title: Specialist trainees on rotation cannot replace dedicated consultant clinicians for antimicrobial stewardship of specialty disciplines.
abstract: Our prospective-audit-and-feedback antimicrobial stewardship (AS) program for hematology and oncology inpatients was switched from one led by dedicated clinicians to a rotating team of infectious diseases trainees in order to provide learning opportunities and attempt a "de-escalation" of specialist input towards a more protocol-driven implementation. However, process indicators including the number of recommendations and recommendation acceptance rates fell significantly during the year, with accompanying increases in broad-spectrum antibiotic prescription. The trends were reversed only upon reverting to the original setup. Dedicated clinicians play a crucial role in AS programs involving immunocompromised patients. Structured training and adequate succession/contingency planning is critical for sustainability.
authors.affiliation: Department of Medicine, National University Health System, NUHS Tower Block Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore. liyang_hsu@yahoo.com.
authors.forename: Chay Leng
authors.initials: CL
authors.lastname: Yeo
authors.forename: Jia En
authors.initials: JE
authors.lastname: Wu
authors.forename: Gladys Wei-Teng
authors.initials: GW
authors.lastname: Chung
authors.forename: Douglas Su-Gin
authors.initials: DS
authors.lastname: Chan
authors.forename: Dale
authors.initials: D
authors.lastname: Fisher
authors.forename: Li Yang
authors.initials: LY
authors.lastname: Hsu