QUIZ #1 – INF

Antibiotic stewardship in critically ill patients

Correct Answer: C

Explanation:
Antibiotic stewardship programs aim to optimize antibiotic use to improve patient outcomes, reduce the development of resistance, and minimize adverse effects. In critically ill patients, this means:

• Avoiding unnecessary antibiotic use: Not treating colonization or contamination as infection.
• Using appropriate empiric therapy: Selecting antibiotics based on likely pathogens and local resistance patterns, but with a focus on narrowing the spectrum as soon as possible.
• De-escalation/Streamlining: Once culture and susceptibility data are available, changing from broader to narrower spectrum antibiotics or discontinuing unnecessary antibiotics. This is the core of effective stewardship.
• Optimizing dosing: Ensuring appropriate doses are used to achieve therapeutic concentrations at the site of infection.
• Duration of therapy: Using the shortest effective duration of therapy.

Options A, B, and D go against these principles, potentially leading to increased resistance, toxicity, and cost.