CASP Resources
Carolina Antimicrobial Stewardship Program (CASP) publications and presentations are intended to improve our understanding of stewardship, document what works, and provide tools to aid in implementation of stewardship activities.
UNC Medical Center Resources
Note: The resources below may require UNC Health login and/or may only be accessed from the UNCMC/UNC campus.
UNC Medical Center Antibiogram
- 2019 Antibiogram (version: 10/2/2020)
UNC Medical Center Antimicrobial Use Guidance
- Updated Restricted Anti-Infective Drugs – Adult & Pediatric (version: 5/2021)
- Update replaces “Red Man Syndrome” with “Vancomycin Flushing Syndrome”
- Best Practices for Duration of Antimicrobial Therapy for Infectious Syndromes (version: 8/2019)
- Guidance for the empiric use of restricted β-lactams with activity against carbapenem-resistant Enterobacterales (CRE) (version: 9/2020)
- Carbapenem Use Guideline (version: 7/2020)
- Updated Rapid Gram-Positive Diagnostic Testing Guideline (version: 6/2021)
- Surgical Prophylaxis:
- Antimicrobial Surgical Prophylaxis Guidelines – Adult (version: 5/2020)
- Perioperative Antibiotic Protocol (version: 5/2019)
- How to Obtain IV Artesunate from the CDC (version: 8/2019)
UNC Medical Center Clinical Syndrome Treatment Guidelines
- Diagnosis and Management of Clostridioides difficile Infection in Adult and Pediatric Patients (version: 12/20)
- Influenza Treatment Guideline (version: 10/2020)
- Community Acquired Pneumonia Guideline (version: 6/2020)
- Hospital Acquired Pneumonia Guideline (version: 6/2020)
- Antibiotic Locks for the Treatment or Prevention of Catheter-Related Bloodstream Infections (version: 2/2020)
- Bloodstream Infection Management Candida (version: 8/2019)
- Bloodstream Infection Management S. aureus (version: 8/2019)
- Vancomycin Resistant Enterococcus (VRE) Treatment (version: 6/2019)
- Urinary Tract Infection (UTI) Guideline (version: 5/2019)
UNC Medical Center Antimicrobial Dosing and Monitoring Resources
- New Renal insufficiency and hemodialysis antimicrobial dosing guideline (version: 6/2021)
- Parenteral Vancomycin and Aminoglycoside Dosing Protocol for Pharmacists – Adult & Pediatric (version:11/2020)
- Antibiotic CVVH/CVVHD Dosing Recommendations (version: 5/2020)
- Amioglycoside Dosing & Monitoring Guidelines (version: 12/2019)
- Laboratory Monitoring Guideline for Outpatient Parenteral and Oral Antimicrobial Therapy for Pediatrics & Adults (version:12/2019)
- Vancomycin Dosing Guidelines (Adult) (version: 11/2019)
- Susceptible Dose Dependent (SDD) Dosing: Daptomycin and Ceftaroline (version: 6/2019)
- Azole Antifungal Therapeutic Drug Monitoring Guidelines (version: 5/2019)
- Antibiotic Hemodialysis Guidelines (version: 2/2018)
- Antibiotic Renal Dosing Guidelines (version: 2/2018)
UNC Children’s Hospital Stewardship Resources
- Pediatric Community-Acquired Pneumonia Clinical Practice Guideline (version: 2/2021)
- Rapid Gram-Positive Diagnostic Testing Guideline (version: 6/2020)
- Neonatal and Pediatric Vancomycin Dosing Guideline (version: 2/2020)
- Diagnosis and Management of Influenza at UNC Children’s Hospital (version: 12/2019)
- Antimicrobial Therapy of Pediatric Community Acquired Pneumonia at UNC (version: 12/2019)
- Neonatal and Pediatric Aminoglycoside Dosing Guideline (version: 11/2019)
- Surgical Prophylaxis (version: 4/2019)
- Pediatric Musculoskeletal Infections (version: 11/2018)
- Empiric Acyclovir Treatment (<90 days of age) Guideline (version: 11/2017)
- Pediatric ED UTI Clinical Algorithm (version: 5/2017)
Other UNC Medical Center Resources
- New Penicillin Allergy Assessment Tool Kit (version: 3/2021)
- Antibiotic Time-outs Readiness Checklist (version: 10/2020)
- C. difficile Infection Prevention Workbook, includes detailed data on CDI (updated monthly)
- Removing Patients from Isolation
- Isolation Policies (version: 4/2021)
Publications
2021
- Spicer JO, Armstrong WS, Schwartz BS, et al.: The IDSA Antimicrobial Stewardship Curriculum Workgroup. Evaluation of the Infectious Diseases Society of America’s Core Antimicrobial Stewardship Curriculum for Infectious Diseases Fellows. Clinical Infectious Diseases. 2021;(ciab600). doi:10.1093/cid/ciab600
- Apisarnthanarak A, Weber DJ. Strategy to limit multidrug-resistant Acinetobacter baumannii transmission in a cohort coronavirus disease 2019 (COVID-19) critical care unit. Infect Control Hosp Epidemiol. 2021 Jun 24:1-2. doi: http://10.1017/ice.2021.289
- Willis ZI, de St Maurice A. A Piece of the Puzzle: The Role of Molecular Testing in Antimicrobial Stewardship. J Pediatric Infect Dis Soc. 2021 Jun 15:piab037. doi: 10.1093/jpids/piab037.
