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Antibiotic Stewardship 2016

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Background Î 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. Î 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." Î 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. Î IDSA and SHEA strongly believe that antibiotic stewardship programs are best led by infectious disease physicians with additional stewardship training. Interventions Î We recommend preauthorization and/or prospective audit and feedback over no such interventions (See Table 1) (S-M). • Preauthorization and/or prospective audit and feedback improve antibiotic use and are a core component of any stewardship program. Programs should decide whether to include one or a combination of both strategies based on the availability of facility-specific resources for consistent implementation, but some implementation is essential. Î We suggest against relying solely on didactic educational materials for stewardship (W-L). • Passive educational activities, such as lectures or informational pamphlets, should be used to complement other stewardship activities. Academic medical centers and teaching hospitals should integrate education on fundamental antibiotic stewardship principles into their preclinical and clinical curricula.

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