Antimicrobial Stewardship

Principles and Practice

January 2017
More details
  • Publisher
  • Published
    31st January 2017
  • ISBN 9781780644394
  • Language English
  • Pages 450 pp.
  • Size 7.5" x 9.625"

In an age where antimicrobial resistance among pathogens grows more prevalent, particularly in the hospital setting, antimicrobial stewardship is an evidence-based, proven measure in the battle against resistance and infection.

This comprehensive, definitive reference work is written by an international team of acknowledged experts in the field. The authors explore the effective use of coordinated antimicrobial interventions to change prescribing practice and help slow the emergence of antimicrobial resistance, ensuring that antimicrobials remain an effective treatment for infection.

Among the first of its kind, Antimicrobial Stewardship provides infectious disease physicians, administrators, laboratory, pharmacy, nursing, and medical staff practical guidance in setting up antimicrobial stewardship programs in their institutions with the aim of selecting the optimal antimicrobial drug regimen, dose, duration of therapy, and route of administration.

Part I: Overview of Antibiotic Stewardship
1: Principles of Antimicrobial Stewardship
2: Clinical Perspective of Antimicrobial Stewardship
3: History of Antimicrobial Stewardship
4: The Importance of Education in Antimicrobial Stewardship

Part II: Antibiotic Resistance Principles in Antibiotic Stewardship
5: Intrinsic and Acquired Mechanisms of Resistance
6: Antimicrobial Resistance: Selection vs. Induction
7: Colonization and its Importance for Emergence of Clinical Resistance
8: Antibiotic Resistance: Associations and Implications for Antibiotic Usage Strategies to Control Multi-resistant Bacteria

Part III: Microbiology Laboratory Role in Antibiotic Stewardship
9: The Role of Active Surveillance in the Prevention of Healthcare-acquired Infections and Antibiotic Stewardship
10: Role of Antibiogram in Antibiotic Stewardship
11: Selective Reporting and Antimicrobial Stewardship
12: Role of New Diagnostics to Enhance Antibiotic Stewardship Efforts

Part IV: Infection Control Aspects of Antibiotic Stewardship
13: Epidemiology of S Aureus and Enterococci in Children and an Overview of Antimicrobial Resistance
14: Epidemiology of Multi-drug Resistant Gram-negative Organisms
15: Pathogenesis and Epidemiology of Clostridium Difficile Infection: Implications for Antibiotic Stewardship
16: Role of the Hospital Epidemiologist in Supporting Antimicrobial Stewardship

Part V: Pharmacokinetic (PK) & Pharmacodynamic (PD) Aspects of Antibiotic Dosing in Antibiotic Stewardship
17: Principles of Pharmacokinetic / Pharmacodynamic Optimization for Antibiotic Dosing
18: Optimal use of Gram-negative Antibiotics in the Real World: Providing Effective Therapy While Minimizing Resistance
19: Optimal Use of Fluoroquinolones
20: Optimal Use of Beta-lactam Antibiotics
21: Current Approach to Optimal Use and Dosing of Vancomycin in Adult Patients
22: Principles of IV to PO Switch

Part VI: Pharmacy Department Role in Antibiotic Stewardship
23: Role of Pharmacists in Antimicrobial Stewardship
24: Formulary Management and Economic Considerations; Bridging the Gap between Quality Care and Cost
25: Approaches in Benchmarking
26: Development and Execution of Stewardship Interventions
27: Technologic Support for Antimicrobial Stewardship

Part VII: Measuring Outcomes in Antibiotic Stewardship Programs
28: Role of Guidelines and Statistical Milestones for Antimicrobial Stewardship
29: Economic Considerations of Antimicrobial Stewardship Programs
30: Pharmacoeconomic Implications of Antimicrobial Adverse Events
31: Antimicrobial Stewardship Programs in Areas of Increased Pathogen Resistance

Part VIII: Antimicrobial Stewardship and Various Practice Sites
32: Role of Antimicrobial Stewardship in Pediatrics
33: Antimicrobial Stewardship in the Intensive Care Unit
34: Role of Antimicrobial Stewardship in a Community Hospital
35: Outpatient Parenteral Antimicrobial Therapy (OPAT)
36: The Importance of Interdisciplinary Collaboration in Antimicrobial Stewardship: Immersion of Future Healthcare Professionals
37: Antimicrobial Stewardship and the Importance of Working with the Government and Pharmaceutical Industry
38: Hospitalist Perspective on the Role of Antimicrobial Stewardship

Eleftherios Mylonakis

Eleftherios Mylonakis is a physician-scientist, and his work focuses on the study of microbial pathogenesis and drug discovery. His research has developed a novel alternative to studying bacterial and fungal infection and host responses: the use of invertebrate model hosts. These surrogate invertebrate hosts fill an important niche in fungal pathogenesis research. His investigations have identified novel virulence factors, cross kingdom pathogen-pathogen interactions, novel antifungal agents, and evolutionarily conserved traits that are involved in host virulence and immune responses during infection. Recently, Dr. Mylonakis implemented high-throughput whole-animal Caenorhabditis elegans assay to screen libraries of chemical compounds and identify those with antimicrobial activity. In vivo evaluation of libraries of chemical compounds could solve some of the main obstacles in current antifungal discovery, such as finding new classes of compounds and solving the bottleneck of toxicity/efficacy testing. This approach challenges the position that studies in fungal pathogenesis should focus on the analysis of the "host," the "pathogen," or the "antimicrobial compound." Dr. Mylonakis has published over 150 articles in the scientific literature, and peer-reviewed grants from the National Institutes of Health and private foundations have supported his studies. He is the founding Editor-in-Chief of the journal Virulence and serves on the editorial boards of many publications and as an ad hoc reviewer for over 40 journals.

Louis Rice

Louis Rice is at Rhode Island Hospital.

Kerry LaPlante

Kerry LaPlante is a tenured Professor of Pharmacy at the University of Rhode Island, an Adjunct Professor of Medicine at Brown University, and the Founding Director of the Antimicrobial Stewardship Research Fellowship at the Providence Veterans Medical Center. Her work is dedicated to furthering antibiotic education and research across the full spectrum of healthcare science, from antibiotic development to clinical applications. An internationally recognized leader in the field of antibiotic research, Dr. LaPlante is an elected Fellow of the American College of Clinical Pharmacy, and has served on the editorial boards for the leading journals in pharmacy and pathogenic microbiology. She is frequently invited to lecture at national infectious diseases meetings and symposia, and is an author on over 60 peer-reviewed articles, and book chapters, which span topics from antimicrobial stewardship, antibiotic resistance, drug discovery and in vitro activity of combination antimicrobial agents.

Cheston Cunha

Cheston Cunha is at Brown University.

Haley Morrill

Haley Morrill is at Veterans Affairs Medical Center.