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.
