EM Vivas · Antimicrobial stewardship
Antimicrobial stewardship — decision viva
Viva balancing early sepsis antibiotics with stewardship.
On this page
Study tools
Target exams
ACEMFRCEMABEM
Prompt
Septic shock empirical therapy vs viral bronchitis antibiotic demand. Discuss 4 Ds, cultures timing, de-escalation.
Interpretation
Reveal interpretationShowHide
4 Ds (+ route). Right Drug, Dose, De-escalation, Duration, and appropriate route.[1]
Sepsis. Cultures immediately if they do not delay therapy; first antibiotic dose without delay in shock.[2] Syndrome-based empirical spectrum; plan de-escalation.
Viral illness. No antibiotics; explain harms; safety-net.[1]
Allergy. Clarify the reported reaction before defaulting to broader agents.[1]
References2ShowHide
- [1]Dellit TH, Owens RC, McGowan JE Jr, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis, 2007.PMID 17173212
- [2]Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med, 2006.PMID 16625125