[Principles of antimicrobial stewardship].

Area of Science:

• Microbiology and Infectious Diseases
• Clinical Pharmacy
• Public Health

Context:

• The global rise of multidrug-resistant pathogens poses a significant threat to public health, compromising the efficacy of essential antimicrobial treatments.
• Inappropriate use of antibiotics, antivirals, and antifungals in human medicine, veterinary practice, and agriculture is the primary driver of antimicrobial resistance (AMR).

Purpose:

• To outline the principles and essential components of Antimicrobial Stewardship (AMS) programs aimed at optimizing antimicrobial prescribing practices.
• To highlight the importance of AMS in preventing the development of resistance, ensuring treatment success, and minimizing adverse effects associated with antimicrobial use.

Summary:

• Antimicrobial Stewardship (AMS) encompasses strategies such as evidence-based guidelines, interdisciplinary consultations, targeted training, and digital support to optimize prescribing.
• Key elements for effective AMS include accurate diagnosis, guideline-concordant empirical therapy, regular patient re-evaluation, dose optimization, early switch to oral administration, and Outpatient Parenteral Anti-infective Therapy (OPAT).
• Short, individualized treatment durations are vital for improving tolerability and reducing resistance pressure, linking epidemiological data with patient-specific factors for personalized infection medicine.

Impact:

• Consistent integration of AMS measures into clinical practice is essential for preserving the long-term efficacy of antimicrobial agents.
• Effective AMS implementation enhances patient care quality and contributes to the global fight against antimicrobial resistance.