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Stan Deresinski, MD, Marisa Holubar, MD, MS, and Natalia Medvedeva, MD

Internet Enduring Material provided by Stanford University School of Medicine (CME). Presented by The Division of Infectious Diseases and Geographic Medicine at Stanford University School of Medicine

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Internet Enduring Material provided by Stanford University School of Medicine (CME). Presented by The Division of Infectious Diseases and Geographic Medicine at Stanford University School of Medicine

Antibiotic misuse is widespread and has dire patient and public health consequences. National organizations, including the CDC and the Joint Commission, advocate for a formal “Antibiotic Timeout” to reassess empiric antibiotics 48-72 hours after their initiation. During this Timeout, clinicians should answer the following questions: Does the patient have an infection that will respond to antibiotics? If so, is the patient on the right antibiotic(s) and is it being administered in the correct dose and by the correct route and (in the case of intravenous therapy) duration of infusion? Can a more targeted antibiotic regimen be used to treat the infection (i.e., de-escalation)? For how long should the antibiotic(s) be administered?

This CME activity provides a practical approach to performing “Antibiotic Timeouts” in the inpatient setting. Using short, didactic sessions, we will provide examples on how to reassess antibiotic therapy started empirically using clinical, laboratory, and microbiological data. The majority of this CME will be high-yield, interactive inpatient cases covering skin and soft tissue infections, pneumonia, catheter-associated urinary tract infections, and neutropenic fever, that illustrate the timeout process and the principles of appropriate use of antimicrobials.

Intended Audience

This course is designed to meet the educational needs of physicians from a wide variety of specialties including cardiology, critical care, family practice, general surgery, hospitalists, infectious diseases, internal medicine, neurology, oncology, pediatrics, and urology, as well as pharmacists, nurse practitioners, and physician assistants.

Accreditation

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit DesignationAmerican Medical Association (AMA) Stanford Medicine designates this Enduring Material for a maximum of 2.00 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Accreditation Council of Pharmacy Education (ACPE) Stanford Medicine designates this knowledge-based activity for a maximum of 2 hours. Credit will be provided to NABP CPE Monitor within 60 days after the activity completion.

If you would like to earn CE credit from Stanford University School of Medicine for participating in this course, please review the information here prior to beginning the activity.

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What's inside

Learning objectives

  • Describe the principles and shortcomings of empiric antibiotic therapy.
  • Routinely conduct all steps of the antibiotic timeout, in accordance with cdc guidelines on antibiotic stewardship.
  • Evaluate the appropriateness of empirically prescribes antibiotics.
  • Indicate the planned duration of antibiotic therapy.

Good to know

Know what's good
, what to watch for
, and possible dealbreakers
Addresses the proper duration of antibiotic therapy, a topic that is vital in ensuring the effectiveness while minimizing adverse reactions
Led by respected instructors who are recognized for their expertise in the field of Infectious Diseases
Emphasizes the importance of reassessing antibiotic therapy based on clinical and laboratory data, aligning with current guidelines to enhance patient outcomes
Provides a comprehensive overview of antibiotic stewardship practices, including the concept of 'Antibiotic Timeout' recommended by leading organizations like the CDC to optimize antibiotic use
Focuses on commonly encountered infections in the inpatient setting, making it highly relevant for healthcare professionals involved in patient care in hospitals
Utilizes a combination of didactic sessions and interactive case studies to enhance understanding and practical application of the principles discussed

