Antibiotic Stewardship: Addressing the "Great Public Health Irony"

Antibiotic stewardship hopes to address the "great public health irony"-the golden age of antibiotics in clinical medicine has turned into a global antibiotic resistance threat. This overview summarizes the problem of antibiotic resistance and antibiotic prescribing trends in outpatient primary care in the United States, then reviews the major antibiotic stewardship campaigns and interventions with a focus on primary care practice. The lessons of these campaigns and interventions can provide guidance for clinicians in practice to better integrate patient-focused primary care with population-oriented population health to address the threat of inappropriate antibiotic prescribing and antibiotic resistance.