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Antimicrobial Stewardship

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Strategy General Management and Implementation Issues Auditing and feedback ÎReal-time auditing helps optimize therapy on an individual-patient basis. ÎConstructive and patient-specific feedback from experts in antimicrobial therapy is essential. ÎThe optimal method of communicating the recommendation to the provider—that is, feedback—must be defined. ÎMatch the mode of communication to the level of acuity and complexity. Prescriber education ÎPassive education about appropriate antimicrobial use can include grand rounds, newsletters, and written guidelines. ÎPassive education should be distinguished from active education that occurs in the context of auditing and feedback or preauthorization for specific patients. ÎEducation about the program itself should not be overlooked. ÎA public, up-to-date Web site is an excellent way to inform providers about their institutional antimicrobial stewardship program and offers easy access to information about current strategies: Informational Websites www.nebraskamed.com/asp www.hosp.uky.edu/pharmacy/AMT/default.html www.ucsf.edu/idmp Guideline implementation ÎGuidelines must be regularly re-evaluated and, if necessary, revised to reflect recent developments reported in the scientific literature. Application of information technology ÎApplications on the Web or on personal digital assistants can greatly facilitate rapid updating and dissemination of information compared with paper-based sources. 1

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