How to De-escalate or Narrow Antibiotic Therapy

In this video, I go over how to assess a patient's antimicrobial therapy for de-escalation.

De-escalation is an Antimicrobial Stewardship strategy that any clinical pharmacist without prior infectious disease training can use to optimize their patient's antimicrobial therapy.

You will need to be familiar with antimicrobial therapies to effectively use this strategy.

Here are some Infectious Disease related resources below that I use in my daily practice as an Antimicrobial Stewardship Pharmacist for you to use as well (I am NOT sponsored by any of the below companies):

-Firstline - Clinical Decisions (formerly 'Spectrum'; free mobile app) - https://apps.apple.com/ca/app/firstli...

-The Sanford Guide to Antimicrobial Therapy (mobile app - ~$40 USD/year; book - ~$35 USD; US based) - https://www.sanfordguide.com

-Bugs & Drugs (free mobile app; based out of Alberta, Canada) - https://www.bugsanddrugs.org

Let me know if the comments below if you have any questions or if you would have topics you would like me to do future videos on.

Thankyou so much for your support 💕

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Timestamp
0:00 - Intro
0:59 - Know your antimicrobial therapies well
1:30 - De-escalation definition
2:05 - Broad versus narrow spectrum antibiotics
3:48 - Sanford Guide introduction
4:45 - Firstline mobile app introduction
7:00 - Ideal time for de-escalation review - Day 3 of antibiotic therapy
7:40 - Advantages of de-escalating therapy
09:02 - Patient case: SF


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.

The patient case presented in this video is a fictitious case. Any similarity with real people are coincidental.