Abstract
The use of antibiotics has come a long way since the discovery of penicillin in 1928, and now enabling better healthcare has helped the delivery of medical (therapeutic) advances such as chemotherapy and surgical prophylaxis. However, with increased access, antibiotics have been taken for granted, thus leading to decades of misuse (abuse!) and overuse, progressing to the development of antimicrobial resistance (AMR). AMR poses a global threat accounting for more than seven million deaths every year. By 2050, the toll will rise to 10 million deaths per year. Despite increasing AMR worldwide, very few newer antibiotics are being developed, compelling the responsible use of antibiotics via antimicrobial stewardship (AMS). AMS has been defined as “co-ordinated interventions designed to improve and measure the appropriate use of antimicrobial agents by promoting the selection of the optimal antimicrobial drug regimen including dosing, duration of therapy and route of administration.” The aim of an Antimicrobial Stewardship Program (ASP) is to optimize antibiotic use by promoting changes in antibiotic prescribing behaviors and to minimize adverse consequences such as toxicity, spread of AMR, and selection of pathogenic organisms (e.g., Clostridium difficile). ASP also attempts to improve clinical outcomes and quality of care and reduce unnecessary healthcare costs. Components of an ASP program include the establishment of an ASP leadership team; communication and collaboration between the ASP team, hospital infection control, and pharmacy; hospital administrative support; information technology (IT); antimicrobial surveillance system; clinical microbiological laboratory set-up; planning and implementation of interventions; education and training; and evaluation via outcomes and process measures.
Journal of Postgraduate Medicine