Antimicrobial Stewardship Program Antimicrobial Stewardship Program Our Mission To promote responsible and rational antimicrobial use by providers and patients alike To increase public health awareness about the threat of antimicrobial resistance To educate and empower clinical champions of antimicrobial stewardship To mentor stewardship leaders of tomorrow Resources Global Health Center Website NYC Department of Health Center for Disease Control More ID Resources What We Do As much as 50 percent of all antibiotic prescriptions are considered “inappropriate.” Experts consider antibiotics to be “inappropriate” when they are prescribed for non-bacterial infections, the spectrum of coverage is overly broad and potentially toxic, the dose is inaccurate for the host, or the intended duration is too long. “Inappropriateness” contributes directly to medication side effects, interactions, kidney and liver dysfunction, Clostridium difficile infections (CDI), and the emergence of multi-drug resistant pathogens. As early as 1945, Sir Alexander Fleming, the pioneer of the antibiotic era, warned that the overuse of antibiotics “clearly drives the evolution of resistance.” In 2014 President Obama introduced multi-drug resistance as a national security issue and recognized antimicrobial stewardship as the first line of defense. In 2016, the Centers for Medicare and Medicaid Services and the Joint Commission joined the narrative by emphasizing the need for stewardship across the healthcare continuum (inpatient and ambulatory sites). Mainstream recognition of the scope of antibiotic resistance allows us to implement meaningful solutions. CDC’s “Core Elements of Hospital Antibiotic Stewardship Programs” provide a framework for successful ASP development. These include: Leadership Commitment Action Education Accountability Tracking Drug Expertise Reporting In July 2008, Montefiore Medical Center initiated a multifaceted interdisciplinary stewardship program to educate, support, and advise practicing physicians throughout its extensive Bronx network of hospitals, ambulatory care clinics, and nursing homes. Stewardship operations occur at each of our academic campuses (Moses, Einstein, and Wakefield) and the Children’s Hospital at Montefiore (CHAM). Our strategic stewardship plan is adapted from the Infectious Diseases Society of America (IDSA) guidelines and upholds the CDC’s core stewardship elements to the highest degree. Together with institutional liaisons and stewardship champions, we provide aggregate data on antimicrobial resistance and microbiology, and promote antimicrobial prescribing best practices. Montefiore Einstein Stewardship members have published in the areas of rapid diagnostic technology and stewardship, quality improvement initiatives to improve community acquired pneumonia management, stewardship and Clostridium difficile infection, stewardship and HIV, stewardship in outpatient parenteral antibiotic therapy, carbapenem-resistant Klebsiella and other enterobacteriaceae, medical education in stewardship and infection prevention, and stewardship in special populations. The Antimicrobial Stewardship Program at Montefiore is featured by the Joint Commission ASP role in Montefiore Einstein’s COVID-19 Pandemic Response The Montefiore Einstein Antimicrobial Stewardship Program has served as a fundamental pillar of the health system’s COVID19 pandemic response. Key stewardship pandemic response functions include: Experimental treatments guideline development Expanded access protocol development Diagnostic stewardship of SARS-CoV-2 PCR and serology Clinical trial assistance (remdesivir, convalescent plasma) Development of empiric antibiotic protocols Data analytics, surveillance, and reporting for crucial COVID-19 metrics Access ASP COVID-19 empiric antibiotic guidelines Featured Publications And News Articles Related to Asps and The Covid 19 Pandemic See More CDC - July 17, 2020 Detection and Genetic Characterization of Community-Based SARS-CoV-2 Infections SpringerLink - July 3, 2020 Antimicrobial Stewardship at the Core of COVID-19 Response Efforts: Implications for Sustaining and Building Programs PubMed - June 2020 Involving antimicrobial stewardship programs in COVID-19 response efforts: All hands on deck Sanford Guide: Montefiore Einstein has partnered with the Sanford Guide on an ID and antimicrobial web resource and smartphone app. This is free for all Montefiore.org or