From the Guidelines
To advocate for antibiotic stewardship, I recommend implementing a comprehensive approach that includes prescribing antibiotics only when truly necessary and selecting the appropriate medication, dose, and duration, as outlined in the most recent guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America 1.
Key Principles of Antibiotic Stewardship
- Confirm bacterial infections through proper diagnostic testing before prescribing antibiotics
- Choose narrow-spectrum agents when possible, such as penicillin for streptococcal pharyngitis, rather than broader agents like azithromycin
- Prescribe antibiotics for the shortest effective duration, often 5-7 days for many common infections, rather than traditional 10-14 day courses
- Document the indication, planned duration, and review date for all antibiotic prescriptions
- Regularly reassess the need for antibiotics, especially in hospitalized patients, and de-escalate from broad-spectrum to narrow-spectrum options once culture results are available
Education and Patient Involvement
- Educate patients about appropriate antibiotic use, including completing the full prescribed course, not saving antibiotics for future use, and not requesting antibiotics for viral infections
- Involve patients in the decision-making process and provide them with clear information about the benefits and risks of antibiotic treatment
Surveillance and Monitoring
- Implement surveillance and monitoring systems to track antibiotic use and resistance patterns, as recommended by the Joint Programming Initiative on Antimicrobial Resistance 1
- Use this data to inform antibiotic stewardship decisions and adjust treatment strategies as needed
Implementation and Leadership
- Implement antibiotic stewardship programs in all healthcare settings, including nursing homes and skilled nursing facilities, as recommended by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America 1
- Ensure that these programs are led by infectious disease physicians with additional stewardship training, as recommended by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America 1
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Advocating for Antibiotic Stewardship
To advocate for antibiotic stewardship, several strategies can be employed:
- Improving antibiotic use to enhance patient outcomes, reduce costs, and combat resistance 2
- Implementing antibiotic stewardship programs to improve clinical outcomes and patient safety 3
- Developing guidelines for antibiotic use in various settings, such as inpatient and outpatient care 4
- Establishing a framework for implementing antibiotic stewardship in ambulatory care settings 5
Key Components of Antibiotic Stewardship Programs
Effective antibiotic stewardship programs should include:
- Prior authorization for select antibiotics
- Antibiotic reviews with prospective audit and feedback
- Guideline development 3
- A multidisciplinary team, including pharmacists and physicians with expertise in stewardship 3
- Access to antibiotic prescribing data to monitor and evaluate program effectiveness 5
Implementing Antibiotic Stewardship in Ambulatory Care
To establish antibiotic stewardship in ambulatory care settings, the following steps can be taken:
- Obtaining support from practice leadership
- Establishing an antibiotic stewardship team
- Building communication skills around antibiotic use
- Implementing educational content around infectious syndromes
- Monitoring antibiotic prescription data
- Implementing a sustainability plan 5
Benefits of Antibiotic Stewardship
Antibiotic stewardship can lead to:
- Improved patient outcomes
- Reduced healthcare costs
- Decreased antibiotic resistance
- Prevention of negative consequences, such as Clostridium difficile infection 2