... ANTjMICROBfAL STEWARDS.HIP PRINCIPtES AND PRACTICE EDII ED BY KERRY LAPLANTE, CHESTON CUNHA, HALEY MORRilL, LOUIS RICE AND ELEFTHERIOS MYLONAKIS Antimicrobial Stewardship: Principles and Practice Antimicrobial Stewardship: Principles and Practice Edited by Kerry L. LaPlante, PharmD, FCCP Cheston B. Cunha, MD Haley J. Morrill, PharmD Louis B. Rice, MD and Eleftherios Mylonakis, MD, PhD, FIDSA CABI is a trading name of CAB International CABI CABI Nosworthy Way 745 Atlantic Avenue Wallingford 8th Floor Oxfordshire OX10 8DE Boston, MA 02111 UK USA Tel: +44 (0)1491 832111 Tel: +1 (617)682-9015 Fax: +44 (0)1491 833508 E-mail: [email protected] E-mail: [email protected] Website: www.cabi.org © CAB International, 2017. All rights reserved. No part of this publication may be reproduced in any form or by any means, electronically, mechanically, by photocopying, recording or otherwise, without the prior permission of the copyright owners. A catalogue record for this book is available from the British Library, London, UK. Library of Congress Cataloging-in-Publication Data Names: LaPlante, Kerry, editor. | C.A.B. International, publisher. Title: Antimicrobial stewardship : principles and practice / senior editors, Kerry LaPlante, Eleftherios Mylonakis, and Louis Rice ; section editors, Kimberle Chapin, Panagiotis Ziakis, Cheston Cunha, Christy Varughese, and Haley Morrill. Description: Wallingford, Oxfordshire ; Boston, MA : CABI, [2017] | Includes bibliographical references. Identifiers: LCCN 2016022765 (print) | LCCN 2016023845 (ebook) | ISBN 9781780644394 (alk. paper) | ISBN 9781780644400 (ePDF) | ISBN 9781786390530 (ePub) Subjects: | MESH: Anti-Bacterial Agents--administration & dosage | Drug Resistance, Microbial | Inappropriate Prescribing--prevention & control Classification: LCC RM267 (print) | LCC RM267 (ebook) | NLM QV 350 | DDC 615.7/922--dc23 LC record available at https://lccn.loc.gov/2016022765 ISBN-13: 978 1 78064 439 4 Commissioning editor: Caroline Makepeace Editorial assistant: Emma McCann Production editor: James Bishop Typeset by SPi, Pondicherry, India Printed and bound by CPI Group (UK) Ltd, Croydon, CR0 4YY Contents Editors and Contributors ix Preface/Introduction xv Acknowledgements xvii I OvErvIEw Of AntIBIOtIC StEwArDShIP Section Editors: Eleftherios Mylonakis and Cheston B. Cunha 1 Principles of Antimicrobial Stewardship 1 Cheston B. Cunha 2 Clinical Perspectives on Antimicrobial Stewardship 8 Styliani Karanika, Suresh Paudel, and Eleftherios Mylonakis 3 history of Antimicrobial Stewardship 15 Powel Kazanjian 4 the Importance of Education in Antimicrobial Stewardship 24 Inge C. Gyssens II PrInCIPLES Of AntIBIOtIC rESIStAnCE In AntIBIOtIC StEwArDShIP Section Editor: Louis B. Rice 5 Mechanisms of resistance to Antibacterial Agents 39 Louis B. Rice 6 Antimicrobial resistance: Selection vs. Induction 53 Rafael Araos, Jose M. Munita, and Cesar A. Arias 7 Colonization and Its Importance for the Emergence of Clinical resistance 68 Curtis J. Donskey 8 Antibiotic resistance: Associations and Implications for Antibiotic Usage Strategies to Control Multiresistant Bacteria 80 Louis B. Rice III rOLE Of thE MICrOBIOLOgy LABOrAtOry In AntIBIOtIC StEwArDShIP Section Editor: Kimberle C. Chapin 9 the role of Active Surveillance in the Prevention of healthcare-acquired Infections and Antibiotic Stewardship 94 Gerald A. Capraro 10 the role of the Antibiogram in Antibiotic Stewardship 104 Gary V. Doern v 11 Selective reporting and Antimicrobial Stewardship 110 Christopher D. Doern and Carey-Ann D. Burnham 12 the role of new Diagnostics to Enhance Antibiotic Stewardship Efforts 124 Kimberle C. Chapin and April M. Bobenchik Iv InfECtIOn COntrOL ASPECtS Of AntIBIOtIC StEwArDShIP Section Editor: Theoklis E. Zaoutis 