Timely antibiotic management
Accurately identify patients who need antibiotic therapy
Obtain appropriate cultures prior to start of antibiotics
Administer antibiotics promptly
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Use biomarkers such as CRP to guide initiation of therapy.
Obtain simultaneous CVC and peripheral blood cultures when possible.
Obtain sufficient blood culture volumes, i.e., > 0.5 mL.
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Appropriate selection, administration, and de-escalation of therapy
Make empiric choices based on local antibiograms
Do not give therapy with overlapping activity
Give the Right Dose and Interval
Stop therapy promptly if indicated by culture results
Review and adjust antibiotics at all transitions of care
Monitor for toxicity and adjust therapy accordingly
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Change vancomycin to oxacillin once infection with MSSA determined.
Aim for higher vancomycin troughs (15–20 mcg/mL) for suspected meningitis.
Discontinue post-operative prophylaxis after 48 hours.
Avoid redundant anaerobic spectrum coverage (e.g., metronidazole and piperacillin/tazobactram).
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Access to expertise at point of care
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Develop an antimicrobial stewardship team incorporating neonatology, clinical pharmacy, hospital epidemiology infectious diseases, and nursing services.
Obtain infectious diseases consultations.
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Improved data monitoring and transparency
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