Strong stewardship to fight antimicrobial resistance
Lancet April 23, 2016 V.387 N.10029
Antibiotics have undoubtedly revolutionised medicine. However, widespread use of antimicrobial drugs in medicine and agriculture has spurred the evolution of pan-resistant bacterial strains. With few new antibiotics in the development pipeline, the threat to public health of antimicrobial resistance is all too real. Strong stewardship policies are urgently needed to stem inappropriate prescribing and use of antibiotics.
On April 13, the Infectious Diseases Society of America and the Society for Health Care Epidemiology of America released a new guideline: Implementing an Antibiotic Stewardship Program, with 27 recommendations that cover a broad range of antibiotic stewardship interventions. Among the recommendations are use of preauthorisation for antibiotic prescribing, restriction of use of antibiotics with high risk of Clostridium difficile infection, and strategies for specific health-care settings (such as nursing homes) to reduce unnecessary or inappropriate antibiotic use. Of note, although these recommendations can be used across a range of clinical settings, the authors highlight the lack evidence for effective antibiotic stewardship interventions, and call for increased research to determine how to best achieve large-scale implementation of these measures.