13 Epidemiology of Staphylococcus aureus and Enterococci and an Overview of Antimicrobial resistance 137 Alison H. Bartlett and Robert S. Daum 14 Epidemiology of Multidrug-resistant gram-negative Organisms 152 Evangelia-Theophano Piperaki, Antonis Markogiannakis, Leonidas Tzouvelekis, and George L. Daikos 15 P athogenesis and Epidemiology of Clostridium difficile Infection: Implications for Antibiotic Stewardship 163 Blanca E. Gonzalez and Philip Toltzis 16 the role of the hospital Epidemiologist in Supporting Antimicrobial Stewardship 175 Michael S. Calderwood v PhArMACOkInEtIC AnD PhArMACODynAMIC ASPECtS Of AntIBIOtIC DOSIng In AntIBIOtIC StEwArDShIP Section Editor: Kerry L. LaPlante 17 Principles of Pharmacokinetic/Pharmacodynamic Optimization for Antibiotic Dosing 179 Islam M. Ghazi, Joseph L. Kuti, and David P. Nicolau 18 Optimal Use of gram-negative Antibiotics in the real world: Providing Effective therapy while Minimizing resistance 196 Jason M. Pogue, Jessica K. Ortwine, and Keith S. Kaye 19 Optimal Use of fluoroquinolones 209 Thomas J. Dilworth, Ramy H. Elshaboury, and John C. Rotschafer 20 Optimal Use of b-Lactam Antibiotics 224 Warren Rose and Andrew Berti 21 Current Approach to Optimal Use and Dosing of vancomycin in Adult Patients 235 Joseph J. Carreno, Dmitriy Martirosov, and Thomas P. Lodise 22 Principles of Switching from Intravenous to Oral Administration 255 Jamie L. Wagner and Susan L. Davis vI rOLE Of thE PhArMACy DEPArtMEnt In AntIBIOtIC StEwArDShIP Section Editors: Haley J. Morrill and Christy A. Varughese 23 the role of Pharmacists in Antimicrobial Stewardship 266 Haley J. Morrill, Monica Dorobisz, and Kerry L. LaPlante 24 formulary Management and Economic Considerations: Bridging the gap between Quality Care and Cost 276 Dayna McManus, Michael A. Ruggero, and Jeffery E. Topal vi Contents 25 Approaches to Benchmarking Antibiotic Use 284 Emily L. Heil and Harold C. Standiford 26 Development and Execution of Stewardship Interventions 290 Amy Hanson and Christopher W. Crank 27 technologic Support for Antimicrobial Stewardship 302 Renée-Claude Mercier and Carla Walraven vII MEASUrIng OUtCOMES In AntIBIOtIC StEwArDShIP PrOgrAMS Section Editors: Cheston B. Cunha and Panayiotis Ziakas 28 role of guidelines and Statistical Milestones for Antimicrobial Stewardship 315 Damary C. Torres 29 Economic Considerations of Antimicrobial Stewardship Programs 322 Panayiotis D. Ziakas 30 Pharmacoeconomic Implications of Antimicrobial Adverse Events 334 Cheston B. Cunha 31 Antimicrobial Stewardship Programs in Areas of Increased Pathogen resistance 342 Michael Samarkos and Nikolaos V. Sipsas vIII AntIMICrOBIAL StEwArDShIP AnD vArIOUS PrACtICE SItES Section Editors: Haley J. Morrill and Kerry L. LaPlante 32 role of Antimicrobial Stewardship in Pediatrics 352 Jennifer L. Goldman and Jason G. Newland 33 Antimicrobial Stewardship in the Intensive Care Unit 363 Mahlet Tadele, Hugh G. Boothe, Melvin E. Stone Jr., and John McNelis 34 role of Antimicrobial Stewardship in a Community hospital 376 Sandy J. Estrada and Aileen Martinez 35 Outpatient Parenteral Antimicrobial therapy 384 Christopher J. Graber and Armen Arshakyan 36 Importance of Interdisciplinary Collaboration in Antimicrobial Stewardship: Immersion of future healthcare Professionals 391 Jacob Morton and Kerry L. LaPlante 37 Antimicrobial Stewardship and the Importance of working with the government and Pharmaceutical Industry 401 Elizabeth D. Hermsen and Nicole M. Mahoney 38 A hospitalist Perspective on the role of Antimicrobial Stewardship 412 Sajeev Handa Index 419 Contents vii Editors and Contributors Cesar A. Arias, MD, PhD, Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, and Division of Infectious Diseases, University of Texas Medical