Introduction
Training in antimicrobial stewardship
Learning objective(s) | Topics | |
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Effect of AMS initiatives on clinical outcome | The participant learns about how AMS contributes to accurate and safer prescribing of antimicrobials, resulting in improved clinical outcomes | Effective treatment |
Clinical outcomes (mortality and morbidity) | ||
Reduction of side effects | ||
Population specific approaches | ||
Effect of AMS initiatives on bacterial resistance | The participant learns about antibiotic resistance mechanisms, including causes and extent | Epidemiology (global) |
Genetics and mechanisms | ||
Relationship to antibiotic use | ||
Discussion of AMS initiatives like prospective audit with feedback and formulary restriction | ||
The participant learns how AMS reduces the spread of antimicrobial resistance | ||
Diagnosis of infection | The participant learns how to accurately interpret laboratory reports in order to make clinical treatment decisions in neonates, infants, children and adolescents; | Proper use and interpretation of bacterial Gram stain/culture, rapid and point-of-care tests, serology, and biomarkers of infection |
Establishment of standardised diagnostic criteria for specific infections | ||
The participant learns how to diagnose an infection in a standardised manner; | ||
Principles of infection management in children | The participant learns how to make informed treatment decisions early in the course of disease in order to positively influence treatment outcomes; | Promptly identify patients who require antibiotics |
Timely and appropriate initiation of antibiotics | ||
Obtain cultures before starting antibiotics | ||
Do not give antibiotics with overlapping activity or combinations not supported by evidence or guidelines | ||
The participant learns how to de-escalate antibiotic use in order to more effectively treat an infection while limiting exposure to broad-spectrum antimicrobials | ||
Determine and verify antibiotic allergies | ||
Consider local antibiotic susceptibility | ||
Specify expected duration of therapy based on evidence and national and hospital guidelines | ||
Ensure appropriate administration (intravenous versus oral) | ||
Give antibiotics at the right dose and interval | ||
Stop or de-escalate therapy promptly based on the culture and sensitivity results or establishment of an alternative diagnosis | ||
Reconcile and adjust antibiotics at all transitions and changes in patient’s condition | ||
Monitor for toxicity reliably and adjust agent and dose promptly | ||
Prescribing of antibiotics | The participant learns the basics needed to prescribe antibiotics for infections caused by susceptible and resistant organisms | Pharmacokinetics and mechanism of action of different classes of antibiotics (‘bug-drug’ coverage) |
Pharmacology and adverse effects, including risk of C. difficile infection | ||
Principles of empirical versus directed therapy | ||
Drug purchasing and dispensing costs | ||
Guidelines for diagnosis and management of most frequent infections in children | Specific instruction for these common infections using principles outlined above | |
Use of national and local guidelines and public health guidance | ||
Prevention of infection | The participant learns about the importance of preventive measures to limit the development of antimicrobial resistance | Hand hygiene |
Prudent use of catheters and devices | ||
Principles and duration of surgical prophylaxis | ||
Communication skills | The participant learns how to apply communication techniques to talk with patients and families about prudent antibiotic use |
AMS (general) | Collection of AMS online courses made by the European Centre for Disease Prevention and Control: Massive Open Online Course on Antimicrobial Stewardship (University of Dundee, UK): Antimicrobial Stewardship Online CME Courses (Stanford University School of Medicine, USA): |
Paediatric AMS | European Society for Paediatric Infectious Diseases (ESPID) online course on paediatric AMS: http://www.espid.org/content.aspx?Page=ESPID%20Online%20Antibiotic%20Management%20Course
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