Implementing Antimicrobial Stewardship in Various Healthcare Settings

Abstract

Antimicrobial resistance is a global health problem associated with mortality, morbidity, and socioeconomic losses. Given the rapid evolution of microorganisms and the scarcity of novel antimicrobials, it is important to implement strategies that promote appropriate, evidence-based use of antimicrobials to preserve their efficacy. These strategies and interventions are collectively referred to as antimicrobial stewardship (AMS). AMS interventions are focused on ensuring that the right antimicrobials are given at the right dose to the right patient, through the right route and for the right duration of time in order to improve patient outcomes, reduce side effects from inappropriate antimicrobial use and reduce the cost of therapy. AMS interventions include providing patient and public education; educating health professionals; ensuring evidence-based antimicrobial use; strengthening infection prevention and control practices; and prioritizing “one health” focused strategies to mitigate AMR in humans, animals, and the environment. Successful antimicrobial stewardship programs possess seven core elements as recommended by the CDC- leadership commitment, education of health professionals, accountability, drug expertise, action-oriented implementations, regular tracking of adherence to stewardship processes, and reporting. Stewardship interventions are successfully implemented when healthcare workers and stakeholders perceive the benefits of the program to be more than the effort required to implement the change.