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Activities

Be better prepared before your course. Deepen your understanding during and after it. Supplement your coursework and achieve mastery of the topics covered in Optimizing Antimicrobial Therapy with Timeouts with these activities:
Create a Repository of Antibiotic Stewardship Resources
Organizes and makes accessible a collection of resources related to antibiotic stewardship.
Browse courses on Antibiotic Stewardship
Show steps
  • Gather resources such as guidelines, articles, and educational materials on antibiotic use.
  • Organize the resources into a structured and searchable system.
  • Share the repository with colleagues and other healthcare professionals.
CDC Antibiotic Use Guidelines Tutorial
Provides a structured understanding of CDC guidelines for appropriate antibiotic use.
Browse courses on Antibiotic Stewardship
Show steps
  • Access the CDC Antibiotic Use Guidelines website.
  • Review the guidelines for common infections and specific patient populations.
  • Take the interactive quizzes to assess your knowledge and understanding.
Review of Infectious Diseases by Mandell
Provides a comprehensive overview of infectious diseases and their management, including antibiotic therapy.
Show steps
  • Read chapters relevant to antibacterial therapy and antimicrobial stewardship.
  • Take notes and highlight key concepts.
  • Discuss the material with a colleague or mentor.
Five other activities
Expand to see all activities and additional details
Show all eight activities
Shadow an Infectious Disease Specialist
Reinforces the principles of antimicrobial use and provides practical experience in real-world settings.
Browse courses on Antimicrobial Stewardship
Show steps
  • Establish contact with an Infectious Disease specialist and express your interest in shadowing.
  • Familiarize yourself with the principles of antibiotic use and antimicrobial stewardship.
  • Observe the Infectious Disease specialist during rounds and consultations.
  • Participate in discussions on antimicrobial therapy and infection management.
  • Reflect on your experience and discuss your observations with the Infectious Disease specialist.
Antibiotic Timeout Discussion Group
Fosters discussion and exchange of experiences on antibiotic decision-making among peers.
Show steps
  • Form a small group of peers with interest in antimicrobial therapy.
  • Select clinical cases for discussion and review relevant clinical and microbiological data.
  • Present and discuss the cases, focusing on the rationale for antibiotic choice and duration of therapy.
Antibiotic Case Review
Enhances the ability to evaluate and select appropriate antibiotics based on clinical scenarios.
Browse courses on Antibiotics
Show steps
  • Review clinical cases that present common infectious disease scenarios.
  • Identify the most likely pathogens and select the appropriate antibiotic therapy.
  • Discuss the rationale for your choices and explore alternative treatment options.
Patient Education Material on Antibiotic Use
Promotes patient understanding of appropriate antibiotic use and reduces misuse.
Browse courses on Antibiotic Stewardship
Show steps
  • Research and gather information on the responsible use of antibiotics.
  • Create educational materials such as pamphlets, brochures, or videos.
  • Distribute the materials to patients and the community.
Antibiotic Stewardship Policy Development
Contributes to the development of evidence-based policies for responsible antibiotic use within a healthcare setting.
Browse courses on Antibiotic Stewardship
Show steps
  • Review existing literature and guidelines on antibiotic stewardship.
  • Collaborate with a team of healthcare professionals to develop a draft policy.
  • Present the draft policy to stakeholders for review and feedback.
  • Finalize the policy and implement it within the healthcare setting.

