ALARA in Antimicrobial Stewardship: Adapting Radiation Safety Principles to Address Antibiotic Overuse

Area of Science:

• Infectious Diseases
• Public Health
• Radiation Safety Principles

Background:

• Antimicrobial stewardship programs struggle with antibiotic overuse due to vague guidelines.
• Existing frameworks lack a unified approach to bridge technical recommendations and clinical practice.
• Antibiotics, like radiation, offer benefits but carry cumulative risks such as microbiome disruption and resistance.

Purpose of the Study:

• To propose the ALARA (As Low As Reasonably Achievable) framework as a novel approach for antimicrobial stewardship.
• To adapt principles from radiation safety for standardizing antibiotic prescribing across medical specialties.
• To address the limitations of subjective terms in current antibiotic use guidelines.

Main Methods:

• Conceptual adaptation of the ALARA framework (justification, optimization, dose limitation) for antibiotic stewardship.
• Analysis of how ALARA principles can standardize prescribing decisions.
• Comparison of antibiotic risks to radiation risks.

Main Results:

• The ALARA framework provides three core pillars directly applicable to antimicrobial stewardship needs.
• This approach offers clear principles to standardize prescribing and reduce subjective judgments.
• ALARA can help manage the inherent risks of antibiotics while maintaining efficacy.

Conclusions:

• Adapting the ALARA framework can transform antibiotic stewardship by providing a unifying, objective approach.
• Implementing ALARA principles can reduce unnecessary antibiotic exposure and mitigate risks.
• This strategy has the potential to improve patient outcomes and combat antimicrobial resistance globally.