Optimizing Antimicrobial Therapy with Timeouts

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.