CHESTGuidelines & Topic CollectionsSepsisAntimicrobial Stewardship Program

Antimicrobial Stewardship Program

An antimicrobial stewardship program is a coordinated program that promotes the appropriate use of antimicrobials, improves patient outcomes, reduces antimicrobial resistance, and decreases the spread of infections due to multidrug-resistant organisms.

These are the key components of an antimicrobial stewardship program for treating patients with severe community-acquired pneumonia AND sepsis.

Remember to C.A.R.E.

Compiled by the CHEST Sepsis Resources Steering Committee

Last updated May 05, 2023

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Selection of antimicrobial agents (Day 0)

Consider: Previous health care exposure and antimicrobial use, prior resistant infections

Daily evaluation and review of clinical stability (Days 3-5, typically)

Key point: Is patient getting better?

Assess: Do we need to continue antibiotics in a rapidly improving patient? If not improving, should therapy be changed?

React: Stopping anti-MRSA drugs when nasal PCR is negative or if cultures are negative for MRSA at 48 hours

Discontinuation of antimicrobials

Elect: Stopping all antibiotics between days 5-7, following clinical stability or procalcitonin if available

This resource was supported by Grant/Cooperative Agreement Number 5 NU50CK000604-02-00 from the Department of Health and Human Services, Centers for Disease Control and Prevention. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department of Health and Human Services, Centers for Disease Control and Prevention.