Pharmacy AI · Module 3 · Unit 2 · Practical 2

Antimicrobial Stewardship Ward Round

Aim — To select safe and effective antimicrobial therapy for a septic patient using the local antibiogram, then follow the patient across five days — de-escalating on culture results, switching to oral therapy and stopping at the right time.

Your patient

You are the antimicrobial stewardship pharmacist. A 74-year-old woman is admitted from a nursing home with suspected urosepsis. You will follow her for five days, and the decision you make on each day changes what you face on the next.

Day 1 is a probability judgement: cultures take 48 hours, so empirical therapy must be chosen from the local antibiogram, not from a textbook.
Day 3 the culture and sensitivities return. Broad-spectrum therapy that was correct on day 1 becomes wrong on day 3 if it is not narrowed.
Every day carries a Stewardship Index (spectrum, route and duration) and a Clinical Response that tracks the patient herself.
Under-treating harms this patient. Over-treating harms the next one — and both are scored.

At the end you see her outcome, and the collateral consequence of what you prescribed.

Assessment rubric

Assessment criteria	Marks
Cultures taken before the first dose	10
Empirical choice justified by the local antibiogram	25
Dose adjustment for renal function	15
De-escalation on culture results	25
IV-to-oral switch at the right moment	15
Stopping at the correct duration	10
Total	100

Pass 50. The Stewardship Index and Clinical Response are reported separately.

Achievement badges

🎯 Right First Time📉 De-escalator 💊 Oral Switch⏹ Stopped on Time🏅 Stewardship Champion

Join the ward round

Candidate name

Registration no.

Alizon Teaching Hospital · Medical Unit 3 · antimicrobial stewardship round

Stewardship report & patient outcome

Complete the five days to generate your report, then write and submit it below.