Genesis of Antibiotic Resistance XXVIII: Mitigation of Antibiotic Resistance Pandemic (ARP) through obdurate implementation of Antibiotics Time Out (ATO)

A comprehensive review of the cause and effect relationship for ATO and its role in ARP has been completed by clinical and microbiology staff at Fort Duncan Regional Medical Center and Southwest Texas Junior College and the outcomes of the colloquium and its implementation strategies are presented in this work. Subsequently, strategic measures are paramount to ATO. Healthcare providers should have a dosage and duration identifiers in all orders and antibiotic orders should include microbiology cultures to check, verify and substantiate resistance to the antibiotic, thus having the propensity to elicit therapeutic change by narrowing the broad spectrum resulting in improved treatment of pathogens. Although a patient appears well, it remains important to check microbiology cultures if it is at all possible for them to be grown and culture results should return within 24 to 48 hours for an antibiotic time out. ATO gives the physician an opportunity to observe and determine the efficacy of the prescribed antibiotic with reevaluation to be conducted after 24 hours. The goal is to get the patient out quickly due to subsequent infection and economic constraints. In addition to reducing antibiotics overuse, implementation of effective infection prevention measures is necessary. The following are obligatory appraisals during ATO: a. Collection of cultures of antibiotics before starting antibiotics, antibiotics require renal dosing, b. ID approval is required for many antibiotics, c. Use the Sanford Guide to Antimicrobial Therapy and hospital literature, d. Medical history of the patient when choosing anti‐biotics (maximum available retrospective data). e. Has patient received recent antibiotic therapy and the details? f. data on hospital flora (day to day basis), g. The presence of underlying disease, h. Antibiogram – complete antibiotic sensitivity profile ‐ culture data of the patient, i. The number of days the patient has been treated with broad spectrum antibiotics (detailed descriptive summary), j. The patterns of resistance in the community, city, state, country, & global (weekly basis) k. Is the patient being treated with immunosuppressive drugs or with disease such as an autoimmune disorder?, l. Joint efforts of the patient advocate and community organizations in monitoring the patient in completion of the entire treatment program such as taking full dosage within the stipulated time periods, m. Major episodes of resistance problems such as hospital infections in that healthcare facility (chances of cross contamination profile), n. Reevaluation of patient antibiotic sensitivity before and after completing treatment. Data analysis and adequate literature sources will be presented at EB 2017. Support or Funding Information Professional development funds to Subburaj Kannan