Antimicrobial stewardship: philosophy versus practice.

Journal Article (Journal Article)

To promote the judicious use of antimicrobials and preserve their usefulness in the setting of growing resistance, a number of policy-making bodies and professional societies have advocated the development of antimicrobial stewardship programs. Although these programs have been implemented at many institutions in the United States, their impact has been difficult to measure. Current recommendations advocate the use of both outcome and process measures as metrics for antimicrobial stewardship. Although patient outcome metrics have the greatest impact on the quality of care, the literature shows that antimicrobial use and costs are the indicators measured most frequently by institutions to justify the effectiveness of antimicrobial stewardship programs. The measurement of more meaningful outcomes has been constrained by difficulties inherent to these measures, lack of funding and resources, and inadequate study designs. Antimicrobial stewardship can be made more credible by refocusing the antimicrobial review process to target specific disease states, reassessing the usefulness of current metrics, and integrating antimicrobial stewardship program initiatives into institutional quality and safety efforts.

Full Text

Duke Authors

Cited Authors

  • Dodds Ashley, ES; Kaye, KS; DePestel, DD; Hermsen, ED

Published Date

  • October 15, 2014

Published In

Volume / Issue

  • 59 Suppl 3 /

Start / End Page

  • S112 - S121

PubMed ID

  • 25261538

Electronic International Standard Serial Number (EISSN)

  • 1537-6591

Digital Object Identifier (DOI)

  • 10.1093/cid/ciu546


  • eng

Conference Location

  • United States