Antimicrobial Stewardship: Optimization of Antibiotic Practices

Stan Deresinski, Stanford University

Internet Enduring Material Sponsored by: Stanford University School of Medicine // Presented by: The Division of Infectious Diseases in the Department of Medicine at Stanford University School of Medicine

Presented by:
    The Division of Infectious Diseases in the Department of Medicine at Stanford University School of Medicine

 >>>> NEWS FLASH ! <<<

This course is now OPEN for ENROLLMENT

Dates & Durations:
  • Ongoing registration for this self-paced course is available until
    November 22nd , 2015
  • Estimated Time to Complete: Six hours
  • CME Processing Fee: $20
  • CME Credits Offered: 6.0

To Obtain CME Credits*:
  • Review the information below, then click the Join for Free button to register and access the course material. If you have already registered for this activity, click the Go to Course button.
  • View all of the videos, then follow the link at the end of the last video to register for CME and pay the $20 CME Processing Fee.
  • Complete the CME course evaluation, CME post-assessment and CME post-test.
  • 75% of case-based post-test questions must be answered correctly in order to receive a CME certificate that will be emailed to the address provided within 2 weeks from the date of receipt.
  • Learners will have 3 attempts to pass the post-test.
  • The Stanford University School of Medicine designates this enduring material for a maximum of 6.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • *Participation in discussion forums, chat rooms, homework assignments and additional readings are not certified for AMA PRA Category 1 Credit™.

Intended Audience
This course will offer a practical approach to prescribing antibiotic therapy and development of antimicrobial stewardship to physicians and pharmacists across all specialties and settings.

Course Description
Antibiotics are among the most frequently prescribed classes of drugs and it is estimated that approximately 50% of antibiotic use, in both the outpatient and inpatient settings, is inappropriate. At the same time, in contrast to any other class of drugs, every antibiotic use has a potential public health consequence – inappropriate use may not harm only the individual patient, but contributes to societal harm by exerting an unnecessary selective pressure that may lead to antibiotic resistance among bacteria. This course will offer a number of illustrative cases, recognizable to the practicing physician in his or her practice to engage the learners in the thought processes that lead to optimal decision making, improved outcomes of individual patients, and harm reduction vis-a-vis the bacterial ecology.

Learning Objectives
  • Develop skills to apply IDSA guidelines in treating common infections such as acute rhino-sinusitis.
  • Apply evidence based antibiotic management to treat sepsis.
  • Implement principles of antimicrobial stewardship when providing care to special populations and in various settings.
  • Apply evidence based antibiotic management to surgical patients requiring antibiotic prophylaxis.
  • Apply evidence based antibiotic stewardship program in the outpatient setting.
Accreditation Statement
The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement
The Stanford University School of Medicine designates this enduring material for a maximum of 6.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The following Course Director has indicated that he has a relationship with industry to disclose relative to the content of this activity during the planning phase. This relationship no longer exists and as a faculty member he has nothing to disclose:
Stan Deresinski, MD FIDSA
Pfizer: Advisory Board member
Clinical Professor, Medicine
Infectious Disease
Antimicrobial Stewardship Program Medical Director 
Stanford University

The following speakers have indicated that they have a relationship with industry to disclose relative to the content of this activity:
Professor of Internal Medicine
Head ID Section
Northeastern Ohio Universities Colleges of Medicine and Pharmacy
Rootstown, Ohio
Chief, Infectious Disease Service
Summa Health System Akron, Ohio

Astellas Pharma, Cubust, Durata, GSK, Merck: Advisory Board member
Pfizer, Boehringer Ingelheim, Gilead, Tobotec: Research
Bayer AG, DalishSankyo, Forest: Consulting

Jason Newland, MD
Medical Director, Patient Safety and System Reliability; Associate Professor of Pediatrics,
University of Missouri-Kansas City School of Medicine
Children’s Mercy Hospital Kansas City

Pfizer: Research

The following planners, speakers and authors have indicated that they have no relationships with industry to disclose relative to the content of this activity 
Stan Deresinski, MD FIDSA
Clinical Professor, Medicine
Infectious Disease
Antimicrobial Stewardship Program Medical Director
Stanford University

Lucy Tompkins, MD PhD FIDSA
Hospital Epidemiologist
Infectious Disease
Co-Course Director, Content Reviewer, and Speaker

Elizabeth Robilotti, MD MPH
Instructor, Infectious Diseases
Antimicrobial Stewardship Program 
Principal Planner and Speaker

Emily Mui, PharmD, BCPS
Infectious Disease Pharmacist
Antimicrobial Stewardship Program
Stanford University

