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Volume 6
Journal of Infectious Diseases and Therapy
ISSN: 2332-0877
Infection Congress 2018
March 01-02, 2018
March 01-02, 2018 Berlin, Germany
5
th
International Congress on
INFECTIOUS DISEASES
State of the art antimicrobial stewardship in immunocompromized hosts
Alla Paskovaty
Memorial Sloan Ketterning Cancer Center, USA
I
nfections cause significant morbidity and mortality in patients with hematologic or solid tumor malignancies. Susceptibility
to infection can occur from the malignancy itself, but the primary risk factor is immunosuppression from cancer treatment
(e.g., cytotoxic chemotherapy, radiation, combined modality). Administration of broad antimicrobial therapy for empertic
treatment of febrile neutropenia is recommended by national guidelines.. This strategy however needs to be balanced
against the desire to continue broad-spectrum therapy for prolonged durations during the patient’s hospitalization. Overuse
of anitibiotics leads to antimicroibal resistance, higher healthcare costs, and poor health oucomes due to antimicrobial side
effects. Immunocompromized paitents are at high risk for being colonized with multidrug resistant organisms, and are at high
risk for morbidity and mortality due to such organisms. In addition, cancer patients are at higher risk for drug-related toxicity,
due to drug-drug interactions between certain antimicrobials, cancer chemotherapy and supportive therapy.
To mitigate the overuse of antibiotics, multidisciplinary approach to atimicriboal steardship needs to be employed. Modern
antimicrobial stewardship programs use tactics such as, pre-prescribing review and approval and/or de-escalation: either by
changing the antimicrobial agent to something narrower or by stopping an antimicrobial combination or both. To aid in
the process, successful stewardship allows collaboration between several departments: Hospital administration, Microbiology,
Pharmacy, Departments of Medicine, Oncology and Infection control, Information Technology among a few. Innovative
approaches in molecular diagnostics allow antimicrobial stewardship to intevene earlier and with higher success rate. Current
technology allows for allerts during prescribing process, allowing for real-time antimicrobial stewardship interventions.
Immunocopromized patients present unique challenges for antimicrobial stewardship. This lecture identifies those challenges
and presents various strategies that employ up-todate technology and diagnostics to aid in the endavor.
Biography
Dr. Paskovaty, holds Doctror of Pharmacy degree from a prestigious Americal Univercity, Albany College of Pharmacy and has been employed for over 15 years
as an antimicrobial stewardship coordinator at a world renown cancer center in NYC: Memorial Sloan Kettering Cancer Center. She has been invited lecturer at
numerous local and international meetings, has published papers and book chapters on topic of Antimicrobial Stweardship.
paskovaa@mskcc.orgAlla Paskovaty, J Infect Dis Ther 2018, Volume 6
DOI: 10.4172/2332-0877-C1-038