Practical Implementation of an Antibiotic Stewardship Program

Tamar F. Barlam MD, M.Sc., FSHEA, FIDSA is a member of the Infectious Disease section at the Boston Medical Center, where she directs the antibiotic stewardship team. She has led antibiotic stewardship efforts at hospitals in New York City and Boston for over 25 years. She is co-chair of the IDSA/SHEA implementation guideline for antibiotic stewardship. Her primary academic interests are studying factors influencing clinician antibiotic prescribing practices and the optimal implementation of hospital-based antibiotic stewardship programs. Melinda M. Neuhauser, PharmD, MPH, FCCP, FASHP previously was employed as the National PBM Clinical Pharmacy Program Manager in Infectious Diseases for the Department of Veterans Affairs (VA) and co-chair of the VA National Antimicrobial Stewardship Task Force. She served as President of the Society of Infectious Disease (SIDP) from 2016–2017. Pranita D. Tamma, M.D., M.H.S. is the Director of the Pediatric Antimicrobial Stewardship Program at The Johns Hopkins University School of Medicine. In this capacity, she assists clinicians with optimizing the selection of antibiotics, developing guidelines to promote the appropriate and judicious use of antibiotics, and monitoring patient outcomes after implementation of these practices. She is the past and present recipient of federal research funding from the National Institutes of Health, Food and Drug Administration, Centers for Disease Control and Prevention (CDC), and Agency for Healthcare Research and Quality to both optimize antibiotic stewardship approaches and curb the spread of antibiotic resistance. Her research focuses on clinical outcomes related to antibiotic administration strategies in both children and adults. She is particularly interested in improving diagnostics and therapeutic choices for infections caused by multidrug resistant gram-negative organisms. Kavita K. Trivedi is the founder of Trivedi Consults, LLC and Adjunct Clinical Assistant Professor of Medicine at Stanford University School of Medicine. She is also an attending physician in the Emergency Room at the San Francisco Veterans' Administration Medical Center. Dr Trivedi also serves as the Infection Control Committee Chair and the Chair of the Antimicrobial Stewardship Committee at Sutter Tracy Community Hospital. She is the Course Director for SHEA's Primer on Healthcare Epidemiology, Infection Control and Antimicrobial Stewardship: An Online Course for ID Fellows. Her consulting work includes projects with the American Institutes of Research, Partnership for Quality Care and the Centers for Disease Control and Prevention (CDC) Foundation. Previously, Dr Trivedi was the Public Health Medical Officer of the Healthcare Associated Infections Program at California Department of Public Health where she created, managed and led the California Antimicrobial Stewardship Program Initiative.

Preface Neil Fishman; 1. The need for antibiotic stewardship programs: an introduction Emily Spivak, Lauri Hicks and Arjun Srinivasan; 2. Structure of an antibiotic stewardship team and core competencies Whitney R. Buckel and Sara E. Cosgrove; 3. The social determinants of antibiotic prescribing: implications for the development and implementation of stewardship interventions Julia E. Szymczak and Jason Newland; 4. Selecting and applying antibiotic stewardship strategies Rebekah Moehring and Whitney A. Jones; 5. Syndrome-based antibiotic stewardship Trevor C. Van Schooneveld and Emily Heil; 6. Duration of therapy: our role as stewards George Nelson and Annie Wong-Beringer; 7. Measurement in antibiotic stewardship Elizabeth Dodds Ashley and Edward Stenehjem; 8. What every steward should know about pharmacokinetics and pharmacodynamics Jason M. Pogue and Marc H Scheetz; 9. Collaborating with the microbiology laboratory Graeme N. Forrest and Denise Kirsch; 10. Informatics and stewardship Francesca Lee and Kristi Kuper; 11. Antibiotic allergies and antibiotic stewardship Keith Hamilton and Holly Maples; 12. Antibiotic stewardship in post-acute care facilities Anurag N. Malani and Christopher J. Crnich; 13. Outpatient antibiotic stewardship Larissa May and Matthew P. Kronman; 14. Maintaining an antibiotic stewardship program: keeping everyone happy and remaining relevant Marisa Holubar, B. Joseph Guglielmo and Stan Deresinski; 15. Practical antibiotic stewardship: implementing an antibiotic stewardship program Richard H. Drew and Rebekah W. Moehring; Index.