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Antimicrobial stewardship.

Neil Fishman1

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

American Journal of Infection Control
|July 4, 2006
PubMed
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Antimicrobial stewardship programs are crucial for preventing antibiotic resistance by optimizing drug use. Comprehensive, multidisciplinary approaches, including computer-assisted tools, are most effective in improving antibiotic selection and reducing resistance.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Clinical Pharmacy

Background:

  • Antimicrobial resistance is a growing threat, exacerbated by inappropriate antibiotic use, which occurs in up to 50% of cases in the US.
  • The pipeline for new antibiotics is limited, making the preservation of current agents' effectiveness a priority.
  • 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 and their potential impact.
  • To emphasize the need for comprehensive, multidisciplinary stewardship programs.

Main Methods:

  • Review of existing strategies for improving antibiotic use, including prescriber education, formulary restrictions, and computer-assisted programs.

Related Experiment Videos

  • Examination of the role of multifaceted, collaborative approaches within healthcare institutions.
  • Case example of the University of Pennsylvania's antimicrobial 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 likely most effective.
    • The University of Pennsylvania's program demonstrated improvements in antibiotic use appropriateness, cure rates, and cost reduction.

    Conclusions:

    • While rigorous data on stewardship's impact on resistance emergence are limited, available evidence suggests it reduces rates of C. difficile, resistant gram-negative bacilli, and VRE.
    • Computer-assisted software may be particularly useful in implementing comprehensive stewardship programs.
    • A multifaceted, multidisciplinary approach is key to successful antimicrobial stewardship and combating resistance.