Einstein.edu users. Featured content includes hospital and ICU antibiograms, empiric antibiotic guidelines, renal dosing guidelines, malaria protocols, Infection Prevention isolation guidelines, and much more. Go to https://webedition.sanfordguide.com/en on your work desktop. You can then register for the smartphone app from here Clinical Guidelines, Protocols, Antibiograms Antibiograms Antibiogram-CHAM, Moses, Wakefield, Weiler, Outpatient, Moses ICU, Wakefield ICU, Weiler ICU CHAM Moses Outpatient Wakefield Weiler ICU-specific Antibiograms Moses ICU Wakefield ICU Weiler ICU Syndrome-specific guidelines Syndrome Specific Guidelines All Campuses Montefiore Respiratory Infection Guideline Transplant Allo-auto HSCT prophylaxis Hematologic malignancy prophylaxis Letermovir Protocol Neutropenic Fever Guideline Car-T Cell Therapy Infectious Disease Prophylaxis Protocol Car-T Cell Therapy Vaccine Protocol Malaria Malaria Treatment Guideline Plasmodium Falciparum algorithm Non-Plasmodium Falciparum algorithm Stewardship Lectures for Skilled Nursing Facilities Video: RTI Webinar Video: SSTI Webinar Video: UTI Webinar Syndrome Based Microbiology Respiratory specimens from ICU Microbiology cultures of diabetic foot infection Other Resources Aerosolized Antimicrobials Policy and Procedure Antimicrobial Restriction Policy C difficile Treatment Guidelines Extended Infusion Dosing Guidelines GI Pathogen Panel Treatment Recommendations HIV Antiretroviral Medications NYC Antibiogram Procalcitonin Guidelines Renal Dosing SSI Ortho Protocol Surgery Prophylaxis Montefiore Einstein Stewardship Team Priya Nori, MD Medical Director of ASP and OPAT 718.920.4622 Montefiore Medical Center Belinda Ostrowsky, MD Founding Member 212.417.5544 Centers for Disease Control and Prevention Yi Guo, PharmD, BCIDP Pharmacy Director of Antimicrobial Stewardship Program 718.920.3751 Montefiore Medical Center Kelsie Cowman, MPH Stewardship Program Analyst 718.920.8029 Montefiore Medical Center Rachel Bartash, MD ASP in Special Populations 718.920.7700 Montefiore Medical Center Hongkai (Jack) Bao, PharmD, BCIDP Wakefield Campus 718.920.9330 Wakefield Campus Philip J. Lee, PharmD, BCPS ID/ASP CHAM Campus 718.741.2093 Children's Hospital, Montefiore Medical Center Gregory D. Weston, MD ID/ASP CCM-ID, IPC 718.920.2961 Montefiore Medical Center Mei Chang, PharmD, BCPS, BCCCP, BCIDP Pharmacy Manager 718.904.2253 Weiler Campus Terrence McSweeney, PharmD Pharmacy Manager 718.904.2708 Moses Campus Our Partners and Champions ID Division Liise-anne Pirofski, MD Chief, Division of Infectious Diseases Professor, Departments of Medicine (ID) and Microbiology & Immunology Essay: Life as an Infectious Diseases Physician Scientist: Science is Humanity’s Lifeline Publiations: (PubMed) Video: Einstein On: Antibotic Resistance; Antibiotic Stewardship: Changing the Culture https://youtu.be/2FVaQWuJC3c Microbiology Laboratory Wendy A. Szymczak, PhD Interim Director, Microbiology Laboratory Assistant Professor, Department of Pathology 718.920.4585 Montefiore Medical Center Philip Gialanella, BS, MS Interim Director, Microbiology Laboratory Assistant Professor, Department of Pathology 718.920.4188 pgialane@montefiore.org Montefiore Medical Center Infection Prevention and Control Gregory D. Weston, MD Infection Control, Moses Campus 718.920.2961 Montefiore Medical Center Inessa Gendlina, MD, PhD Infection Control, Moses Campus Ruchika Jain, MD Infection Control, Moses Campus Marilou Corpuz, MD Infection Control, Wakefield Campus Distinctions 2015-2016 Belinda Ostrowsky, MD 2016 Montefiore President's Award Priya Nori, MD Rising Star Award IDSA Medical Education Community of Practice, March 2022 Featured Educator Yi Guo, PharmD, BCIDP President of New York City Society of Health-system Pharmacists 2015-2016 Publications See All Publications Phytoremediation with kenaf (Hibiscus cannabinus L.) for cadmium-contaminated paddy soil in southern China: translocation, uptake, and assessment of cultivars Correction: Translational Modeling Predicts Efficacious Therapeutic Dosing Range of Teclistamab for Multiple Myeloma Modulation of laser damage by temporal shaping of double picosecond pulses Hole transport free carbon-based high thermal stability CsPbI1.2Br1.8 solar cells with an amorphous InGaZnO4 electron transport layer Structure analysis of lipid A species in Vibrio parahaemolyticus by constructing mutants lacking multiple secondary acyltransferases of lipid A
