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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 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


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 enhance monitoring
12. Establish partnership with Emergency Medicine to identify opportunities to optimize antimicrobial use