Antibiotic Stewardship Workshop Dr. Jason Profetto, BKin, MD, CCFP

Brief introduction

Case 1: Mary 40 year old female 3 days of cough and feeling unwell She is concerned that she has pneumonia

Case 1: Mary As a group, come up with 3 additions things that you wish to do/ask/order

Case 1: Mary Would you treat with an antibiotic? Which one would you choose?

Case 1: Abx Choices Amoxicillin/Penicillin (B-Lactam) Doxycycline (Tetracyline) Clarithromycin/Azithromycin (Macrolide) Moxifloxacin/Levofloxacin (Resp Fluoroquinolone)

Case 2: Giovanna 75 year old female 1 day of dysuria, urgency and frequency Concerned she has an urinary tract infection

Case 2: Giovanna As a group, come up with 3 additions things that you wish to do/ask/order

Case 2: Giovanna Would you treat with an antibiotic? Which one would you choose?

Case 2: Abx Choices Nitrofurantoin (Macrobid) Amoxicillin TMP-SMX (Septra) Fosfomycin Ciprofloxacin (Cipro)

Case 3: Kamlesh 60 year old female 7 days of a growing rash on her right leg It’s red and painful You are concerned about cellulitis (infection of the subcutaneous lair of skin)

Case 3: Kamlesh As a group, come up with 3 additions things that you wish to do/ask/order

Case 3: Kamlesh Would you treat with an antibiotic? Which one would you choose?

Case 4: Abx Choices Cephalexin (Keflex) - cephalosporin Clindamycin - lincosamide TMP-SMX - sulfa Ciprofloxacin - fluoroquinolone Amoxicillin-Clavulinate (Clavulin)

Learning points? The role of clinical questions The role of diagnostic tests The role of antibiotics

Pieces of advice: Contextualize Don’t try to learn Abx all at once There are many nuances There are many misconceptions

Don’t do this: Amoxicillin Penicillin Clavulin Levofloxacin Ciprofloxacin Moxifloxacin Keflex Macrobid Septra Etc

Do this: UTI Sinusitis AOM Strep Throat Pneumonia Cellulitis Diverticulitis Bacterial gastroenteritis Etc

The End!