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Guidance for Antibiotic Use in the Inpatient Setting

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  • Related Summaries

  • Overview

  • Background

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    Antibiotic Prescribing in the Inpatient Setting

    • Rates of antibiotic use in the inpatient setting

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      Inappropriate antibiotic use in the inpatient setting

      • Definitions of appropriateness

      • Rates of inappropriate antibiotic use

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    Adverse Events with Inpatient Antibiotic Use

    • Rates of antibiotic-associated adverse events

    • Clostridium difficile

    • Development of antibiotic resistance

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      Notable antibiotic-associated adverse events

      • Quinolones

      • Aminoglycosides

      • Vancomycin

      • Linezolid

      • Daptomycin

      • Cotrimoxazole (trimethoprim-sulfamethoxazole [TMP-SMX])

      • Metronidazole

      • Clindamycin

      • Macrolides

      • Tetracyclines

      • Beta-lactam antibiotics

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    Inpatient Antimicrobial Stewardship Programs

    • General antibiotic stewardship considerations

    • Institutional antibiograms and resistance data reporting

    • Preauthorization and prospective audit and feedback strategies

    • Rational pharmacokinetic and pharmacodynamic antibiotic dose adjustment

    • Renal dosing

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    Antibiotic Recommendations for Specific Conditions

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      Critical care and septic patients

      • General considerations for antibiotic use in critical care

      • Sepsis and septic shock

    • Central line-associated infections

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      Pneumonia

      • Community-acquired pneumonia requiring admission

      • Hospital-acquired pneumonia

      • Ventilator-acquired pneumonia

    • Febrile neutropenia

    • Complicated urinary tract infections (UTI)

    • Osteomyelitis

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      Skin and soft tissue infections

      • Necrotizing fasciitis

      • Cellulitis

    • Bacterial meningitis

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      Gastrointestinal infections

      • Clostridium difficile infection

      • Acute pancreatitis

      • Diverticulitis

    • Complicated intra-abdominal infections

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      Surgical site infections

      • Prophylaxis of surgical site infections

      • Treatment of surgical site infections

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    Guidelines and Resources

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      Guidelines

      • International guidelines

      • United States guidelines

    • Review articles

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    Quality Improvement

    • Choosing Wisely

    • Choosing Wisely Australia

  • Patient Information

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    References

    • General references used

    • Recommendation grading systems used

    • DynaMed Editorial Process

    • Special acknowledgements

    • How to cite

Topic Editor
Gail Scully MD, MPH
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Affiliations

Assistant Professor of Medicine, Department of Medicine, and Medical Director, Antimicrobial Stewardship, UMASS Memorial Medical Center; Massachusetts, United States; Hospital Epidemiologist, Fairlawn Rehabilitation Hospital; Massachusetts, United States

Conflicts of Interest

Dr. Scully declares no relevant financial conflicts of interest.

Deputy Editor
Vito Iacoviello MD, FIDSA
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Affiliations

Deputy Editor of Infectious Diseases, Immunology and Rheumatology, Dynamed; Massachusetts, United States; Assistant Professor of Medicine, Harvard Medical School; Massachusetts, United States; Chief of the Division of Infectious Diseases, Mount Auburn Hospital; Massachusetts, United States

Conflicts of Interest

Dr. Iacoviello declares no relevant financial conflicts of interest.

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