[ANTIBIOTIC STEWARDSHIP IN ISRAEL - WHERE ARE WE HEADED IN 2018?]

We live in an age where antibiotic resistant pathogens are common, and we see an increase in infections caused by multidrug resistant pathogens. This arises from the broad use of antibiotics, many times inappropriately, combined with slackening in recent years of new antibiotic development. This combination of events threatens the core of modern medical care, increasing the number of patients with resistant infections resulting in prolonged illness with high morbidity and mortality. Most antibiotics are not prescribed by infectious disease specialists and inappropriate antibiotic use habits foster increased resistance. When prescribing an antibiotic to a patient, the physician impacts the society and environment, as well as his patient, hence the critical need for implementing antibiotic stewardship programs. The incorporation of electronic medical records into medical care in the last decade provides effective opportunities for implementing antibiotic stewardship. In this review we present the elements of antibiotic stewardship and suggest different methods for Israeli medical organizations to implement an antibiotic stewardship program. There are many different interventions that may be applied, and each institution or organization must evaluate their unique environment and challenges and implement a program that has the best possibility to succeed. There is no single program that fits all. The programs must be led by Infectious Disease specialists and management must prioritize the resources needed and continuously stay involved to keep the agenda in the forefront, so we may lead a change in our healthcare system, which is critical for our health and for the future of modern medicine.