Center for Antimicrobial Utilization, Stewardship, and Epidemiology (CAUSE)

CAUSE is charged with optimizing the utilization of antimicrobial agents to prevent or slow the emergence of resistance among microorganisms.

CAUSE is the antimicrobial stewardship program of Wake Forest Baptist Medical Center. Its main charge is to optimize the utilization of antimicrobial agents. CAUSE was developed in February 2000 as a joint program of the Section on Infectious Diseases and the Department of Pharmacy.

Program Goals and Objectives

Improve patient outcomes through improving the utilization of antimicrobial agents
Reduce the proportion of antimicrobial-resistant organisms in the hospital and community
Utilize pharmacodynamic principles to optimize antimicrobial dosing
Reduce adverse drug events and antimicrobial administration errors
Reduce hospital costs
Utilize continuous quality improvement principles to study and enhance the way antimicrobials are prescribed

Education and Training

Antimicrobial Stewardship

Implementation of Antimicrobial Stewardship should prevent or slow the emergence of resistance among microorganisms and subsequently reduce patient length of stay, adverse drug events, morbidity, mortality and direct and indirect attendant costs.

A National Crisis

Antimicrobial resistance is a substantial threat to public health in the United States. The improper, injudicious and overuse of antimicrobials by physicians, both in the inpatient and outpatient setting is, in part, responsible for the current crisis in antimicrobial resistance.

The extent of antimicrobial overuse is exemplified in the outpatient setting by the therapy of respiratory tract infections. Approximately 50% of upper respiratory tract infections and 80% of acute bronchitis are treated with antibiotics despite evidence that antibiotics have little impact in the resolution or outcome of these predominantly viral illnesses.

Antimicrobial overuse has contributed to the alarmingly rapid rise in the prevalence of antibiotic-resistant Streptococcus pneumoniae in the US. North Carolina, in fact, has some of the highest levels of S. pneumoniae drug resistance seen in this country.

Similarly, in the hospital and long-term care facility (LTC), antimicrobial resistant pathogens are responsible for infections in increasing numbers of patients, particularly in intensive care units. Infections due to these pathogens result in increased morbidity, mortality, length of hospital stay, and health care expenditure.

Technology Transfer and Commercialization

Research Focus Areas

Translation to Care

More Resources

Center for Antimicrobial Utilization, Stewardship, and Epidemiology (CAUSE)

Program Goals and Objectives

Treatment and Dosing Guidelines

Prior Authorization of Restricted Antimicrobials

Leadership and Faculty

Vera Parkhurst Luther, MD

Christopher A. Ohl, MD

Education and Training

A National Crisis