Antibiotic Optimization: Concepts and Strategies in Clinical Practice (HBK) (Infectious Disease and Therapy)

This book focuses on topics ranging from the economics of drug-resistant infections and the management of antimicrobial use to new information on methods to optimize the selection, route of administration, dosing, and duration of antimicrobial therapies for common infections. In addition to offering ideas on studied programmatic approaches for judicious utilization of antimicrobial agents, this reference discusses practical means to track intervention outcomes through benchmarking. Authored by experts in their respective fields, the book contains essential principles and practical strategies to optimize the utility of antimicrobial agents in modern inpatient health care settings. Book Cover......Page 1 Title......Page 2 Series Title......Page 3 Half-Title......Page 6 Copyright......Page 7 Foreword......Page 8 Preface......Page 10 Contents......Page 12 1: How to Create a Therapeutics Committee That Is Scientifically and Economically Sound......Page 17 2 The Public Health Action Plan to Combat Antimicrobial Resistance and the Prevention of Antimicrobial Resistance in Health Care Settings......Page 29 3 Why Appropriate Antimicrobial Selection Is Important: Focus on Outcomes......Page 42 4 Understanding Pharmacokinetics and Pharmacodynamics: Application to the Antimicrobial Formulary Decision Process......Page 57 5 Optimization of Antibacterial Therapy to Minimize Costs, Medication Errors, and Adverse Outcomes......Page 73 6 Basic Pharmacoeconomics for the Hospital Decision-Maker......Page 89 7 Measuring the Attributable Costs of Resistant Infections in Hospital Settings......Page 107 8 Optimizing Antimicrobial Use and Combating Bacterial Resistance: Benchmarking and Beyond......Page 134 9 The Role of Infection Control and Hospital Epidemiology in the Optimization of Antibiotic Use......Page 152 10 Antimicrobial Stewardship Initiatives: A Programmatic Approach to Optimizing Antimicrobial Use......Page 185 11 Role of Computer-Assisted Programs in Optimizing the Use of Antimicrobial Agents......Page 233 12 Application of Pharmacodynamic Principles: From Theory to Practice......Page 250 13 The Antimicrobial Formulary: Reevaluating Parenteral Cephalosporins in the Context of Emerging Resistance......Page 271 14 Early Discharge Strategies: Role of Transitional Therapy Programs......Page 302 15 Impact of Guidelines on Antimicrobial Treatment of Respiratory Tract Infections......Page 317 16 Abbreviated Courses of Antibacterial Therapy......Page 344 17 Antibiotic Cycling Strategies......Page 362 18 Outpatient Parenteral Antimicrobial Therapy: Role in Optimizing Length of Hospital Stay......Page 385 19 Rational Use of Antifungals for Invasive Fungal Infections in the Institutional Setting......Page 401 Index......Page 442 "Antimicrobial stewardship," a term coined by Dr. Dale Gerding, applies to the selection of an antimicrobial agent and its appropriate dosage and duration of therapy. In principle, this results in the best clinical outcome in the treatment or prevention of infection, with the least toxicity and, most important, a minimal effect on the development of resistance in the patient and in larger populations, whether in the hospital or the community. The goal of this book is to provide the practicing clinician and the interested administrator with the background, scientific foundation, and practical knowledge required to develop institutional programs that foster good antimicrobial stewardship. The book draws on many recommendations by professional societies and national and international organizations that have recognized the importance of antimicrobial stewardship as a mechanism to prevent antimicrobial resistance. The editors are to be congratulated for assembling an expert group of authors to write the 19 chapters that make up this treatise. The book has two main parts. The initial chapters provide an overview of topics that serve as the foundation of a successful program of antimicrobial stewardship, such as the importance of a pharmacy and therapeutics committee, a program for infection control and hospital epidemiology, and a basic understanding of pharmacoeconomics, pharmacokinetics, and pharmacodynamics. The remainder of the book deals with examples of the application of antimicrobial stewardship. These chapters provide insight into the importance of pharmacodynamic principles, transitional-therapy programs, and the development and implementation of an antimicrobial formulary. The chapters are very well referenced and understandable for readers without expert knowledge of the subject. In general, the references are to articles published up to 2003, with a few from 2004 Presents critical concepts, principles, and rationale to improve, update, and adapt antimicrobial utilization to maximize outcomes and minimize resistance and costs. This book describes the economics of drug-resistant infections and the management of antimicrobial use, and provides information on methods to optimize the selection. One of the primary challenges in today's medical environment is to find treatments that provide good clinical outcomes but also satisfy pressures on heath care professionals and hospitals to deliver health care as cost effectively as possible. Presenting essential principles and strategies to optimize the utility of antiomicrobial agents in modern inpatient healthcare settings, this reference also discusses practical means to track intervention outcomes through benchmarking