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What do the "low-hanging fruit" AS interventions consist of?

Video explaining what is the basis of a "low-hanging fruit" intervention

Watch the second video with Dr Adrian Brink and Dr Dena van den Berg as she explains the five “low-hanging fruit” chosen for their intervention:

  • Whether cultures were performed prior to antibiotic prescription
  • Concurrent use of ≥ four antibiotics
  • Duration of antibiotic therapy >seven days
  • Duration of antibiotic therapy > 14 days
  • Concurrent “double-cover” i.e. redundant anaerobe, Gram-negative and Gram-positive cover.

NB: These examples are determined by local needs and priorities. In other healthcare systems surgical prophylaxis, IV to oral conversion are commonly used as “low-hanging”interventions.

It is worth noting that data at all participating sites in the group was collected during pharmacist AMS ward rounds conducted initially in intensive care and high care units followed by audits in wards. For above basic interventions, clinicians were consulted in every instance before changes were affected. Interventions did not occur for established, extended treatment syndromes such as infective endocarditis and other deep-seated infections (e.g. osteo-myeilitis and septic arthritis). In addition, antimicrobials used in patients for HIV infections, Mycobacterium tuberculosis and/or Pneumocystis jiroveciI pneumonia were excluded. Only parenteral use was measured and topical or inhaled antibiotics and antifungal use was excluded in this study.

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Antimicrobial Stewardship: Managing Antibiotic Resistance

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