Antimicrobial Stewardship Program Our Mission To promote responsible and rational antimicrobial use by providers and patients alike To increase public health awareness about the threat of antimicrobial resistance To educate and empower clinical champions of antimicrobial stewardship To mentor stewardship leaders of tomorrow Resources Global Health Center Website NYC Department of Health Center for Disease Control More ID Resources What We Do As much as 50 percent of all antibiotic prescriptions are considered “inappropriate.” Experts consider antibiotics to be “inappropriate” when they are prescribed for non-bacterial infections, the spectrum of coverage is overly broad and potentially toxic, the dose is inaccurate for the host, or the intended duration is too long. “Inappropriateness” contributes directly to medication side effects, interactions, kidney and liver dysfunction, Clostridium difficile infections (CDI), and the emergence of multi-drug resistant pathogens. As early as 1945, Sir Alexander Fleming, the pioneer of the antibiotic era, warned that the overuse of antibiotics “clearly drives the evolution of resistance.” In 2014 President Obama introduced multi-drug resistance as a national security issue and recognized antimicrobial stewardship as the first line of defense. In 2016, the Centers for Medicare and Medicaid Services and the Joint Commission joined the narrative by emphasizing the need for stewardship across the healthcare continuum (inpatient and ambulatory sites). Mainstream recognition of the scope of antibiotic resistance allows us to implement meaningful solutions. CDC’s “Core Elements of Hospital Antibiotic Stewardship Programs” provide a framework for successful ASP development. These include: Leadership Commitment Action Education Accountability Tracking Drug Expertise Reporting In July 2008, Montefiore Medical Center initiated a multifaceted interdisciplinary stewardship program to educate, support, and advise practicing physicians throughout its extensive Bronx network of hospitals, ambulatory care clinics, and nursing homes. Stewardship operations occur at each of our academic campuses (Moses, Einstein, and Wakefield) and the Children’s Hospital at Montefiore (CHAM). Our strategic stewardship plan is adapted from the Infectious Diseases Society of America (IDSA) guidelines and upholds the CDC’s core stewardship elements to the highest degree. Together with institutional liaisons and stewardship champions, we provide aggregate data on antimicrobial resistance and microbiology, and promote antimicrobial prescribing best practices. Montefiore Einstein Stewardship members have published in the areas of rapid diagnostic technology and stewardship, quality improvement initiatives to improve community acquired pneumonia management, stewardship and Clostridium difficile infection, stewardship and HIV, stewardship in outpatient parenteral antibiotic therapy, carbapenem-resistant Klebsiella and other enterobacteriaceae, medical education in stewardship and infection prevention, and stewardship in special populations. The Antimicrobial Stewardship Program at Montefiore is featured by the Joint Commission ASP role in Montefiore Einstein’s COVID-19 Pandemic Response The Montefiore Einstein Antimicrobial Stewardship Program has served as a fundamental pillar of the health system’s COVID19 pandemic response. Key stewardship pandemic response functions include: Experimental treatments guideline development Expanded access protocol development Diagnostic stewardship of SARS-CoV-2 PCR and serology Clinical trial assistance (remdesivir, convalescent plasma) Development of empiric antibiotic protocols Data analytics, surveillance, and reporting for crucial COVID-19 metrics Access ASP COVID-19 empiric antibiotic guidelines Featured Publications And News Articles Related to Asps and The Covid 19 Pandemic See More CDC - July 17, 2020 Detection and Genetic Characterization of Community-Based SARS-CoV-2 Infections SpringerLink - July 3, 2020 Antimicrobial Stewardship at the Core of COVID-19 Response Efforts: Implications for Sustaining and Building Programs PubMed - June 2020 Involving antimicrobial stewardship programs in COVID-19 response efforts: All hands on deck Sanford Guide: Montefiore Einstein has partnered with the Sanford Guide on an ID and antimicrobial web resource and smartphone app. This is free for all Montefiore.org or Einstein.edu