Niaz Banaei MD
Assistant Professor of Pathology and Medicine (Infectious Diseases)
Director, Clinical Microbiology Laboratory

Anne Liu MD
Clinical Assistant Professor, Pediatrics - Immunology and Allergy
Clinical Assistant Professor, Medicine - Infectious Diseases
Pediatric Allergy & Immunology Clinic

Kavita Trivedi MD
Public Health Medical Officer
Healthcare Associated Infections Program
Center for Health Care Quality
California Department of Public Health
Collaborator and Speaker

Sasha Madison, MPH 
Manager, Infection Prevention and Control Department 
Stanford Hospital and Clinics

R. Michael Buckley, M.D.
Executive Director
Pennsylvania Hospital
Professor of Clinical Medicine
Perelman School of Medicine
University of Pennsylvania

Conan MacDougall, PharmD, MAS, BCPS
Associate Professor of Clinical Pharmacy
University of California San Francisco School of Pharmacy

Kristi Kuper, PharmD, BCPS
GSPC Clinical Pharmacy Manager
VHA Performance Services

Preeti N. Malani, MD, MSJ
Associate Professor of Internal Medicine
Divisions of Infectious Diseases and Geriatric and Palliative Medicine
University of Michigan Medical School
Veterans Affairs Ann Arbor Healthcare System

Technical Design and Development
Mike McAuliffe
Stanford EdTech 
Pauline Becker
Stanford EdTech 
Relly Brandman

Contact Information
For further information regarding the content, CME credit or if you experience any technical difficulties with this enduring material please send an email to

Commercial Support Acknowledgement
Stanford University School of Medicine has received and has used undesignated program funding from Pfizer, Inc. to facilitate the development of innovative CME activities designed to enhance physician competence and performance and to implement advanced technology. A portion of this funding supports this activity.

California Assembly Bill 1195 – Cultural and Linguistic Competency
California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect July 1, 2006, to encourage physicians and surgeons, CME providers in the State of California and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws. You are encouraged to visit the portal:


Terms of Use


Unit 1: The Basic Clinical Science of Antimicrobial Use:

    • Introduction to Antimicrobial Stewardship
    • The Story of Penicillin
    • Principles of Antimicrobial Use
    • Principles of Antibacterial Pharmacokinetics & Pharmacodynamics
    • Sepsis Case Study: Application of Principles
    • Introduction to Bacterial Resistance
    • Antibiotic Resistance: Gram Positive Resistance Beyond PCN
    • Antimicrobial Resistance: Mycobacterial, Viral and Fungal Resistant 
    • Acute Bacterial Skin and Skin Structure Infections
    • Antibiotic Allergies
    • Cystitis
    • Upper Respiratory Tract Infections
    • Community Acquired Pneumonia in the Outpatient Setting

Unit 2: Practical Aspects of Antimicrobial Stewardship and Application to Special Circumstances and Populations:

    • Antibiotic Stewardship Interventions
    • Convincing the C-Suite
    • Measurements and Metrics
    • Incorporating Clinical Decision Support into Stewardship
    • Diagnostics 
    • Infection Prevention and Antimicrobial Stewardship
    • Surgical Site Prophylaxis 
    • Out-Patient Parenteral Therapy
    • Antimicrobial Stewardship in Pediatrics 
    • Antimicrobial Stewardship and Transplant Infectious Diseases
    • Antimicrobial Stewardship: Long-term Care
    • Antimicrobial Use at the end of life
    • Conclusion

Course Format

Videos by leading experts in the field will provide up to date scientific information and case studies will engage learners in the educational process. Quizzes will facilitate better integration of the information into strategies to apply in practice. 


System Requirements
You will need a reasonably reliable Internet connection to access course resources and to watch (or download) lecture videos. Please note that while most features of the Coursera site will load and function on a mobile device (such as a smartphone or a tablet), Coursera does not officially support these devices and cannot guarantee full site functionality if you are accessing Coursera from a mobile device. More information available via Coursera’s help page.

Can I get a Statement of Accomplishment for completing this course?
Yes. While this course is designed as a Continuing Medical Education (CME) course, non-CME learners can earn a Statement of Accomplishment by completing both the post-course survey and the post-course exam with at least 75% of the maximum possible score. Please review the Coursera Course Logistics page within the course for more details.
  • 22 November 2013, 105 weeks
Course properties:
  • Free:
  • Paid:
  • Certificate:
  • MOOC:
  • Video:
  • Audio:
  • Email-course:
  • Language: English Gb


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