Antibiotic Stewardship

Antibiotic stewardship is defined as “coordinated interventions designed to improve and measure the appropriate use of antimicrobial agents by promoting the selection of the optimal antimicrobial drug regimen.” The goal is to achieve optimal clinical outcomes while minimizing toxicity and other adverse events. Of particular interest is reducing the incidence and preventing the spread of antibiotic-resistant infections by organisms such as methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterococci, and Clostridioides difficile. Antibiotic stewardship should be practiced in hospitals, ambulatory settings, and in post-acute and long-term care. Whatever the setting, it must involve cooperation between clinicians, nurses, and pharmacists; prescribing guidelines and, when appropriate, a formulary; measurement and reporting of antibiotic use and, ideally, guideline adherence; and ongoing quality improvement efforts to improve prescribing.