Antimicrobial stewardship programs (ASPs) have made headway in improving antimicrobial prescribing using such “top-down” methods as formulary restriction and prospective audit with feedback.

Strategies that include frontline prescribers and other unit-based healthcare providers have the potential to expand stewardship, both to augment existing centralized ASPs and to provide alternative approaches to perform stewardship at healthcare facilities with limited resources.

Learning Outcomes

In this session, you will:

  • Review ACSQHC clinical standards for antimicrobial stewardship
  • Discuss most recent recommendations for clinical management of use of antimicrobials
  • Learn about the unnecessary and inappropriate use of antimicrobials
  • Ascertain the potential cost of inappropriate use of antimicrobials to the health system
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