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Antimicrobial Stewardship

It has been recognized for nearly five decades that up to 50 percent of antimicrobial use is inappropriate. The consequences of inappropriate use include increased microbial resistance, toxicity, hospital lengths of stay, as well as increased costs to patients, hospitals and payors. Efforts to bring improved appropriate use and reduce resistance have come from many stakeholders,  including professional societies; government and accrediting organizations; pharmaceutical companies; and a number of state public and private initiatives. The goal of all these public and private initiatives is to challenge practitioners to re-evaluate their practices and implement institution-wide policies and procedures regarding appropriate antimicrobial utilization. Antimicrobial stewardship programs (ASPs) are the current standard for meeting these challenges. Such programs seek to optimize antimicrobial selection, dosing, timing and durations of therapy in order to reduce resistance, reduce toxicities and enhance patient outcomes.1

The greatest success can be achieved with an institution-wide comprehensive antimicrobial management program that has a multidisciplinary approach and focuses on appropriate selection, dosing, route and duration of antimicrobial therapy.2

  1. IDSA-SHEA Guidelines for Institutional Programs for Antimicrobial Stewardship Clinical Infectious Diseases. 2007;44(15 Jan):159-177 http://www.journals.uchicago.edu/doi/pdf/10.1086/510393
  2. Society of Infectious Diseases Pharmacist review and recommendations for implementing antimicrobial stewardship programs. Pharmacotherapy. 2004;24(7):896-908.

Antimicrobial Stewardship Tools