Sepsis Wave II
Balancing Antibiotics Stewardship with Sepsis
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Antibiotic Stewardship and Sepsis: Importance, Challenges, and Strategies, Exams of Public Health
The importance of antibiotic stewardship in the context of sepsis treatment and prevention. It covers the objectives of antibiotic stewardship programs, the challenges in the ED, and the role of antibiotic stewardship in sepsis diagnosis and treatment. The document also touches upon the importance of public health initiatives and the impact of antibiotic resistance.
Typology: Exams
2021/2022
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Sepsis Wave II
Balancing Antibiotics Stewardship with Sepsis
Presenters
Jessica Whittle, Phd, MD Lauren Epstein, MD, MSc
Jessica Whittle, MD, PhD, FACEP
Research Director, Department of Emergency Medicine
University of Tennessee College Of Medicine, Chattanooga
Erlanger Health System
ACEP E-QUAL SEPSIS Steering Committee
ACEP liaison to IDSA for workgroup on antibiotic selection in sepsis
I have no financial relationships of any kind with any of the
manufacturers of the drugs or the software discussed in this
presentation and the opinions expressed are mine alone.
Ventola CL. The Antibiotic Resistance Crisis: Part 1: Causes and Threats. Pharmacy and Therapeutics. 2015;40(4):277-283.
GETTING SMART - OVERVIEW
Meningitis: vancomycin cefdinir (Rocephin) +/- ampicillin Pearl: acyclovir steroids prior to antibiotics Pitfall: delay early bacterial meningitis can look viral Van de Beek, D et. al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med. 2004 Oct 28;351(18):1849-59.
Mouth: amoxicillin/ clavulanate (Augmentin) clindamycin pen Vee K cefdinir (Rocephin) Pearl: Source control Pitfall: MRSA
Lungs: Bronchitis: doxycycline azithromycin, clarithromycin Pneumonia: (above +) amoxicillin/ clavulanate (Augmentin) cephalosporins trimethoprim/sulfamethoxazole (Bactrim) Or levofloxacin (Levaquin ) / moxifloxacin Hospital Acquired: ( Pseudomonas , MRSA) Zosyn/ Levaquin/ Meropenem/ cefepime Pearl: remember atypicals (Mycoplasm) Pitfall: PE
Bladder: trimethoprim/sulfamethoxazole (Bactrim) macrobid cephalosporins amoxicillin/ clavulanate (Augmentin) Pearl: Consider doxycycline or azithromycin Pitfall: fluoroquinolones NOT recommended 1st^ line "Guidelines for Antimicrobial Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women” Clin Inf Dis; 2011 ; 52 : e103 - e
When you have no idea what’s going on…. ... then use vancomycin and pipercillin + tazobactam (Zosyn) OR Carbapenem +/- MRSA coverage
STAYING SMART – ANTIBIOGRAMS AND RESOURCES
Antibiogram Usually obtain through pharmacy
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