Antimicrobial stewardship programs in health care systems

Area of Science:

• Infectious Diseases
• Clinical Pharmacy
• Health Services Research

Background:

• Antimicrobial resistance is a growing global threat, necessitating optimized antimicrobial prescribing.
• Few new antimicrobial agents are in development, increasing the importance of stewardship.
• Hospital antimicrobial stewardship programs (ASPs) aim to improve patient outcomes and reduce costs.

Purpose of the Study:

• To outline the essential components and strategies for effective antimicrobial stewardship programs.
• To emphasize the role of multidisciplinary teams and administrative support in ASP success.
• To highlight the integration of clinical computer systems and novel strategies like antibiotic rotation.

Main Methods:

• Review of current understanding of antimicrobial use and resistance.
• Description of multidisciplinary team composition (physicians, pharmacists, microbiologists, infection control).
• Outline of strategies: prescriber education, formulary management, prescribing review with feedback, and antibiotic rotation.

Main Results:

• Clinical computer systems, particularly expert systems, can significantly aid ASP implementation at the point of care.
• Tailoring strategies to specific hospital needs and resources is crucial for program success.
• Multidisciplinary teams and administrative support are vital for effective antimicrobial stewardship.

Conclusions:

• Antimicrobial stewardship programs are critical for preserving the efficacy of existing antimicrobials.
• Successful ASPs require a comprehensive approach integrating education, formulary control, feedback, and technology.
• Hospitals must customize their stewardship strategies based on unique needs and available resources.