Antimicrobial stewardship programs in health care systems

  • C. M
  • MacDougall C
  • Polk R
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Antimicrobial stewardship programs in hospitals seek to optimize antimicrobial prescribing in order to improve individual patient care as well as reduce hospital costs and slow the spread of antimicrobial resistance. With antimicrobial resistance on the rise worldwide and few new agents in development, antimicrobial stewardship programs are more important than ever in ensuring the continued efficacy of available antimicrobials. The design of antimicrobial management programs should be based on the best current understanding of the relationship between antimicrobial use and resistance. Such programs should be administered by multidisciplinary teams composed of infectious diseases physicians, clinical pharmacists, clinical microbiologists, and infection control practitioners and should be actively supported by hospital administrators. Strategies for changing antimicrobial prescribing behavior include education of prescribers regarding proper antimicrobial usage, creation of an antimicrobial formulary with restricted prescribing of targeted agents, and review of antimicrobial prescribing with feedback to prescribers. Clinical computer systems can aid in the implementation of each of these strategies, especially as expert systems able to provide patient-specific data and suggestions at the point of care. Antibiotic rotation strategies control the prescribing process by scheduled changes of antimicrobial classes used for empirical therapy. When instituting an antimicrobial stewardship program, a hospital should tailor its choice of strategies to its needs and available resources.

Author-supplied keywords

  • *Anti-Infective Agents/ad [Administration & Dosage
  • *Decision Support Systems
  • *Drug Resistance
  • *Infection Control/st [Standards]
  • *antiinfective agent/dt [Drug Therapy]
  • *antiinfective agent/iv [Intravenous Drug Administ
  • *antiinfective agent/pe [Pharmacoeconomics]
  • *antiinfective agent/po [Oral Drug Administration]
  • *antimicrobial stewardship program
  • *antimicrobial therapy
  • *health program
  • *infection/dm [Disease Management]
  • *infection/dr [Drug Resistance]
  • *infection/dt [Drug Therapy]
  • *infection/et [Etiology]
  • Anti-Bacterial Agents/tu [Therapeutic Use]
  • Anti-Infective Agents/tu [Therapeutic Use]
  • Bacterial
  • Clinical
  • Cross Infection/dt [Drug Therapy]
  • Cross Infection/ep [Epidemiology]
  • Drug Utilization/st [Standards]
  • Gram negative bacterium
  • Gram positive bacterium
  • Humans
  • Medical Informatics
  • Outcome Assessment (Health Care)/st [Standards]
  • Pharmacy Administration
  • Program Development
  • Terminology as Topic
  • amikacin/dt [Drug Therapy]
  • aminoglycoside antibiotic agent/dt [Drug Therapy]
  • amoxicillin plus clavulanic acid/dt [Drug Therapy]
  • amoxicillin plus clavulanic acid/po [Oral Drug Adm
  • antibiotic resistance
  • behavior modification
  • ceftriaxone/dt [Drug Therapy]
  • ceftriaxone/iv [Intravenous Drug Administration]
  • cephalosporin derivative/dt [Drug Therapy]
  • clindamycin/dt [Drug Therapy]
  • computer system
  • cost control
  • dalbavancin
  • drug efficacy
  • drug indication
  • drug use
  • ertapenem/dt [Drug Therapy]
  • ertapenem/iv [Intravenous Drug Administration]
  • expert system
  • gentamicin/dt [Drug Therapy]
  • good clinical practice
  • health care availability
  • health care planning
  • health care quality
  • hospital
  • hospital administrator
  • hospital cost
  • human
  • medical education
  • meticillin
  • microbiology
  • patient care
  • pharmacist
  • physician
  • piperacillin plus tazobactam/dt [Drug Therapy]
  • prescription
  • quinoline derived antiinfective agent/dt [Drug The
  • quinoline derived antiinfective agent/po [Oral Dru
  • review
  • teamwork
  • tobramycin/dt [Drug Therapy]
  • treatment planning
  • vancomycin/dt [Drug Therapy]
  • vancomycin/iv [Intravenous Drug Administration]
  • vancomycin/po [Oral Drug Administration]

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  • MacDougall C.

  • Conan MacDougall

  • Ron E Polk

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