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Paeds Casesinfectious-diseases

Paeds Cases · infectious-diseases

The antibiotic that won't stop — antimicrobial stewardship structured encounter

A bedside structured encounter testing empiric antimicrobial selection, developmental dosing, therapeutic drug monitoring, de-escalation, IV-to-oral switch, penicillin allergy assessment and delabeling, and duration review within an antimicrobial stewardship framework.

structured clinical encounter6 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Study tools

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Emma is 6 and has been on broad-spectrum intravenous antibiotics for 4 days. Her cultures returned at 48 hours, but no one has reviewed the prescription. Her mother asks when Emma can go home.

Station status

This is one MedVellum formative structured clinical encounter. The scoring, prompts and performance descriptions are educational feedback tools. They are not an official college station, timing, mark allocation, pass score or reproduced examination format. The encounter assesses empiric-to-targeted antimicrobial selection, developmental dosing, therapeutic drug monitoring, de-escalation, IV-to-oral switch, penicillin allergy delabeling, and duration review. [1] [13]

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References7ShowHide
  1. [1]Barlam TF, Cosgrove SE, Abbo LM, et al. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016.PMID 27080992
  2. [2]Moja L, Zanichelli V, Mertz D, et al. WHO's essential medicines and AWaRe: recommendations on first- and second-choice antibiotics for empiric treatment of clinical infections. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2024.PMID 38342438
  3. [3]Rybak MJ, Le J, Lodise TP, et al. Therapeutic Monitoring of Vancomycin for Serious Methicillin-resistant Staphylococcus aureus Infections: A Revised Consensus Guideline and Review. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020.PMID 32658968
  4. [10]Vyles D, Antoon JW, Norton A, et al. Children with reported penicillin allergy: Public health impact and safety of delabeling. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2020.PMID 32224207
  5. [11]Copaescu AM, Vogrin S, James F, et al. Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy: The PALACE Randomized Clinical Trial. JAMA internal medicine, 2023.PMID 37459086
  6. [13]Hersh AL, Beekmann SE, Polgreen PM, et al. Antimicrobial stewardship programs in pediatrics. Infection control and hospital epidemiology, 2009.PMID 19852666
  7. [15]Pineda LC, Watt KM New antibiotic dosing in infants. Clinics in perinatology, 2015.PMID 25678003
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