- Seidelman JL, Moehring RW, Weber DJ, Anderson DJ, Lewis SS. The impact of patient-reported penicillin or cephalosporin allergy on surgical site infections. Infect Control Hosp Epidemiol. 2021 Jun 9:1-5. doi: https://doi.org/10.1017/ice.2021.232
- Ross RK, Gerber JS, Willis ZI, Hersh AL, Kinlaw AC. Outpatient Fluoroquinolone Use in Children, 2000-2018. J Pediatric Infect Dis Soc. 2021 May 28;10(5):576-585. doi: 10.1093/jpids/piaa156.
- Jantarathaneewat K, Apisarnthanarak A, Limvorapitak W, Weber DJ, Montakantikul P. Pharmacist-Driven Antibiotic Stewardship Program in Febrile Neutropenic Patients: A Single Site Prospective Study in Thailand. Antibiotics (Basel). 2021 Apr 17;10(4):456. doi: http://10.3390/antibiotics10040456
- Luther VP, Shnekendorf R, Logan A, et al.: The IDSA Antimicrobial Stewardship Curriculum Workgroup. Investing in the Future: A Role for Professional Societies to Prepare the Next Generation of Healthcare Leaders through Curriculum Development and Dissemination. Clinical Infectious Diseases. 2021;(ciab244). doi:10.1093/cid/ciab244
- Garcia Reeves AB, Trogdon JG, Stearns SC, Lewis JW, Weber DJ, Weinberger M. Are Rates of Methicillin-Resistant Staphylococcus aureus and Clostridioides difficile Associated With Quality and Clinical Outcomes in US Acute Care Hospitals? Am J Med Qual. 2021 Mar-Apr 01;36(2):90-98. doi: http://10.1177/1062860620942310
- Garcia Reeves AB, Stearns SC, Trogdon JG, Lewis JW, Weber DJ, Weinberger M. Impact of California’s mandate for antimicrobial stewardship programs on rates of methicillin-resistant Staphylococcus aureus and Clostridioides difficile infection in acute-care hospitals. Infect Control Hosp Epidemiol. 2021 Mar;42(3):298-304. doi: http://10.1017/ice.2020.446
2020
- Cawcutt KA, Patel R, Gerber J, Caliendo AM, Cosgrove SE, Ashley ED, Garzaro P, Miller M, Lautenbach E; IDSA Research Summit ‘Leveraging Existing and Novel Diagnostics for Optimizing Outpatient Antibiotic Stewardship in Patients with Respiratory Tract Infections’ Group. Leveraging Existing and Soon-to-Be-Available Novel Diagnostics for Optimizing Outpatient Antibiotic Stewardship in Patients with Respiratory Tract Infections. Clin Infect Dis. 2020 Dec 4:ciaa1815. doi: 10.1093/cid/ciaa1815. Epub ahead of print.
- Parr JB.Time to Reassess Tocilizumab’s Role in COVID-19 Pneumonia. JAMA Intern Med. Published online October 20, 2020. doi:10.1001/jamainternmed.2020.6557
- Willis ZI, Wilson WS. Revised Daptomycin Interpretation Criteria for Enterococcus faecium: What Are the Implications for Children? J Pediatric Infect Dis Soc. 2020;9(2):265-267. doi:10.1093/jpids/piz066
- Daniels LM, Weber DJ. Interventions to improve antibiotic prescribing at hospital discharge: A systematic review. Infection Control and Hospital Epidemiology 2020 Sept 1: 1-4 doi: 10.1017/ice.2020.367
- Layton JB, McGrath LJ, Sahrmann JM, Ma Y, Dharnidharka VR, O’Neil C, Weber DJ, Butler AM. Comparative safety of high-dose versus standard-dose influenza vaccination in patients with end-stage renal disease. Vaccine. 2020 Jul 14;38(33):5178-5186.
