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Specialist trainees on rotation cannot replace dedicated consultant clinicians for antimicrobial stewardship of specialty disciplines

Author(s): Yeo Chay Leng | Wu Jia En | Chung Gladys Wei-Teng | Chan Douglas Su-Gin | Fisher Dale | Hsu Li Yang

Journal: Antimicrobial Resistance and Infection Control
ISSN 2047-2994

Volume: 1;
Issue: 1;
Start page: 36;
Date: 2012;
Original page

Keywords: Antimicrobial stewardship | Antimicrobial resistance | Trainee supervision | Compliance

Abstract Our prospective-audit-and-feedback antimicrobial stewardship (AS) program for hematology and oncology inpatients was switched from one led by dedicated clinicians to a rotating team of infectious diseases trainees in order to provide learning opportunities and attempt a “de-escalation” of specialist input towards a more protocol-driven implementation. However, process indicators including the number of recommendations and recommendation acceptance rates fell significantly during the year, with accompanying increases in broad-spectrum antibiotic prescription. The trends were reversed only upon reverting to the original setup. Dedicated clinicians play a crucial role in AS programs involving immunocompromised patients. Structured training and adequate succession/contingency planning is critical for sustainability.
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