School at Houston, 6431 Fannin, MSB 1.150, Houston, TX 77030, US. E-mail: [email protected] rafael Araos, MD, MMSc, Assistant Professor of Medicine, Infectious Diseases Unit, Department of Medicine, Facultad de Medicina Clinica Alemana—Universidad del Desarrollo, Avenida Vitacura 5951, Vitacura, Santiago, 7650568, Chile. E-mail: [email protected] Armen Arshakyan, MD, Saban Community Clinic, 8405 Beverly Blvd, Los Angeles, CA 90048, US. E-mail: [email protected] Allison h. Bartlett, MD, MS, Assistant Professor of Pediatrics, Section of Infectious Diseases, Quality Chief, Department of Pediatrics, Associate Medical Director, Infection Control and Antimicrobial Stewardship Programs, Fellowship Director, Pediatric Infectious Diseases, The University of Chicago Medicine, 5841 S. Maryland Ave, Rm C-638A, MC6054 Chicago, IL 60637, US. E-mail: [email protected] Andrew Berti, PharmD, PhD, Research Fellow, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Room 1204, Madison, WI 53705-2222, US. E-mail: [email protected] April M. Bobenchik, PhD, D(ABMM), Assistant Professor of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, 293 Eddy St., APC 11, Providence, Rhode Island 02903, US. E-mail: [email protected] hugh g. Boothe, PharmD, Clinical Supervisor of Inpatient Pharmacy, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY 10461. E-mail: [email protected] Carey-Ann D. Burnham, PhD, D(ABMM), Associate Professor of Pathology and Immunology, Molecular Microbiology, and Pediatrics, Washington University in St. Louis School of Medicine, 660 S Euclid Ave, Campus Box 8118, St. Louis, MO 63110, US. E-mail: [email protected] Michael S. Calderwood, MD, MPH, FIDSA, Regional Hospital Epidemiologist, Assistant Professor of Medi- cine, Infectious Disease & International Health, Dartmouth-Hitchcock Medical Center, One Medical Cent- er Drive, Lebanon, NH 03756, US. E-mail: [email protected] Michael S. Calderwood, MD, MPH, FIDSA, Regional Hospital Epidemiologist, Assistant Professor of Medicine, Infectious Disease & International Health, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, US. gerald A. Capraro, MS, PhD, D(ABMM), Medical Director, Clinical Microbiology Laboratory, Carolinas Pathology Group, Carolinas Healthcare System, 5040 Airport Center Parkway, Building H, Suite A, Charlotte, NC 28208, US. E-mail: [email protected] Joseph J. Carreno, PharmD, Assistant Professor, Pharmacy Practice, Albany College of Pharmacy and Health Sciences, 106 New Scotland Ave, Albany, NY 12208-3492, US. E-mail: [email protected] kimberle C. Chapin, MD, ABMM, FCAP, Director of Microbiology and ID Molecular Diagnostics, Department of Pathology, Lifespan Academic Medical Centers, Professor of Medicine and Pathology, The Warren Alpert Brown University Medical School of Brown University, 222 Richmond St, Providence, RI 02903, US. E-mail: [email protected] Christopher w. Crank, PharmD, MS, BCPS AQ ID, Associate Director, Clinical Pharmacy Services, Clinical Specialist, Infectious Diseases, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL 60612, US. E-mail:[email protected] ix Cheston B. Cunha, MD, Assistant Professor of Medicine, Medical Director, Antimicrobial Stewardship Program, Rhode Island Hospital and Miriam Hospital, Division of Infectious Disease, Rhode Island Hospital, 593 Eddy Street, Physician’s Office Building Suite # 328, Providence, RI 02903, US. E-mail: [email protected] george L. Daikos, First Department of Medicine, Medical School, National and Kapodistrian University of Athens, Agiou Thoma 17, Goudi 11527, Athens, Greece, E-mail: [email protected] robert S. Daum, MD, CM, Professor of Pediatrics, Microbiology, and Molecular Medicine, Director, The University of Chicago Medicine, MRSA Research Center, Department