Antibiotic Stewardship

Publication Date: April 13, 2016

Background

Background

Approaches to optimize the use of both existing antibiotics and newly developed antibiotics are of critical importance to ensure that we continue to reap their benefits and provide the best care to patients.

Antibiotic stewardship has been defined as “coordinated interventions designed to improve and measure the appropriate use of antibiotic agents by promoting the selection of the optimal antibiotic drug regimen including dosing, duration of therapy, and route of administration.”

The benefits of antibiotic stewardship include improved patient outcomes, reduced adverse events including Clostridium difficile infection (CDI), improvement in rates of antibiotic susceptibilities to targeted antibiotics, and optimization of resource utilization across the continuum of care.

IDSA and SHEA strongly believe that antibiotic stewardship programs are best led by infectious disease physicians with additional stewardship training.

Interventions

...terventions

...nd preauthorization and/or prospective audit...


...against relying solely on didactic ed...


...e 1. Comparison of Preauthorization...


...st antibiotic stewardship programs (ASPs) develop...


...uggest ASPs implement interventions to improve a...


...ecommend antibiotic stewardship interventions desi...


...use of strategies (e.g., antibiotic time...


...incorporation of computerized clinical d...


...e suggest against the use of antibiotic cy...


Optimization

...imizatio...

...d that hospitals implement pharmacokine...


...same for vancomycin. (W - Weak, L - Low)65...


...spitalized patients, we suggest ASPs advocate...


...ASPs implement programs to increase both app...


...s with a history of β-lactam allergy,...


...that ASPs implement guidelines and strategies...


Microbiology and Laboratory Diagnostics

...obiology and Laboratory Diagnostic...

...development of stratified antibiogram...


...lective and cascade reporting of antibiotics o...


...uggest the use of rapid viral testing for re...


...suggest rapid diagnostic testing in...


...ults in ICUs with suspected infect...


...ients with hematologic malignancy at...


Measurement

Measurem...

...suggest monitoring antibiotic use as measur...


...recommend measuring antibiotic costs b...


...consider the goals and size of the syndrome-sp...


Table 2. Possible Metrics for Evaluation of In...


Special Populations

...cial Populations...

...gest ASPs develop facility-specific guideli...


...plementation of ASP interventions to...


...ing homes and skilled nursing facilities, we s...


...lementation of antibiotic stewardship interventio...


...l patients, we suggest ASPs provide support to...