Antibiotic Stewardship Sample Policies

Below is a collection of sample policies and procedures that facility administrators may use to effectively implement the Antibiotic Stewardship Program within their clinic or hospital. The available policies cover a wide breadth of topics, including:

  • Sepsis management protocols
  • Renal dosing program guidelines
  • Antibiotic Stewardship infection control policies and tools

  • Policy Templates

    Policy Templates

    Sample Antibiotic Stewardship Policy

    A sample organization-wide antibiotic stewardship policy that includes measures of success.

    TAGS: Clinical, ABS, Infection, Control, Physician

  • Policy Templates

    Policy Templates

    Sample 2 Antibiotic Stewardship Policy

    A sample organization-wide antibiotic stewardship policy that incorporates a Physician Champion.

    TAGS: Clinical, Practice, Infection, Policy

  • Policy Templates

    Policy Templates

    Sample 3 Antibiotic Stewardship Policy

    A sample organization-wide antibiotic stewardship policy.

    TAGS: Clinical, Practice, Prevention, Infection, ABS

  • Assessment tools

    Assessment tools

    Medication Tracking Log

    A sample tool that can be used to track the use of antibiotics in your organization.

    TAGS: Tracking, Clinical, Practice, Prevention, Physician, ABS

  • Flyer/Sign/Poster

    Flyer/Sign/Poster

    Antibiotic Soft Stop Order Notice

    A tool that be placed on medical records to prompt the physician to either discontinue or reorder antibiotics after 14 days.

    TAGS: Antibiotic, Clinical, Infection, ABS, Practice, Prevention

  • Policy Templates

    Policy Templates

    Antibiotic Time Out

    A sample policy for re-evaluating the need for continuation of an antibiotic.

    TAGS: Clinical, Practice, Infection, Prevention, Antibiotic, Time, Control

  • Policy Templates

    Policy Templates

    Extended Infusion Auto-substitution for Zosyn

    A sample policy to guide pharmacy dosing of Zosyn.

    TAGS: Clinical, Practice, Prevention, ABS, Infusion, Infection

  • Guidelines/Recommendations

    Guidelines/Recommendations

    Guidance on Contract Language

    Sample language that can be used in a contract with an Infectious Disease Physician to oversee Antibiotic Stewardship program.

    TAGS: Guidance, Contract, Clinical, Practice, Infection, Prevention, Physician, Office, Control

  • Policy Templates

    Policy Templates

    IV to PO Conversion Protocol

    Sample IV to PO conversion protocol to facilitate transition of IV medications to oral.

    TAGS: Clinical, Practice, Infection, Prevention, Control, IV, ABS

  • Assessment tools

    Assessment tools

    LIP Reassessment of Volume Status and Tissue Perfusion

    Tool to facilitate the volume status and tissue perfusion reassessment 6 hours after a patient presents in septic shock.

    TAGS: Clinical, Infection, Medical, Prevention, Practice, LIP, ABS

  • Policy Templates

    Policy Templates

    Renal Dosing Clarification Order

    A sample renal dosing clarification order that can be used by pharmacist when adjusting doses per an approved dosing program.

    TAGS: Clinical, Infection, Quality, Prevention, Control, MEC, ABS, Renal

  • Assessment tools

    Assessment tools

    Pharmacy Rounding Form

    Sample tool that can be used by pharmacist during patient rounds.

    TAGS: Clinical, Practice, Infection, Pharmacy, ABS, Prevention, Control

  • Policy Templates

    Policy Templates

    Sample Physician Order set for Pneumonia

    Sample physician order set for pneumonia. These orders are designed according to evidence-based practice and with antibiotic stewardship in mind.

    TAGS: Clinical, Practice, Infection, Prevention, Medical, Physician

  • Policy Templates

    Policy Templates

    Sample Physician Order set for Pneumonia/Sepsis

    Sample physician order set for pneumonia/sepsis. These orders are designed according to evidence-based practice and with antibiotic stewardship in mind.

    TAGS: Sepsis, Clinical, Practice, Prevention, Physician, Control, Infection

  • Policy Templates

    Policy Templates

    Sample Antibiotic Review Policy

    A sample policy that describes the process of pharmacy review of organizational antibiotic use.

    TAGS: Clinical, Infection, Physician, Quality, Prevention, Control, Practice, ABS, Policy

  • Policy Templates

    Policy Templates

    Sample Policy for Protected Antimicrobials

    Sample policy describing review of use of antimicrobials that are on the restricted use list.

    TAGS: Clinical, Infection, Prevention, Practice, Control, Protected, ABS

  • Policy Templates

    Policy Templates

    Renal Dosing Program

    Sample policy that provides clinical directive for renal dose adjustments for adults based on the degree of renal impairment.

    TAGS: Clinical, Infection, Practice, Renal, Dosing, Program, Medical, Staff, ABS

  • Policy Templates

    Policy Templates

    Renal Dosing Protocol

    Detailed sample protocol for renal adjustments on specific medications.

    TAGS: Renal, Dosing, Protocol, Clinical, Practice, Infection, Medical, Prevention, Control, ABS

  • Policy Templates

    Policy Templates

    Sample Sepsis Physician Order Set

    Sample physician order set for sepsis. These orders are designed according to evidence-based practice and with antibiotic stewardship in mind.

    TAGS: Clinical, Infection, Practice, Prevention, Control, Medical, ABS, Sepsis, Management