users. Featured content includes hospital and ICU antibiograms, empiric antibiotic guidelines, renal dosing guidelines, malaria protocols, Infection Prevention isolation guidelines, and much more. Go to https://webedition.sanfordguide.com/en on your work desktop. You can then register for the smartphone app from here Clinical Guidelines, Protocols, Antibiograms Antibiograms Antibiogram-CHAM, Moses, Wakefield, Weiler, Outpatient, Moses ICU, Wakefield ICU, Weiler ICU CHAM Moses Outpatient Wakefield Weiler ICU-specific Antibiograms Moses ICU Wakefield ICU Weiler ICU Syndrome-specific guidelines Syndrome Specific Guidelines All Campuses Montefiore Respiratory Infection Guideline Transplant Allo-auto HSCT prophylaxis Hematologic malignancy prophylaxis Letermovir Protocol Neutropenic Fever Guideline Car-T Cell Therapy Infectious Disease Prophylaxis Protocol Car-T Cell Therapy Vaccine Protocol Malaria Malaria Treatment Guideline Plasmodium Falciparum algorithm Non-Plasmodium Falciparum algorithm Stewardship Lectures for Skilled Nursing Facilities Video: RTI Webinar Video: SSTI Webinar Video: UTI Webinar Syndrome Based Microbiology Respiratory specimens from ICU Microbiology cultures of diabetic foot infection Other Resources Aerosolized Antimicrobials Policy and Procedure Antimicrobial Restriction Policy C difficile Treatment Guidelines Extended Infusion Dosing Guidelines GI Pathogen Panel Treatment Recommendations HIV Antiretroviral Medications NYC Antibiogram Procalcitonin Guidelines Renal Dosing SSI Ortho Protocol Surgery Prophylaxis Montefiore Einstein Stewardship Team Priya Nori, MD Medical Director of ASP and OPAT 718.920.4622 Montefiore Medical Center Belinda Ostrowsky, MD Founding Member 212.417.5544 Centers for Disease Control and Prevention Yi Guo, PharmD, BCIDP Pharmacy Director of Antimicrobial Stewardship Program 718.920.3751 Montefiore Medical Center Kelsie Cowman, MPH Stewardship Program Analyst 718.920.8029 Montefiore Medical Center Rachel Bartash, MD ASP in Special Populations 718.920.7700 Montefiore Medical Center Hongkai (Jack) Bao, PharmD, BCIDP Wakefield Campus 718.920.9330 Wakefield Campus Philip J. Lee, PharmD, BCPS ID/ASP CHAM Campus 718.741.2093 Children's Hospital, Montefiore Medical Center Gregory D. Weston, MD ID/ASP CCM-ID, IPC 718.920.2961 Montefiore Medical Center Mei Chang, PharmD, BCPS, BCCCP, BCIDP Pharmacy Manager 718.904.2253 Weiler Campus Terrence McSweeney, PharmD Pharmacy Manager 718.904.2708 Moses Campus Our Partners and Champions ID Division Liise-anne Pirofski, MD Chief, Division of Infectious Diseases Professor, Departments of Medicine (ID) and Microbiology & Immunology Essay: Life as an Infectious Diseases Physician Scientist: Science is Humanity’s Lifeline Publiations: (PubMed) Video: Einstein On: Antibotic Resistance; Antibiotic Stewardship: Changing the Culture https://youtu.be/2FVaQWuJC3c Microbiology Laboratory Wendy A. Szymczak, PhD Interim Director, Microbiology Laboratory Assistant Professor, Department of Pathology 718.920.4585 Montefiore Medical Center Philip Gialanella, BS, MS Interim Director, Microbiology Laboratory Assistant Professor, Department of Pathology 718.920.4188 pgialane@montefiore.org Montefiore Medical Center Infection Prevention and Control Gregory D. Weston, MD Infection Control, Moses Campus 718.920.2961 Montefiore Medical Center Inessa Gendlina, MD, PhD Infection Control, Moses Campus Ruchika Jain, MD Infection Control, Moses Campus Marilou Corpuz, MD Infection Control, Wakefield Campus Distinctions 2015-2016 Belinda Ostrowsky, MD 2016 Montefiore President's Award Priya Nori, MD Rising Star Award IDSA Medical Education Community of Practice, March 2022 Featured Educator Yi Guo, PharmD, BCIDP President of New York City Society of Health-system Pharmacists 2015-2016 Publications See All Publications Phytoremediation with kenaf (Hibiscus cannabinus L.) for cadmium-contaminated paddy soil in southern China: translocation, uptake, and assessment of cultivars Correction: Translational Modeling Predicts Efficacious Therapeutic Dosing Range of Teclistamab for Multiple Myeloma Modulation of laser damage by temporal shaping of double picosecond pulses Hole transport free carbon-based high thermal stability CsPbI1.2Br1.8 solar cells with an amorphous InGaZnO4 electron transport layer Structure analysis of lipid A species in Vibrio parahaemolyticus by constructing mutants lacking multiple secondary acyltransferases of lipid A