of Pediatrics, Section of Infectious Diseases, 5841 South Maryland Avenue, MC 6054, Chicago, IL 60637-1470, US. E-mail: rdaum@peds. bsd.uchicago.edu Susan L. Davis, PharmD, Associate Professor (Clinical), Pharmacy Practice, Wayne State University and Infectious Diseases Pharmacy Specialist, Henry Ford Hospital, Detroit. Address: Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI 48201, US. E-mail: [email protected] thomas J. Dilworth, PharmD, BCPS-AQ ID, Clinical Specialist, Infectious Diseases, Department of Pharmacy Services, Aurora St. Luke’s Medical Center, 2900 W. Oklahoma Ave, Milwaukee, WI 53215, US. E-mail: [email protected] Christopher D. Doern, PhD, Assistant Professor of Pathology, Director of Clinical Microbiology, Department of Pathology, School of Medicine, Virginia Commonwealth University, PO Box 980662, 1101 E. Marshall Street, Richmond, VA 23298-0662, US. E-mail: [email protected] gary v. Doern, PhD, Emeritus Professor of Pathology, Department of Pathology, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, US. E-mail: [email protected] Curtis J. Donskey, MD, Professor of Medicine, Division of Infectious Diseases and HIV Medicine, Case Western University, Cleveland, Ohio; and Staff Physician; Infectious Diseases Section, Cleveland Ohio Geriatric Research, Education, and Clinical Center (GRECC), Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Blvd, Cleveland, OH 44106, US. E-mail: [email protected] Monica Dorobisz, PharmD, Infectious Diseases Pharmacist and Chair of the Kent Antimicrobial Stewardship Program, Department of Pharmacy, Kent Hospital, 455 Toll Gate Rd, Warwick, RI 02886, US. E-mail: [email protected] ramy h. Elshaboury, PharmD, BCPS AQ-ID, Clinical Pharmacy Coordinator—Infectious Diseases, Massachusetts General Hospital, 55 Fruit Street GRB005, Boston, MA 02114, US. E-mail: [email protected] Sandy J. Estrada, PharmD, BCPS AQ-ID, Pharmacist Specialist, Infectious Diseases, Department of Pharmacy, Lee Memorial Hospital, PO Box 2218, Fort Myers, FL 33902, US. E-mail: [email protected] Islam M. ghazi, PharmD, BCPS, BCACP, Pharmacotherapy Research Fellow, Center for Anti-Infective Research and Development, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, US. E-mail: islam. [email protected] Jennifer L. goldman, MD, MS, Assistant Professor of Pediatrics, University of Missouri-Kansas City, and Medical Director, Antimicrobial Stewardship Program, Children’s Mercy Hospital, Kansas City, 2401 Gillham Road, Kansas City, MO 64108, US. E-mail: [email protected] Blanca E. gonzalez, MD, Center for Pediatric Infectious Diseases, Cleveland Clinic Children’s Hospital, Assistant Professor of Pediatrics, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue/S25, Cleveland, OH 44195, US. E-mail: [email protected] Christopher J. graber, MD, MPH, FIDSA, Associate Clinical Professor, David Geffen School of Medicine at UCLA (University of California, Los Angeles), and Infectious Diseases Section, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, 111-F, Los Angeles, CA 90073, US. E-mail: [email protected] Inge C. gyssens, MD, PhD, Professor of Infectious Diseases, Research Group of Immunology and Biochemistry, Faculty of Medicine, Hasselt University, Hasselt, Belgium and Department of Medicine, Radboud University Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands. E-mail: [email protected] x Editors and Contributors Inge C. gyssens, MD, PhD, Professor of Infectious Diseases, Research Group of Immunology and Biochemistry, Faculty of Medicine, Hasselt University, Hasselt, Belgium; Department of Medicine, Radboud University Nijmegen Medical Centre and Canisius-Wilhelmina Ziekenhuis (Hospital), Weg door Jonkerbos 100 6532 SZ Nijmegen, The Netherlands. E-mail: [email protected] Sajeev