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Antibiotic Stewardship: Improving Use In The Community

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Antibiotic stewardship is the effort to improve antibiotic prescribing so that antibiotics are used correctly - and only when needed. It includes monitoring antibiotic prescribing; avoiding unnecessary use; minimizing underuse due to missed or delayed diagnoses; and, when an antibiotic is needed, ensuring selection of the appropriate drug, dose, route of administration, and duration of therapy. The goal of antibiotic stewardship is to treat infections effectively, while minimizing unintended consequences of antibiotic use. These include side effects (eg, antibioticassociated diarrhea, especially that caused by Clostridium difficile infection) and the emergence of antibiotic resistance.

Despite the growing problem of antibiotic resistance, FDA approval of new antibiotics declined by about 80% between 1983 and 2012, providing fewer new treatments for drug-resistant bacterial infections. The emergence of antibiotic resistance cannot be stopped; however, the pace at which it evolves can be slowed. Antibiotic overuse and inappropriate use are important modifiable behaviors that contribute to resistance. In the US, the majority of antibiotic use occurs in the community, and a substantial percentage of these prescriptions are inappropriate. An estimated 30% of outpatient antibiotic prescriptions in the US are unnecessary.

National organizations, including the White House and the CDC, recognize the threat posed by antibiotic resistance and have committed to several strategies to combat it. In 2015, the White House released the "National Action Plan for Combating Antibiotic-Resistant Bacteria" (CARB), laying the foundation for collaborative action among various groups and individuals worldwide. A major goal is that, by 2020, aggressive action by all those involved will improve antibiotic use across all US healthcare settings...


Publication Date: 04/20/2017
Expiration Date: 04/20/2020
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Tracy Farnen, PharmD, is an Associate Editor for The Rx Consultant.

Pamela Mausner MD, is a Medical Writer/Editor and Healthcare Advocate.

Christopher Stock, PharmD, BCPP, has 30 years of experience working as a clinical pharmacy specialist in substance use disorders, and as a researcher collaborating with the National Institutes on Drug Abuse. Recently, his practice and research efforts have focused on prescription opioid safety and overdose prevention.

Disclosure Statement

Dr. Tracy Farnen, Dr. Pamela Mausner and Dr. Christopher Stock report no financial relationship with the manufacturer(s) or provider(s) of any commercial interest(s) or service(s) that appears in this issue.

Guest Editorial Advisor

Dominic Chan, PharmD, BCPS is the Infectious Diseases specialist and Pharmacy Clinical Coordinator/Co-Director of the Antimicrobial Stewardship Program at Legacy Health in Oregon and Southern Washington.

Katie J. Suda, PharmD, M.S. is a Research Health Scientist, Department of Veterans Affairs Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital and Research Associate Professor, Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois at Chicago.

Target Audience

This accredited program is targeted to pharmacists .

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Review mechanisms of antibiotic resistance and its spread. Describe current antibiotic resistance trends in the US.
    2. Describe the extent of overuse and misuse of antibiotics in the US and the patient harms that can occur with antibiotic use.
    3. Review the CDC’s recommendations for diagnosis and treatment of common outpatient respiratory infections.
    4. Discuss the CDC's 4 components of an outpatient antibiotic stewardship program. Provide examples of how community providers may be involved in stewardship programs and strategies that can help improve antibiotic use.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-17-005-H01-P

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator

Terry M. Baker, PharmD

Managing Editor

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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