Optimizing Antimicrobial Therapy with Timeouts

Overview Internet Enduring Material Jointly Provided by Stanford University School of Medicine (CME) and University of Rhode Island College of Pharmacy. Presented by The Division of Infectious Diseases and Geographic Medicine at Stanford University School of Medicine Antibiotic misuse is widespread and has dire patient and public health consequences. National organizations, including the CDC and the Joint Commission, advocate for a formal “Antibiotic Timeout” to reassess empiric antibiotics 48-72 hours after their initiation. During this Timeout, clinicians should answer the following questions: Does the patient have an infection that will respond to antibiotics? If so, is the patient on the right antibiotic(s) and is it being administered in the correct dose and by the correct route and (in the case of intravenous therapy) duration of infusion? Can a more targeted antibiotic regimen be used to treat the infection (i.e., de-escalation)? For how long should the antibiotic(s) be administered? This CME activity provides a practical approach to performing “Antibiotic Timeouts” in the inpatient setting. Using short, didactic sessions, we will provide examples on how to reassess antibiotic therapy started empirically using clinical, laboratory, and microbiological data. The majority of this CME will be high-yield, interactive inpatient cases covering skin and soft tissue infections, pneumonia, catheter-associated urinary tract infections, and neutropenic fever, that illustrate the timeout process and the principles of appropriate use of antimicrobials. Intended Audience This course is designed to meet the educational needs of physicians from a wide variety of specialties including cardiology, critical care, family practice, general surgery, hospitalists, infectious diseases, internal medicine, neurology, oncology, pediatrics, and urology, as well as pharmacists, nurse practitioners, and physician assistants. Accreditation The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Stanford University School of Medicine designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. If you would like to earn CME credit from Stanford University School of Medicine for participating in this course, please review the information here prior to beginning the activity. Additional Instructors Emily Mui, PharmD, BCPS Katherine E. Fleming-Dutra, MD Lauri Hicks, DO