Antibiotics have revolutionized the practice of medicine and antibiotic stewardship programs are being put in place so that the benefits of this revolution are not offset by its rampant and unscientific use. The antimicrobial stewardship program is in its infancy. It has much scope for growth and a tremendous potential for promoting evidence-based therapy for infectious disease. An attempt is made in this article to put together strategies for its effective implementation in healthcare facilities.
Fishman N, Patterson J, Saiman L, et al. Society for Healthcare Epidemiology of America; Infectious Diseases Society of America; Pediatric Infectious Diseases Society. Policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol 2012;33(4):322–327. DOI: 10.1086/665010.
Dellit TH, Owens RC, McGowan Jr JE, et al. Infectious Diseases Society of America; Society for Healthcare Epidemiology of America. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007;44(2):159–177. DOI: 10.1086/510393.
Malani AN, Richards PG, Kapila S, et al. Clinical and economic outcomes from a community hospital's antimicrobial stewardship program. Am J Infect Control 2013;41(2):145–148. DOI: 10.1016/j.ajic.2012.02.021.
Stach LM, Hedican EB, Herigon JC, et al. Clinicians’ attitudes towards an antimicrobial stewardship program at a children's hospital. J Pediatric Infect Dis Soc 2012;1(3):190–197. DOI: 10.1093/jpids/pis045.
Weber DJ. Collateral damage and what the future might hold. The need to balance prudent antibiotic utilization and stewardship with effective patient management. Int J Infect Dis 2006;10(S2):S17–S24. DOI: 10.1016/S1201-9712(06)60004-0.
Essential medicines and health products.WHO releases the 2019 AWaRe Classification Antibiotics. https://www.who.int/medicines/news/2019/WHO_releases2019AWaRe_classification_antibiotics/en/ Accessed on 23/10/20.
Hsia Y, Lee BR, Versporten A, et al. Mike sharland on behalf of the GARPEC and global-PPS networks*. Use of the WHO access, watch, and reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries. Lancet Glob Health 2019;7(7):e861–e871. DOI: 10.1016/S2214-109X(19)30071-3.
Doron S, Davidson LE. Antimicrobial stewardship. Mayo Clin Proc 2011;86(11):1113–1123. DOI: 10.4065/mcp.2011.0358.
Hayman JN, Sbravati EC. Controlling cephalosporin and aminoglycoside costs through pharmacy and therapeutics committee restrictions. Am J Hosp Pharm 1985;42(6):1343–1347. DOI: 10.1093/ajhp/42.6.1343.
Bauer KA, West JE, Balada-Llasat JM, et al. An antimicrobial stewardship program's impact with rapid polymerase chain reaction methicillin-resistant Staphylococcus aureus/S. aureus blood culture test in patients with S. aureus bacteremia. Clin Infect Dis 2010;51(9):1074–1080. DOI: 10.1086/656623.
Solomon DH, Van Houten L, Glynn RJ, et al. Academic detailing to improve use of broad-spectrum antibiotics at an academic medical center. Arch Intern Med 2001;161(15):1897–1902. DOI: 10.1001/archinte.161.15.1897.
Graber CJ, Jones MM, Glassman PA, et al. Taking an antibiotic time-out: utilization and ssability of a self-stewardship time-out program for renewal of vancomycin and piperacillin-tazobactam. Hosp Pharm 2015;50(11):1011–1024. DOI: 10.1310/hpj5011-1011.
Garau J, Bassetti M. Role of pharmacists in antimicrobial stewardship programmes. Int J Clin Pharm 2018;40(5):948–952. DOI: 10.1007/s11096-018-0675-z.
Weinstein MP, Lewis II JS. The clinical and laboratory standards institute subcommittee on antimicrobial susceptibility testing: background, organization, functions, and processes. J Clin Microbiol 2020;58(3):1–7. DOI: 10.1128/JCM.01864-19.
Lee C, Kwa ALH, Apisarnthanarak A, et al. Procalcitonin (PCT)-guided antibiotic stewardship in Asia-pacific countries: adaptation based on an expert consensus meeting. Clin Chem Lab Med 2020;58(12):1983–1991. DOI: 10.1515/cclm-2019-1122.
de Jong E, van Oers JA, Beishuizen A, et al. Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial. Lancet Infect Dis 2016;16(7):819–827. DOI: 10.1016/S1473-3099(16)00053-0.
Seah J, Beriault D, Langford B, et al. Serial procalcitonin measurement in a community intensive care unit: is there value in the setting of an established antibiotic stewardship. Open Forum Infect Dis 2019;6(S2):S669. DOI: 10.1093/ofid/ofz360.1675.
Al-Tawfiq JA, Momattin H, Al-Habboubi F, et al. Restrictive reporting of selected antimicrobial susceptibilities influences clinical prescribing. J Infect Public Health 2015;8(3):234–241.
Morris AM. Antimicrobial stewardship programs: appropriate measures and metrics to study their impact. Curr Treat Options Infect Dis 2014;6(2):101–112.