Antimicrobial Stewardship Rotation

The Antimicrobial Stewardship Program (ASP) at Stony Brook University Medical Center (SBUMC) is focused on helping clinicians improve the quality of patient care through the appropriate use of antimicrobial agents. The ASP provides oversight on antimicrobial use and gives recommendations for the appropriate selection, dosing, route of administration, and duration of therapy. The directors of this program are Drs. Roderick Go and Melinda Monteforte (PharmD).

The rotation are on Mondays from 9am to 12pm for the Clinic and Research fellow. As part of this yearlong rotation, Infectious Diseases fellows (IDF) will learn about the functions of an ASP in a large university hospital setting. The objectives of this rotation will be met via direct interaction and supervision with the ASP and regular didactics addressing the core elements of this program.

Fellows will learn about antimicrobial use monitoring and metrics for measuring use in an institution. They will learn about strategies for guiding appropriate use. This includes performing prospective audits and providing feedback to clinicians. They will also learn about prior authorization strategies for controlling antimicrobial use. They will also learn about the use of institutional practice guidelines to direct clinicians.

Fellows will develop enhanced knowledge of antimicrobials, the spectrums of activity against microorganisms, and common associated adverse reactions. Fellows will learn appropriate dosage ranges for the different agents in both the normal host as well as those with impaired renal and/or hepatic function. Fellows will learn microbiology testing and interpretation and how it helps guide medication recommendations. The Fellows will learn how to utilize the institutional antibiogram to guide decision making. The fellows will also utilize basic pharmacodynamics and pharmacokinetic principles to understand the rationale for selecting specific antimicrobial agents and in determining appropriate dosing. They will also learn cost considerations in developing a hospital formulary.