Concept Introduction

Antimicrobial Stewardship is hardly a new concept or practice in healthcare. The emergence of multi-drug resistant organisms over the last thirty years, and particularly the alarming increase in pan-resistant organisms (those resistant to any available antimicrobial agent) has increased the attention to and proliferation of dedicated Antimicrobial Stewardship Programs (ASP). While international policy and practice has led the way in establishing antimicrobial stewardship as a central practice in healthcare, the U.S. has struggled to standardize methods for tracking and comparing antimicrobial utilization and lacks a national initiative to ensure stewardship programs and initiatives exist universally in healthcare settings. As attention to the National Action Strategy for Healthcare-Associated Infections has grown and with the public awareness of healthcare-associated infections (HAI) outbreaks and particularly drug-resistant pathogens, there is an important opportunity to elevate this perceived “niche focus” to a central component of quality improvement in healthcare.

The value of antimicrobial stewardship interventions to both clinical and institutional outcomes is compelling. While more research is needed to demonstrate the economic benefits of stewardship programs, recently published studies (Stevenson et al; Standiford et al, ICHE April 2012) show significant economic impacts and the consequences of turning away from such approaches. Most important is the clear opportunity to improve clinical outcomes for patients: among them avoidance of adverse medication events, prevention of unnecessary therapy in transitions of care, and reduced incidence of Clostridium difficile (Shrestha NK et al; Elligsen M et al, Kook et. al, ICHE, 2012).