Career center

Learners who complete Optimizing Antimicrobial Therapy with Timeouts will develop knowledge and skills that may be useful to these careers:
Infectious Disease Physician
Infectious Disease Physicians specialize in the diagnosis and treatment of infectious diseases. They are often involved in antibiotic stewardship programs, which aim to improve the appropriate use of antibiotics. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for an Infectious Disease Physician. The course would also help physicians to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Clinical Pharmacist
Clinical Pharmacists work with patients and other healthcare professionals to ensure the safe and effective use of medications. They are often involved in antibiotic stewardship programs, which aim to improve the appropriate use of antibiotics. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for a Clinical Pharmacist. The course would also help pharmacists to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Nurse Practitioner
Nurse Practitioners are licensed healthcare professionals who work under the supervision of a physician. They are trained to perform a variety of tasks, including diagnosing and treating illnesses, prescribing medications, and ordering tests. Nurse Practitioners often work in primary care settings, where they may be involved in antibiotic stewardship programs. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for a Nurse Practitioner. The course would also help Nurse Practitioners to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Physician Assistant
Physician Assistants are licensed healthcare professionals who work under the supervision of a physician. They are trained to perform a variety of tasks, including diagnosing and treating illnesses, prescribing medications, and ordering tests. Physician Assistants often work in primary care settings, where they may be involved in antibiotic stewardship programs. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for a Physician Assistant. The course would also help Physician Assistants to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Infection Preventionist
Infection Preventionists are responsible for preventing and controlling infections in healthcare settings. They work with healthcare providers, patients, and families to identify and implement infection prevention measures. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for an Infection Preventionist. The course would also help Infection Preventionists to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Microbiologist
Microbiologists study microorganisms, such as bacteria, viruses, and fungi. They are often involved in identifying and characterizing infectious agents, and in developing new antibiotics. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for a Microbiologist. The course would also help Microbiologists to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Epidemiologist
Epidemiologists study the distribution and determinants of health-related states or events in specified populations. They are often involved in investigating outbreaks of infectious diseases, and in developing strategies to prevent and control them. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for an Epidemiologist. The course would also help Epidemiologists to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Public Health Nurse
Public Health Nurses work to promote health and prevent disease in communities. They may be involved in antibiotic stewardship programs, and in educating the public about the importance of appropriate antibiotic use. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for a Public Health Nurse. The course would also help Public Health Nurses to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Healthcare Administrator
Healthcare Administrators plan, direct, and coordinate the provision of health care services in hospitals, clinics, and other healthcare settings. They are often responsible for developing and implementing antibiotic stewardship programs. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for a Healthcare Administrator. The course would also help Healthcare Administrators to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Policymaker
Policymakers develop and implement policies that affect the health of populations. They may work in government, academia, or the private sector. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for a Policymaker. The course would also help Policymakers to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Registered Nurse
Registered Nurses provide direct patient care in hospitals, clinics, and other healthcare settings. They may be involved in antibiotic stewardship programs, and in educating patients about the importance of appropriate antibiotic use. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for a Registered Nurse. The course would also help Registered Nurses to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Physician Associate
Physician Associates are licensed healthcare professionals who work under the supervision of a physician. They are trained to perform a variety of tasks, including diagnosing and treating illnesses, prescribing medications, and ordering tests. Physician Associates often work in primary care settings, where they may be involved in antibiotic stewardship programs. This course would provide a strong foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be essential knowledge for a Physician Associate. The course would also help Physician Associates to develop the skills needed to assess the appropriateness of empirically prescribed antibiotics and to indicate the planned duration of antibiotic therapy.
Clinical Research Coordinator
Clinical Research Coordinators work with researchers to manage clinical trials. They are responsible for ensuring that clinical trials are conducted in accordance with ethical guidelines and regulations. This course may be useful to Clinical Research Coordinators who are working on clinical trials of antibiotics. The course would provide a foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be helpful for understanding the rationale for clinical trials of antibiotics.
Data Analyst
Data Analysts collect, analyze, and interpret data. They may work in a variety of industries, including healthcare. This course may be useful to Data Analysts who are working in healthcare. The course would provide a foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be helpful for understanding the data that is collected on antibiotic use.
Quality Improvement Specialist
Quality Improvement Specialists work to improve the quality of care in healthcare settings. They may be involved in antibiotic stewardship programs. This course may be useful to Quality Improvement Specialists who are working on antibiotic stewardship programs. The course would provide a foundation in the principles of empiric antibiotic therapy and the antibiotic timeout, which would be helpful for understanding the interventions that can be used to improve antibiotic use.

Reading list

We've selected seven books that we think will supplement your learning. Use these to develop background knowledge, enrich your coursework, and gain a deeper understanding of the topics covered in Optimizing Antimicrobial Therapy with Timeouts.
A comprehensive reference providing in-depth information on the mechanisms of action, antimicrobial activity, and clinical uses of antimicrobial agents.
This widely recognized textbook covers a broad range of infectious diseases, including their diagnosis, treatment, and prevention. It valuable reference for healthcare professionals seeking comprehensive information on infectious disease management.
A comprehensive textbook that combines theoretical and practical aspects of antimicrobial therapy, providing a thorough understanding of the field.
This concise report from the World Health Organization provides an overview of the global threat of antibiotic resistance. It summarizes the current state of the problem, its impact on public health, and strategies for addressing it.
This practical guide from the World Health Organization provides guidance on appropriate antibiotic prescribing for medical officers in resource-limited settings. It covers common infections, antibiotic selection, and dosing.
A concise and accessible guide to antibiotics, providing essential information on their mechanisms of action, indications, and adverse effects.

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