Antibiotics and adverse events: the role of antimicrobial stewardship programs in 'doing no harm'

Area of Science:

• Infectious Diseases
• Public Health
• Pharmacology

Background:

• Antimicrobial resistance (AMR) is a growing global crisis, projected to cause over 10 million deaths annually by 2050.
• Antibiotic overuse and misuse, particularly in hospitals (up to 50% inappropriate prescriptions), are the primary drivers of AMR.
• Antimicrobial stewardship programs (ASPs) are recognized for mitigating resistance, but require enhanced patient safety integration.

Purpose of the Study:

• To highlight the critical need for aligning ASPs with patient safety goals.
• To provide the rationale for ASPs to lead efforts in preventing antibiotic-associated adverse drug events (ADEs) and multidrug-resistant infections.
• To address the current gap in correlating ASP initiatives with patient safety outcomes.

Main Methods:

• Review of existing literature and evaluations on antibiotic use and patient safety.
• Analysis of the impact of antibiotic-associated adverse drug events (ADEs).
• Assessment of the link between inappropriate antibiotic prescribing and the development of resistance and Clostridium difficile infections.

Main Results:

• A recent evaluation found 20% of adult patients on systemic antibiotics experienced an ADE.
• Non-clinically indicated antibiotic regimens were associated with ADEs in 20% of cases.
• Inappropriate antibiotic use is linked to multidrug-resistant infections and Clostridium difficile infection.

Conclusions:

• There is a significant gap in current ASPs regarding the correlation of initiatives with patient safety goals.
• ASPs are optimally positioned to spearhead collaborative efforts to prevent antibiotic-associated ADEs.
• Integrating patient safety principles into ASPs is crucial for advancing AMS and combating AMR effectively.