[Prudent antibiotic use in response to the antimicrobial resistance challenges]

Prudent antibiotic use in response to the antimicrobial resistance challenges. Appropriate antimicrobial use and hospital infection control are the two pillars on which control of antimicrobial resistance relies. Components of prudent antimicrobial prescribing in the hospital setting include : 1) an accurate microbiological diagnosis of the infection treated using appropriate microbiological samplings before initiating therapy, while avoiding treatment of patients only colonised ; 2) reappraisal of therapy at 48 to 72 h, considering de-escalation and considering PK/PD parameters; 3) reappraisal of therapy in between the 5th and 7th day, giving consideration to shortening the duration of therapy to the minimum effective length. Local epidemiology is also important to consider, especially in high-risk units. Antimicrobial stewardship teams have an important role to play in the overall fight against antimicrobial resistance in hospitals, notably regarding good prescribing of "critically important" antibiotics.