The Critical Role of Antimicrobial Stewardship in Hospitals

In the complex landscape of healthcare, the effective management of antimicrobials is essential for preserving their efficacy and preventing the rise of resistant strains. Antimicrobial stewardship (AMS) programs in hospitals play a pivotal role in achieving this delicate balance. What is antimicrobial stewardship? In this blog post, we will explore the scientific foundations of AMS, its significance in healthcare settings, and the imperative for evidence-based practices.

The Scientific Foundations of Antimicrobial Stewardship

1. Understanding Antimicrobial Resistance (AMR): antimicrobial resistance is a natural evolutionary process accelerated by the overuse and misuse of antimicrobial agents. A comprehensive understanding of the molecular mechanisms behind AMR is crucial for developing effective stewardship strategies (1).
2. Optimising Antimicrobial Use: antimicrobial stewardship focuses on optimizing the use of antimicrobial agents to achieve the best clinical outcomes while minimising the development of resistance. This involves appropriate prescribing, dosage adjustments, and the duration of antimicrobial therapy (2).

The Significance of Antimicrobial Stewardship in Hospitals

1. Reducing Healthcare-Associated Infections (HAIs): AMS programs contribute to the reduction of healthcare-associated infections by preventing the spread of resistant pathogens within healthcare facilities. This is achieved through targeted interventions such as infection prevention and control measures (3).
2. Economic Impact: effective antimicrobial stewardship leads to significant cost savings by reducing unnecessary antimicrobial use, hospital stays, and the need for more expensive second-line treatments. Resource optimisation is crucial with increasingly strained healthcare budgets (4).

The Imperative for Evidence-Based Practices

1. Guidelines and Best Practices: AMS programs should be founded on evidence-based guidelines and best practices. Collaborative efforts, guided by scientific evidence, are crucial for the development and implementation of successful stewardship initiatives (5).
2. Continuous Surveillance and Evaluation: ongoing surveillance and evaluation of AMS programs are essential to assess their impact, identify areas for improvement, and adapt strategies to better combat AMR (6).

Conclusion

Antimicrobial stewardship is not just a buzzword; it is a scientific necessity in modern healthcare. Supported by evidence-based practices, AMS programs in hospitals drastically improve standards of public health, ensuring that antimicrobials remain effective in the face of evolving resistance. By embracing the scientific principles behind AMS, healthcare institutions can pave the way for a sustainable and resilient approach to infection control.

References:

1. Ventola C. L. (2015). The Antibiotic Resistance Crisis: Part 1: Causes and Threats. Pharmacy and Therapeutics: 40(4), 277–283.
2. Dellit T. H., Owens R. C., McGowan Jr J. E., Gerding D. N., Weinstein R. A., Burke J. P., & Fishman, N. O. (2007). Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clinical Infectious Diseases: 44(2), 159-177.
3. Davey P., Brown E., Charani E., Fenelon L., Gould I. M., Holmes A., & Wilcox, M. (2013). Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews: (4), CD003543.
4. Nathwani D., Varghese D., Stephens J., Ansari W., Martin S., Charbonneau C., & Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) Working Group. (2018). Value of hospital antimicrobial stewardship programs [ASPs]: a systematic review. Antimicrobial Resistance & Infection Control: 7(1), 1-13.
5. Barlam T. F., Cosgrove S. E., Abbo L. M., MacDougall C., Schuetz A. N., Septimus E. J., & Dellit, T. H. (2016). Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Diseases: 62(10), e51-e77.
6. Dyar O. J., Huttner B., Schouten J., & Pulcini C. (2017). What is antimicrobial stewardship? Clinical Microbiology and Infection: 23(11), 793-798.