What is antimicrobial stewardship?

Antimicrobial stewardship (AMS) is defined as a coordinated program or set of strategies designed to improve and measure the appropriate use of antimicrobials (including antibiotics, antivirals, antifungals, and antiparasitics). The primary goals of AMS are to optimize clinical outcomes while minimizing adverse effects, including antimicrobial resistance, and to reduce unnecessary costs associated with healthcare.

Key components of antimicrobial stewardship include:

1. Optimizing Antibiotic Use: Ensuring that antibiotics are used appropriately in terms of drug selection, dosage, route of administration, and duration of therapy.
2. Improving Patient Outcomes: Enhancing the effectiveness of treatment for infections, reducing the incidence of adverse drug reactions, and improving overall patient health outcomes.
3. Reducing Resistance: Minimizing the development and spread of antimicrobial-resistant organisms through judicious use of antibiotics.
4. Cost-Effectiveness: Decreasing healthcare costs by reducing unnecessary or inappropriate antibiotic use and associated complications.
5. Education and Training: Providing ongoing education and resources for healthcare providers about the principles and practices of appropriate antimicrobial use.
6. Surveillance and Monitoring: Tracking antibiotic prescribing patterns, resistance trends, and the impact of stewardship interventions to continually improve practices.
7. Policy Development: Creating and implementing guidelines, protocols, and policies that support effective antimicrobial use within healthcare settings.

By focusing on these areas, AMS programs aim to ensure that patients receive the most appropriate antimicrobial therapy, thereby improving clinical outcomes, reducing resistance, and lowering healthcare costs.

The definition is based on widely accepted principles and objectives as outlined by various health organizations, professional societies, and academic sources. These include:

• Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA): These organizations have developed guidelines for implementing AMS programs, emphasizing optimal antibiotic use, improving patient outcomes, reducing resistance, and controlling costs.
• Centers for Disease Control and Prevention (CDC): The CDC defines AMS as a set of coordinated strategies to improve the use of antimicrobial medications with goals that include enhancing patient health outcomes, reducing resistance to antibiotics, and decreasing unnecessary costs.
• World Health Organization (WHO): The WHO promotes AMS to optimize the treatment of infections and reduce adverse events associated with antibiotic use, including antimicrobial resistance.
• Scientific Literature and Academic Resources: Numerous studies and reviews in the field of infectious diseases and clinical microbiology outline the key components and goals of AMS, consistently emphasizing the importance of appropriate antimicrobial use, education, surveillance, and policy development.