Intro
Introduction
References
Contents
1: Antimicrobial Stewardship in Long-Term Care Facilities (Nursing Homes and Rehabilitation Centers)
Introduction
Antimicrobial Stewardship Programs and Why Your Facility Should Have One
Acute Rehabilitation Centers, Sub-Acute Rehabilitation, and Long-Term Care Facilities
Existing Guidance
Infections in Long-Term Care Facilities and Rehabilitation Centers
Steps for Antimicrobial Stewardship Program Implementation in Long-Term Care and Rehabilitation Facilities
Step 1: Secure a Commitment
Step 2: Create a Committee

Step 3: Gather Data
Step 4: Identify Areas for Improvement
Step 5: Design and Implement Interventions
Example Interventions
Diagnostic Stewardship and Management Algorithms
Urinary Tract Infections
Respiratory Tract Infections
Antibiotic Utilization
Clostridioides Difficile
Antibiotic Time-Out
Step 6: Measure and Re-Assess
Step 7: Educate, Educate, Educate
Conclusion
References
2: Antimicrobial Stewardship in the Outpatient Setting
The Essentials of Stewardship in the Outpatient Setting
Primary Care Setting
Acute Respiratory Tract Infections

Urinary Tract Infections
Outpatient Parenteral Antimicrobial Therapy
Outpatient Hemodialysis Centers
Conclusion
References
3: Antibiotic Stewardship in the Emergency Department
Introduction
Stewardship Priorities
Respiratory Tract Infection
Diagnosis
Treatment
Pneumonia
Diagnosis
Treatment
Urinary Tract Infections
Diagnosis
Treatment
Skin and Soft Tissue Infections
Diagnosis
Treatment
Conclusions
References
4: Antimicrobial Stewardship in Critical Access Hospitals
Introduction
Critical Access Hospital Designation

Antimicrobial Utilization and Resistance
Antimicrobial Stewardship Program Requirements
Antimicrobial Stewardship Challenges
Solutions and Strategies
Conclusion
References
5: Antimicrobial Stewardship in Ambulatory Surgery Centers
Epidemiology of Surgical Site Infections
Principles of Surgical Infection Prophylaxis
Timing of Antimicrobial Administration
Antimicrobial Agents
Dosing of Agent
Penicillin Allergy
Duration of Antimicrobial Prophylaxis
The Role of Microbiological Screening and Decolonization

The Role of Antiseptic or Antibiotic Irrigations for Surgical Wounds
Clinician Education
Principles of Antimicrobial Stewardship
References
6: Antimicrobial Stewardship in Canine and Feline Veterinary Medicine
Introduction
Resistance Prevalence and Shared Flora Between Pets and their Owners
Antimicrobial Stewardship Principles and Perceptions in Companion Animal Medicine
Current Status of Antimicrobial Stewardship Efforts and Available Guidelines in the USA
Urinary Tract Infections (Original Publication in 2011, Updated in 2019) [62, 63]