Antimicrobial Stewardship Program

2023 Stony Brook University Hospital Antibiograms (updated 2/23/24)

Links to University Hospital's 2023 Antibiograms are below:

Stony Brook University Hospital Antibiogram (2023 data, COMMUNITY origin isolates)

Stony Brook University Hospital Antibiogram (2023 data, HOSPITAL origin isolates)

 

Antibiogram Notes

In general, cultures obtained from outpatients are more likely to have drug susceptible bacteria compared to cultures obtained from inpatients.  The Community antibiogram is more likely to reflect those patients seen in our clinics and those patients seen in our emergency room without recent healthcare exposures (i.e. hospitalization within the past 30 days).  This data may be more applicable to those less sick patients without risk factors for multidrug resistant pathogens. 

For patients at risk for nosocomial infections (occurring >3 days in the hospital), the Hospital based antibiogram should be used to help guide antibiotic therapy as it may better reflect the resistance patterns encountered.

The CLSI M100 reference standard is used for antibiotic breakpoints.  Based on the most recent update, some bacteria are now considered to be intrinsically resistant to antibiotics that have been previously used for treatment.  Those antibiotics for which a bacteria is considered to be intrinsically resistant are now labelled with a "R".

 

11/18/24

Upcoming Changes to Antibiotic Restriction Policy (MM0086)

Changes are coming to Stony Brook Medicine's Antibiotic Restriction Policy (MM0086).  Moving forward, restrictions will be separated into two tiers:

- Tier One: Requires Infectious Diseases consultation within 24 hours for continued use

- Tier Two: Requires either Infectious Diseases or Antimicrobial Stewardship Program approval for use

More information regarding implementation of this policy will be forthcoming.

 

 

11/18/24 - 11/24/24

 

U.S. Antibiotic Awareness Week

 

U.S. Antibiotic Awareness Week (USAAW) is an annual observance that highlights steps that everyone can take to improve antibiotic prescribing and use. 

The advent of antibiotics have transformed medical care, treating diseases that would otherwise be fatal and allowing for interventions not previously possible such as organ transplantations.  Antibiotics are powerful and beneficial tools in combating many infectious diseases; however, they are not without risk.  Antibiotics can be associated with medication side effects (i.e. acute kidney injury with vancomycin and piperacillin-tazobactam), disruption of the microbiome leading to Clostridioides difficile infection, and antibiotic resistance.

Antibiotic resistance is an urgent global public health threat.  In the United States alone, more than 2.8 million antibiotic-resistant infections occur, and more than 35,000 people die as a result.  Many more die from complications from antibiotic-resistant infections.  Bacteria and fungi develop resistance in response to outside pressures such as antibiotic exposure.

Improving the way healthcare professionals prescribe antibiotics and the way people take antibiotics helps in both the short term and in the long term.  Smart antibiotic use helps ensure that our patients get the most appropriate treatment for their infections.  Over the long term, judicious use of appropriate antibiotics helps us fight the looming threat of resistance and ensure that these life-saving drugs will be available for future patients.

This year, we invite you to Go Purple for USAAW!

You can learn more USAAW here.

How much do you know about antibiotics?  Test your knowledge about antibiotics here.

 

 

8/28/24

Blood culture Guidelines.  When and how many?

Blood cultures are a staple test when evaluating patients with infections.  But does everyone with an infection need blood cultures?  The decision to order blood cultures should depend on whether a patient has a new diagnosis of sepsis or if there is high concern for bacteremia.  The Diagnostic Stewardship working group has written guidance on when blood cultures may be indicated as well as how many and how often the test should be done.

Note: due to the nationwide shortage of BD Bactec blood culture vials, restrictions on the ordering of blood cultures may be imposed that are not in accordance with these guidelines.  

Blood Culture Guideline for Non-Severely Immunocompromised Adult Patients

Blood Culture Guideline for Immunocompromised Patients without Neutropenic Fever

 

 

11/19/24

Updated Institutional Treatment Guidelines

Stony Brook Medicine Clostridioides difficile Guidelines

Stony Brook Medicine Neutropenic Fever Treatment Guidelines

Stony Brook Medicine Invasive Fungal Infection Treatment Guidelines

Stony Brook Medicine Community Acquired Bacterial Pneumonia Treatment Guidelines (updated 4/16/2024)

Stony Brook Medicine Community Acquired UTI Treatment Guidelines

Stony Brook Medicine COVID Treatment Guidelines (updated 11-19-24)

 

 

8/2/23

Restricted Antibiotic Standard Operating Procedure

 

 

 

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10/31/2024

Formulary updates

Stony Brook University Hospital has recently added the following antimicrobials to the formulary:

Sulbactam-durlobactam (Xacduro)

This beta lactam-beta lactamase combination has been approved for the treatment of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia cased by susceptible strains of Acinetobacter baumannii-calcoaceticus complex.  Acinetobacter infections can be challenging to treat in the hospital setting as it is common to encounter multidrug resistant strains.  Sulbactam-durlobactam is not FDA approved for the treatment of causes of HAP/VAP other than Acinetobacter baumannii-calcoaceticus complex.  Infectious Diseases consultation is required for use beyond 24 hours.

 

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