Curr Treat Options Infect Dis (2018) 10:281–290
Antimicrobial Stewardship (A Pakyz, Section Editor)
on the Antimicrobial Timeout:
Where Does It Stand and What
Is Its Future?
Patrick Kinn, PharmD
Michael Postelnick, RPh
Stephanie Schroeder, PharmD
Lucas T Schulz, PharmD
University of Wisconsin Health, 600 Highland Avenue, Madison, WI, USA
Northwestern Memorial Hospital, Chicago, IL, USA
Fairview Pharmacy Services, Minneapolis, MN, USA
Published online: 7 February 2018
* Springer Science+Business Media, LLC, part of Springer Nature 2018
This article is part of the Topical Collection on Antimicrobial Stewardship
for Disease Control and Prevention
Purpose of review To summarize literature describing the antimicrobial timeout, its
rationale for use as an antimicrobial stewardship program (ASP) strategy, and its potential
role in overall ASP strategy.
Recent findings Studies have correlated a formal antimicrobial timeout process with
increased rates of therapy modification and reductions in use of select broad-spectrum
antibiotics. There remains a need for further guidance on how to best implement a system-
wide antimicrobial timeout.
Summary The antimicrobial timeout is a stewardship tool that protocolizes review of objective
clinical data and encourages stewardship practices, such as antimicrobial de-escalation,
parenteral-to-enteral route interchange, dose optimization, and appropriate duration. Logical-
ly, the timeout encourages thoughtful reassessment of antimicrobial therapy and should
produce positive antimicrobial utilization outcomes; however, clinical effectiveness data is
conflicting, with more research necessary. Institutions should implement standardized process-
es by which their clinical services evaluate and thoughtfully assess use of antimicrobials among
their patients whether they are being treated in the hospital or possibly, at home. Implemen-
tation of a formal timeout may allow a greater sharing of responsibility for antimicrobial
stewardship among formal members of stewardship programs and front-line clinicians.