71 Antibiotic Stewardship
71.1 What this covers
- Do not renally adjust first dose of antibiotics (pharmacokinetics of first dose: concentration in blood is a result of volume of distribution. Elimination is only impactful on subsequent doses).
- Spiraling empiricism:
- Disease severity is not correlated with resistant organisms. Rationale for broad initial coverage assumes that more severe illness is not at higher risk of adverse effects.
71.2 Learning objectives
- Do not renally adjust first dose of antibiotics (pharmacokinetics of first dose: concentration in blood is a result of volume of distribution. Elimination is only impactful on subsequent doses).
- Spiraling empiricism:
- Disease severity is not correlated with resistant organisms. Rationale for broad initial coverage assumes that more severe illness is not at higher risk of adverse effects.
71.3 Bottom line / summary
- Do not renally adjust first dose of antibiotics (pharmacokinetics of first dose: concentration in blood is a result of volume of distribution.
- Elimination is only impactful on subsequent doses).
- Spiraling empiricism:
- Disease severity is not correlated with resistant organisms.
- Rationale for broad initial coverage assumes that more severe illness is not at higher risk of adverse effects.
71.4 Approach
- Antibiotic Stewardship
71.5 Red flags / when to escalate
- TODO: List red flags that require urgent escalation.
71.6 Common pitfalls
- Do not renally adjust first dose of antibiotics (pharmacokinetics of first dose: concentration in blood is a result of volume of distribution. Elimination is only impactful on subsequent doses).
71.7 References
TODO: Add landmark references or guideline citations.
71.8 Source notes
71.8.1 Antibiotic Stewardship
72 Antibiotic Stewardship
Do not renally adjust first dose of antibiotics (pharmacokinetics of first dose: concentration in blood is a result of volume of distribution. Elimination is only impactful on subsequent doses).
Spiraling empiricism:
Disease severity is not correlated with resistant organisms. Rationale for broad initial coverage assumes that more severe illness is not at higher risk of adverse effects.