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graph of OPAT conditions by yearThe Carolina Antimicrobial Stewardship Program (CASP) and the Outpatient Parenteral Antibiotic Therapy Program (OPAT) began in 2016 as joint programs of the UNC Medical Center Department of Pharmacy and the Divisions of Adult and Pediatric Infectious Diseases.

OPAT Objectives

  • 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

Learn more about OPAT at the UNC Medical Center

CASP supports the appropriate and effective use of antimicrobials

A multidisciplinary team provides guidance and tools to support clinical decision-making. CASP provides stewardship consults to assist UNC Medical Center colleagues with:

  • CDC Optimizing therapyEmpiric 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

Each year, CASP implements strategies to optimize antimicrobial therapies for patients who need them. Core strategies (1-4 below) are carried out every year as foundational to UNCMC’s antimicrobial stewardship program; special focus strategies (5-12 below) are projects led by CASP pharmacists and physicians to respond to opportunities for quality improvement based on hospital data and trends.

Carolina Antimicrobial Stewardship Program’s 2022-23 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 Stop Healthcare-associated Infections in Every Patient (SHINE) Initiative
4. Carry out antimicrobial stewardship education and training


5.  Implement, expand, and monitor penicillin allergy assessments to improve the accuracy of allergy documentation
6.  Expand outpatient stewardship and optimize outpatient antimicrobial data dashboard to enhance monitoring
7.  Improve diagnosis and management of non-catheter-associated urinary tract infections among adults
8.  Optimize ordering, dispensing, and delivery of peri-operative antibiotics in the Children’s Hospital operating room to prevent surgical site infections
9.  Enhance pediatric healthcare-associated pneumonia and ventilator-associated pneumonia diagnostic stewardship
10.  Develop, implement, and monitor guideline for pediatric febrile neutropenia
11.  Develop a guide to assist with pediatric empiric antimicrobial selection