Practicing MINDFUL-ness With Antibiotic Prescribing

Be more MINDFUL when ordering or reviewing your patients’ antimicrobial therapies, by considering the following:

M - Microbiology (use cultures to guide therapy)

I - Indication (choice of agent should be guided by evidence)

N - Narrow (use the narrowest spectrum)

D - Duration (give antimicrobial therapy for the shortest time needed to treat the infection based on evidence)

F - Find (the right dose for the type and site of infection)

U - Understand (your antimicrobial agent - eg mechanism of action, efficacy data for the indication, safety/adverse effect profile, pharmacokinetic and pharmacodynamic characteristics)

L - Lose (the double coverage in most cases - eg review for unnecessary double anaerobic coverage)

Acronym inspired by and adapted from the South Australian expert Advisory Group on Antimicrobial Resistance group’s antimicrobial creed.

Reference to the original antimicrobial creed below.

South Australian expert Advisory Group on Antimicrobial Resistance (SAAGAR). IV to Oral Switch Clinical Guideline for adult patients: Can antibiotics S.T.O.P. Version No.: 1.1 [Internet]. Australia: South Australian expert Advisory Group on Antimicrobial Resistance (SAAGAR); 2017 [updated 2017 Oct 23; cited 2022 Oct 8]. Available from: https://www.sahealth.sa.gov.au/wps/wc...

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Timestamp
0:00 - Intro
0:10 - MINDFUL acronym
0:29 - M: Microbiology
0:51 - I: Indication
1:02 - N: Narrowest spectrum
1:25 - D: Duration
1:42 - F: Figure out the right antibiotic dose
1:53 - U: Understand the antimicrobial agent you're using
2:22 - L: Lose the duplicate coverage in most cases

Disclaimer: I have no doubt that you already do this, but always use your clinical judgement when reviewing your patients' medication therapies and engage in discussion with your multidisciplinary team members when discussing your suggestions. I have confidence that you will be a great antimicrobial steward, however, I must put a disclaimer here that I will not accept responsibility for any harms (including patient harms) associated with the use of this video to make clinical judgements or decisions. This video constitutes my own thought process and views, and do not reflect those of my employer, organization, committee, or other group or individual.