Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients.
According to the 2024 article published in npj Antimicrobials and Resistance, Antimicrobial stewardship (AMS) is a concept that relates to the use of antimicrobials in a way that preserves antimicrobial effectiveness while ensuring their ongoing availability for those who need them.
Antibiotic stewardship has wide application, right from humans, animals, to plants and agriculture, thus having various definitions to define its meaning. It mainly encompasses two different concepts relating to the appropriate use of antimicrobials:
- conservation: in determining when and when not to use antimicrobials.
- optimization: including considerations of how to use antimicrobials appropriately.
Goals of AMSP
• Coordinated interventions designed to improve and measure the appropriate use of antibiotics by
• Promoting the selection of the optimal antibiotic, correct dose, duration, and route of administration
• Leading to improved patient outcomes and decreased adverse events, C. difficile infections, and AMR rates
PRINCIPLES OF AMSP
• Step 1: Make a diagnosis using multiple data points (treat patients, not blood tests) AND send confirmatory tests — cultures, etc.
• Step 2: Limit empiric antibiotic therapy to life-threatening situations
• Step 3: Know the local antibiotic resistance patterns
• Step 4: Use the correct choice, dose, and route of antibiotic (PK-PD parameters of the antibiotic prescribed should be known)
• Step 5: De-escalate once diagnosis and antibiotic susceptibility are known.
MBH/AB