Mr. BC has been admitted to hospital with urosepsis, recently treated with oral amoxicillin-clavulanic acid by his general practitioner (“GP”). His past medical history includes long term foley, from atonic bladder, recurrent UTI previously involving Extended-spectrum beta-lactamases (“ESBL”) producing Enterobacteriaceae, Type II DM, hypertension, Parkinson's Disease. 

a) The treating team asked for your advice on the appropriate empirical treatment to start for Mr. BC for his urosepsis. What is your choice of antimicrobial for Mr. BC? Explain your answers. (3 marks) 

b) Discuss the factors that need to be considered for choosing the appropriate empirical treatment for Mr. BC. (4 marks) 

c) Infections involving multi-drug resistant organisms (“MDRO") are becoming more prevalent in health care settings. Antibiotic stewardship Program (“ASP) has been utilized as one of the strategies to combat MDRO. Discuss what antibiotic stewardship program is and how ASP can improve clinical outcomes and optimize patient care in the context of managing infection involving MDROs. Include examples of pharmacists' role in your discussion. (8 marks)