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Antibiotic stewardship program in children

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Antibiotic stewardship program in children

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Antibiotic stewardship program in children

  1. 1. Introduction • Factors that may contribute to the emergence and dissemination of antimicrobial resistance o ► Inadequate infection control o ► High antimicrobial usage per geographic area per unit time o ► Increased use of antimicrobial prophylaxis o ► Increased empiric polymicrobial antimicrobial therapy.
  2. 2. o ► Greater severity of illness of hospitalized patients o ► More severely immunocompromised patients o ► Newer devices and procedures in use o ► Agricultural use of antimicrobials o ► Social factors o ► International travel o ► Evolution of pathogens
  3. 3. Bad Bugs, No Drugs: No ESKAPE! • Over past 30 years at least one new infectious disease • discovered /year • Very few new antibiotics during that time • Future currently not looking very promising • Antibiotics considered to be one of the 5 most important medical developments • Without antibiotics medicine as we know it will changeforever
  4. 4. What is Misuse of Antibiotics?: • When antibiotics are prescribed unnecessarily; • When antibiotic administration is delayed in critically ill patients; • When antibiotic treatment is not given according to microbiological culture data results. • When the dose is lower or higher than appropriate for the specific patient; and route of administrations [IV vs. oral] not appropriate • When the duration of treatment is too short or too long;
  5. 5. Stewardship Programs • Is an organized antimicrobial management program that can be undertaken to improve antimicrobial usage in order to achieve optimal outcomes to cure or prevent infection, and while minimizing toxicity and emergence of resistance. • One overarching programme of policies, management programmes, control programmes directed at improving antimicrobial use, resistance and clinical outcomes
  6. 6. Stewardship Team
  7. 7. Antimicrobial stewardship is the 8 R’s: • Right drug, • Right time • Right dose • Right route • Right Resident • Right Documentation • Right Reason • Right Response
  8. 8. • Right drug – Check the medication label, check the order • Right time – Check the frequency of ordered medication – Confirm when last dose was given • Right dose
  9. 9. • Right route – Check order for appropriateness of route ordered(IV/IM/oral) – Confirm resident can take or receive med by the ordered route • Right resident – Check name on the order and the resident
  10. 10. • Right documentation – Document administration after giving med – Chart the time, route, and other necessary information • Right reason why medication ordered • Right response – Desired response achieved
  11. 11. Goals of Antibiotic Stewardship Programs 1. Reduce antibiotic consumption and inappropriate us 2. Improve patient outcomes & decrease morbidity and mortality 3. Increase adherence/utilization of treatment guidelines 4. Reduce adverse drug events 5. Decrease or limit antibiotic resistance 6. reduce healthcare costs
  12. 12. Why Stewardship
  13. 13. Classification of Antibiotic According to steward ship program • A-Green flag : prescribed by all doctors • Amoxil, ampicilline,Ampiclox, • Gentamycine, Amikacin • Aciclovir IV • Ceftriaxone / Cefotaxime • Clarithromycin • Amikacin • Azithromycin • Keflex,suprax and others…..etc
  14. 14. which can be prescribed with the permission of infectious disease comitte • Vancomycin • meropenem,imipeme m,cefepime, • levofloxacine • Itraconazole • levofloxacine • Piperacillin + Tazobactam (Tazocin®) • Ribavirin • Teicoplanin • Terbinafine • Ticarcillin + Clavulanate (Timentin) • Valganciclovir • Fluconazole IV • Sodium Fusidate B-Orange flag continue
  15. 15. C-Red flag: • Used only by infectious disease doctors (consultant) • linezolid, • daptomycin, • colistin, • Amphotericin , • Caspofungin, • Moxifloxacin, • Pristinamycin • Tigecycline, • Voriconazole

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