Essentials of Antimicrobial Stewardship

Section 1: Core Components of Antimicrobial Stewardship
1. Introduction to Antimicrobial Stewardship
2. Implementation of Antimicrobial Stewardship Program
2.1. Core Elements of AMS Program
2.2. Steps of Implementation of AMS Program in a Hospital
2.3. Role of Information Technology in AMS Program
2.4. AMS Interventions
2.5. Role of Behavioral Change in AMS
3. Monitoring of Antimicrobial Stewardship
4. Current Scenario of Antimicrobial Resistance and Role of AMR Surveillance

Section 2: Diagnostic Stewardship

5. Introduction to Diagnostic Stewardship
6. Role of Appropriate Specimen Collection
7. Role of Direct Microscopy
8. Accurate Processing of Clinical Specimens and Reporting of Cultures
9. Role of Accurate Microbial Identification
10. Basics of Antimicrobial Susceptibility Testing
11. Interpretation of Antimicrobial Susceptibility Testing
12. Detection of Specific Antimicrobial Resistance
13. Quality Control in Antimicrobial Susceptibility Testing
14. Direct Susceptibility Testing
15. Selective Reporting and Role of Breakpoint-to-MIC Quotient
16. Comments in Clinical Microbiology Reporting
17. Role of Biomarkers and Point-of-care Tests (POCT) in AMS

Section 3: Hospital Antibiogram

18. Introduction to Antibiogram
19. Routine Antibiogram
20. Specialized Antibiograms
21. Use of Antibiogram
22. Analysis of MDR/XDR/PDR Phenotypes

Section 4: Antimicrobial Agents

23. Antimicrobial Agents: Classification and PK-PD Considerations
24. Cell Wall Active Agents-I: B-lactams
25. Cell Wall Active Agents-II: Glycopeptides and Fosfomycins
26. Cell Membrane Acting Agents: Polymyxins and Daptomycin
27. Protein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Glycylcyclines, Macrolides, Lincosamides, Oxazolidinones, Streptogramins, Chloramphenicol and Others
28. Nucleic Acid, Folic Acid Synthesis Inhibitors and Others: Quinolones, Nitroimidazoles, Nitrofurans,
Cotrimoxazole and Topical Agents
29. Antitubercular Drugs and Treatment Guidelines
30. Antiviral Drugs
31. Antifungal Drugs
32. Antiparasitic Drugs

Section 5: Antimicrobial Therapy (Clinical Stewardship)

33. Empirical Antimicrobial Therapy
33.1. Cardiovascular Infections
33.2. Sepsis and Bloodstream Infections
33.3. Central Nervous System Infections
33.4. Intra-abdominal Infections
33.5. Skin and Soft Tissue Infections
33.6. Respiratory Tract Infections
33.7. Genito-urinary Tract Infections
33.8. Bone and Joint Infections
33.9. Post-cardiovascular Surgery Infections
33.10. Ocular Infections
33.11. Ear Infections
33.12. Burn Wound Infections
33.13. Antimicrobial Policy in Febrile Neutropenia
33.14. Infections in Solid Organ Transplant Recipients (Non-neutropenic Settings)
33.15. Pediatric Infections
33.16. Neonatal Infections
34. Targeted Antimicrobial Therapy for Gram-positive Bacterial Infections
35. Targeted Antimicrobial Therapy for Gram-negative Bacterial Infections
36. Antifungal Stewardship and Treatment of Fungal Infections
37. Antimicrobial Prophylaxis

Section 6: Miscellaneous

38. Antimicrobial Stewardship in Special Situations
38.1. AMS in Outpatient Setting
38.2. AMS in Outpatient Parenteral Antimicrobial Therapy (OPAT) Settings
38.3. AMS in Long-term Care Facility Setting
38.4. AMS in Critical Care Units
38.5. AMS in Immunocompromised Patients
38.6. AMS in Pediatric Units
38.7. AMS in Community Hospitals
39. One Health Approach in Antimicrobial Stewardship
40. Hospital Source Control–Unmet Need of an Integrated Antimicrobial Stewardship Practice
41. Puzzles in Rational Use of Antimicrobial Agents

Apurba S Sastry MD (JIPMER) DNB MNAMS PDCR
Ketan Priyadarshi MD (IMS-BHU) DNB PDCC-Infectious Diseases PDF-Hospital Infection Control (JIPMER)
Deepashree R MD (Gold Medal) DNB MNAMS