CHESTGuidelines & Topic CollectionsSepsisAntimicrobial Stewardship Program

Antimicrobial Stewardship Program

Compiled by the CHEST Sepsis Resources Steering Committee

Last updated May 05, 2023

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Selection of antimicrobial agents (Day 0)

Consider: Previous health care exposure and antimicrobial use, prior resistant infections

Daily evaluation and review of clinical stability (Days 3-5, typically)

Key point: Is patient getting better?

Assess: Do we need to continue antibiotics in a rapidly improving patient? If not improving, should therapy be changed?

React: Stopping anti-MRSA drugs when nasal PCR is negative or if cultures are negative for MRSA at 48 hours

Discontinuation of antimicrobials

Elect: Stopping all antibiotics between days 5-7, following clinical stability or procalcitonin if available