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Antimicrobial Stewardship Program

Antimicrobial Stewardship Program

​​The primary goal of the antimicrobial stewardship program (ASP) is to optimize clinical outcomes while minimizing unintended consequences of antimicrobial use, including toxicity and the selection of resistant organisms, through the most appropriate use of antimicrobials. Currently, the antimicrobial stewardship team performs daily monitoring of restricted antimicrobials, antiretrovirals, aminoglycosides, and positive blood and CSF cultures.

The team also performs annual antimicrobial use and expenditure reviews, creates antibiograms, and provides education in a variety of settings. The ASP Steering Committee meets quarterly to review guidelines, resistance trends, antimicrobial use, and antimicrobial expenditures.

Evidence-Based Guidelines and Protocols

The following evidence-based guidelines and protocols were developed for adult patients at Ochsner Medical Center - Jefferson Highway and should not replace clinical judgement. 

Select Principles of Antibiotic Dosing in Renal Failure 
More Details

  1. Fill the tank. Consider a loading dose to rapidly attain therapeutic concentrations.
  2. After the load, decrease the dose based on the degree of renal dysfunction. 
  3. Balance the risk of overdosing versus underdosing. The more severe the infection, the higher risk of underdosing. 
  4. The Cockcroft-Gault equation should be used to estimate renal function for drug dosing, though most equations are inaccurate with changing renal function. 
  5. When adjusting the dose, either the dose or interval can be adjusted. Consider the pharmacodynamics of the antimicrobial when deciding.
  6. Estimation of removal of drug by dialysis is dependent on many factors. Supplemental dosing after hemodialysis is often necessary.
  7. Doses may need to change. Be flexible!
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