ABSTRACT
Optimal antibiotic use is the basis of antibiotic stewardship programs (ASPs), which include coordination with the microbiology laboratory and infection control and hospital epidemiology. In the CCU, antibiotic stewardship is critical to clinical outcomes as well as for minimizing antibiotic resistance and adverse effects, e.g., C. difficile diarrhea/colitis. The ASP initiatives in the CCU are an important component of hospital-wide antibiotic initiatives. Of particular ASP importance in the CCU are appropriate antibiotic selection based on site-pathogen correlation and PK-based dosing. This chapter also provides a clinical approach to several key ASP components, e.g., differentiating colonization from infection, monotherapy vs. combination therapy, antibiotic formulary restriction, antibiotic resistance prevention strategies, and the clinical approach to real and apparent antibiotic failure.