handa, MD, SFHM, Director, Division of Hospital Medicine, Rhode Island Hospital. Clinical Assistant Professor of Medicine and Clinical Assistant Professor of Neurology, The Warren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI 02903, US. E-mail: [email protected] Amy hanson, PharmD, BCPS, AQ-ID, Clinical Pharmacy Specialist, Infectious Diseases, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL 60612, US. E-mail: [email protected] Emily L. heil, PharmD, BCPS AQ ID, Infectious Diseases Specialist and Assistant Professor, University of Maryland School of Pharmacy, 20 N Pine St, Baltimore, MD 21201, US. E-mail: [email protected] Elizabeth D. hermsen, PharmD, MBA, BCPS ID, Head, Global Antimicrobial Stewardship, Global Population Health, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ 07033, US. E-mail: elizabeth. [email protected] Styliani karanika, MD, Postdoctoral Research Associate, Infectious Diseases Division, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street, POB, 3rd Floor, Suite 328/330, Providence, RI 02903, US. E-mail: [email protected] keith S. kaye, MD, MPH, Professor of Medicine, Corporate Vice President of Quality and Patient Safety, Corporate Medical Director, Infection Prevention, Epidemiology and Antimicrobial Stewardship, Detroit Medical Center, Wayne State University, University Health Center, 4201 Saint Antoine, Suite 2B, Box 331, Detroit, MI 48201, US. E-mail: [email protected] Powel kazanjian, MD, PhD, Professor of Medicine, Chief, Infectious Disease Division, Taubman Center, University of Michigan Health System, Floor 3 Reception D, 1500 E Medical Center Dr SPC 5352, Ann Arbor, MI 48109, US. E-mail: [email protected] Joseph L. kuti, PharmD, Associate Director, Clinical and Economic Studies, Center for Anti-Infective Research and Development, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, US. E-mail: joseph.kuti@ hhchealth.org kerry L. LaPlante, PharmD, Associate Professor of Pharmacy, University of Rhode Island, Kingston, Adjunct Clinical Associate Professor of Medicine, Brown University, Providence, Rhode Island, Director of the Rhode Island Infectious Diseases Research Program (RIID), Veterans Affairs Medical Center, Providence, Rhode Island and Infectious Diseases Pharmacotherapy Specialist, University of Rhode Island College of Pharmacy, 7 Greenhouse Road Suite 295A, Kingston RI 02881, US. E-mail: [email protected] thomas P. Lodise, PharmD, PhD, Associate Professor, Pharmacy Practice, Albany College of Pharmacy and Health Sciences, 106 New Scotland Ave, Albany, NY 12208-3492, US. E-mail: [email protected] nicole M. Mahoney, PhD, Director, Global Regulatory Policy, Global Regulatory Affairs, Merck & Co., Inc., 1700 Rockville Pike, Suite 525, Rockville MD 20852, US. E-mail: [email protected] Antonis Markogiannakis, BPharm, MPH, PhD, Department of Pharmacy, Laikon General Hospital, Athens, Greece. E-mail: [email protected] Aileen Martinez, PharmD, BCPS, Pharmacist Specialist, Infectious Diseases, Martin Health System, 200 SE Hospital Ave., Stuart, FL 34994, US. E-mail: [email protected] Dmitriy Martirosov, PharmD, Clinical Pharmacy Specialist, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, US. E-mail: [email protected] Dayna McManus, PharmD, BCPS, Clinical Pharmacy Specialist-Infectious Diseases, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, US. E-mail: [email protected] or [email protected] John Mcnelis, MD FACS FCCM, Professor of Clinical Surgery, Department of Surgery, Albert Einstein College of Medicine, and Chairman, Department of Surgery, North Bronx Health Network, Jacobi Medical Center, North Central Bronx Hospital, Rm 513, 1400 Pelham Parkway South, Bronx, NY 10461, US. E-mail: [email protected] Editors and Contributors xi