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

...rventions...

...recommend preauthorization and/or prospec...


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


...1. Comparison of Preauthorization...


...tibiotic stewardship programs (ASPs) develop facil...


...suggest ASPs implement interventi...


...nd antibiotic stewardship interventions designed...


...use of strategies (e.g., antibioti...


...gest incorporation of computerized clinical...


...t against the use of antibiotic cycling as...


Optimization

...imization...

...recommend that hospitals implement pharmacok...


...est the same for vancomycin. (W - Weak, L - L...


...spitalized patients, we suggest ASPs adv...


...ASPs implement programs to increase both appr...


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


...nd that ASPs implement guidelines an...


Microbiology and Laboratory Diagnostics

...iology and Laboratory Diagnostic...

...uggest development of stratified antibiogr...


...est selective and cascade reporting...


...the use of rapid viral testing for r...


...rapid diagnostic testing in addition to conve...


...ults in ICUs with suspected infection,...


...patients with hematologic malignancy at...


Measurement

...easurement

We suggest monitoring antibiotic use as measur...


...nd measuring antibiotic costs based on...


...es that consider the goals and size of the syn...


...ble 2. Possible Metrics for Evalua...


Special Populations

...al Populations...

...s develop facility-specific guidelines for fe...


...e suggest implementation of ASP interventions...


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


We suggest implementation of antibiotic stewards...


...ll patients, we suggest ASPs provide support to cl...