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Rhea S, Jones K, Endres-Dighe S, Munoz B, Weber DJ, Hilscher R, MacFarquhar J, Sickbert-Bennett E, DiBiase L, Marx A, Rineer J, Lewis J, Bobashev G. Modeling inpatient and outpatient antibiotic stewardship interventions to reduce the burden of Clostridioides difficile infection in a regional healthcare network. PLoS One. 2020;15(6):e0234031. Published 2020 Jun 11. doi:10.1371/journal.pone.0234031
Carolina Antimicrobial Stewardship Posters & Presentations
- Walker Mason, Alan Kinlaw, Emily Ciccone, Kevin Alby, Melissa Miller, Lindsay Daniels. Implementation of rapid diagnostic testing and antimicrobial stewardship interventions to reduce time to optimal therapy for Staphylococcus aureus bacteremia. October 2019 (Poster requires UNC Health log in.) Summary: This was a successful multidisciplinary collaborative project implementing rapid diagnostic testing and antimicrobial stewardship interventions to reduce time to optimal antimicrobial therapy for patients with for S. aureus bacteremia.
- Zach Willis, May-Britt Sten, Ronald Davis, Donna Krzastek, Lindsay Daniels, Jon Juliano, Clare Mock, Michael Swartwood, and Will Stanley. Implementation of Antibiotic Time Outs at UNC Medical Center. October 2019.
- Emily Ciccone, Alan C. Kinlaw, Wilbur Woodhouse, Vahini Chundi, Melissa B. Miller, David J. Weber, Jonathan J. Juliano, Ravi Jhaveri, and Zachary Willis on behalf of the UNC Medical Center Carolina Antimicrobial Stewardship Program. Respiratory Viral Testing and Antimicrobial De-escalation Among Hospitalized Patients at a Tertiary Care Facility, 2015-2016: A Matched Cohort Study Series. Open Forum Infectious Diseases, Volume 6, Issue supplement 2, 23 October 2019, Page S986, https://doi.org/10.1093/ofid/ofz360.2467
- Ashley Marx, Vahini Chundi, Jill Zaccardelli, Jon Oriet, Tim Angle, Michael Swartwood, Lindsay Daniels, Ross Boyce, Jonathan Juliano. Effects of An Antimicrobial Stewardship Team-led Staphylococcus aureus Bacteremia Management Bundle: A Quasi-Experimental Study. Open Forum Infectious Diseases, Volume 6, Issue supplement 2, 23 October 2019, Page S366, https://doi.org/10.1093/ofid/ofz360.904
- Erin Mays, Alan Kinlaw, Michael Swartwood, Asher Schranz, Renae Boerneke, Claire Farel, Ashley Marx. Evaluation of Adverse Drug Reactions due to Common Beta-Lactam Therapies Among Patients Enrolled in an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program. Open Forum Infectious Diseases, Volume 6, Issue supplement 2, 23 October 2019, Page S332, https://doi.org/10.1093/ofid/ofz360.811
- The Impact of a Positive Respiratory Viral Panel Among Hospitalized Adult Patients with Negative Rapid Influenza Testing at an Academic Tertiary Care Facility: A-matched Cohort Study. Open Forum Infectious Diseases, Volume 5, Issue suppl 1, 26 November 2018, Pages S268.
- Combating Carbapenem-Resistant Enterobacteriaceae: a presentation by Laurence Wright, PharmD, as a part of the Carolina Antimicrobial Stewardship Program Learning Series, September 2018
- Emily Ciccone, Vahini Chundi, Melissa Miller, Lauren DiBiase, David Weber, Jonathan Juliano, Ravi Jhaveri, Zachary Willis, on behalf of the UNC Antimicrobial Stewardship Team. The Impact of Respiratory Viral Testing in Hospitalized Adult Patients at a Tertiary Care Facility. Open Forum Infectious Diseases, Volume 4, Issue suppl 1, 1 October 2017, Pages S510, https://doi.org/10.1093/ofid/ofx163.1323
