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Missed benefits when MDT engagement is lacking: Part 2

In this article, we explore part 2 of this case study, investigating what can be missed when an MDT is not in place.
Distressed female doctor with head in hands.
© BSAC

Initial treatments often require use of broader spectrum antimicrobials until the source and type of infection is known. Consider how involvement of the ID physician and the wider AMS MDT team may help with the diagnosis of this infection.

Read through the patient’s treatment timeline below, and try to think about what the missing step may be:

To view a larger version of this infographic, click here. Screen reader compatible version available here.

In this case, a lack of AMS MDT involvement during the patient’s treatment led to continued use of broad spectrum antimicrobials, as well as the addition of two further antimicrobials administered without appropriate sampling to aid diagnosis or source control.

In what ways could an AMS MDT have improved management of the patient?

Read through the timeline shown again below, and try to recognise how the AMS MDT involvement has improved patient outcomes.

To view a larger version of this infographic, click here. Screen reader compatible version available here.

This case shows how the interventions of a functioning AMS MDT, working together with the clinical team, can benefit the patient and how improvements to infection management may be missed when an AMS MDT is not in place.

With no initial AMS MDT consultation, this patient deteriorated on treatment with broad spectrum antimicrobials, leading to increased length of stay and cost of care. Addition of empirical amikacin and vancomycin with no Therapeutic Drug Monitoring led to worse patient outcomes due to the development of drug-related acute kidney injury. Following advice from the MDT, appropriate source control was implemented through aspiration/drainage of the abscess, and sampling of fluids to allow for targeted antimicrobial treatment with a less toxic single agent.

In the next case study we’ll take a look at how patient outcomes improve when a well-functioning AMS MDT is in place. Click ‘next’ when you are ready to move on.

© BSAC
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Improving Antimicrobial Stewardship Programs using Multidisciplinary Teams

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