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The Carolina Antimicrobial Stewardship Program (CASP) supports the appropriate and effective use of antimicrobials at the UNC Medical Center. A multidisciplinary team provides guidance and tools to support clinical decision-making. Optimizing antimicrobial therapy helps to reduce complications associated with these drugs, improve patient outcomes, reduce cost, and slow antimicrobial resistance.

Carolina Antimicrobial Stewardship Program’s Fiscal Year 2022 strategies include:

CORE STRATEGIES

1. Conduct prospective audit and feedback on antibiotic use
2. Participate in the CDC National Healthcare Surveillance Network’s Antibiotic Use module
3. Collaborate with the Healthcare-associated Infections Prevention Initiative to improve diagnostic stewardship
4. Carry out antimicrobial stewardship education and training

SPECIAL FOCUS STRATEGIES

5. Promote best practices for evidence-based durations of antimicrobial therapy for common infections
6. Increase participation in antibiotic time-outs
7. Implement, monitor, and support evidence-based practice for pediatric community-acquired pneumonia
8. Optimize processes of ordering, dispensing, and delivery of perioperative antibiotics in the Children’s Operating Room to enhance patient safety and prevent surgical site infections
9. Implement penicillin allergy assessments to improve the accuracy of allergy documentation
10. Improve process of collecting appropriate cultures in the adult operating room when indicated
11. Develop outpatient antimicrobial data dashboard to improve monitoring
12. Establish partnership with Emergency Medicine to identify opportunities to optimize antimicrobial use

CASP provides assistance with:

  •   Empiric use of antimicrobials
  •   Optimal duration of therapy
  •   Diagnostic testing for infections
  •   Approval of restricted antimicrobials
  •   Alternative antibiotics in patients with allergies
  •   De-escalation of antibiotics

CASP and the Outpatient Parenteral Antibiotic Therapy Program (OPAT) program began in 2016 as a joint program of the Department of Pharmacy and the Divisions of Adult and Pediatric Infectious Diseases.

The primary objectives of the OPAT program are to:

  • Ensure accurate transitions of care for patients leaving UNC Hospitals on parenteral antibiotics
  • Provide monitoring and evaluation of clinical issues for patients enrolled in the program