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Antimicrobial stewardship.

Neil Fishman1

  • 1Department of Healthcare Epidemiology and Infection Control, Antimicrobial Management Program, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104-4283, USA. neil.fishman@uphs.upenn.edu

The American Journal of Medicine
|June 1, 2006
PubMed
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Antimicrobial stewardship programs are crucial for preventing resistance by optimizing antibiotic use. Comprehensive, multidisciplinary approaches, including computer-assisted tools, are most effective in improving antibiotic selection and reducing infections caused by resistant bacteria.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Health Policy

Background:

  • Antimicrobial resistance is a growing threat, exacerbated by inappropriate antibiotic use (up to 50% in the US).
  • The pipeline for new antibiotics is limited, making the preservation of existing agents' effectiveness critical.
  • Effective antimicrobial stewardship is essential to combat resistance and improve patient outcomes.

Purpose of the Study:

  • To highlight the importance of antimicrobial stewardship in preventing antimicrobial resistance.
  • To discuss various strategies for improving antibiotic use.
  • To emphasize the benefits of a comprehensive, multidisciplinary stewardship program.

Main Methods:

  • Review of existing literature on antimicrobial stewardship strategies.

Related Experiment Videos

  • Discussion of various interventions like prescriber education, formulary restrictions, and computer-assisted programs.
  • Case example of the Hospital of the University of Pennsylvania's stewardship program.

    • Main Results:

    • Inappropriate antibiotic use creates significant pressure for the selection of resistant bacterial strains.
    • Comprehensive stewardship programs incorporating multiple strategies and interdisciplinary collaboration are most effective.
    • Computer-assisted software can aid in implementing these programs.
    • The University of Pennsylvania's program demonstrated improved antibiotic use, cure rates, and reduced costs.

    Conclusions:

    • Good antibiotic stewardship is vital for minimizing toxicity and preventing the emergence of resistant bacteria.
    • Available data suggest stewardship reduces rates of Clostridium difficile-associated diarrhea, resistant gram-negative bacilli, and vancomycin-resistant enterococci.
    • Multifaceted, multidisciplinary approaches are key to successful antimicrobial stewardship.