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Antimicrobial stewardship programs: how to start and steer a successful program.

Publication ,  Journal Article
Drew, RH
Published in: J Manag Care Pharm
March 2009

BACKGROUND: Antimicrobial stewardship programs (ASPs) promote the appropriate use of antimicrobials by selecting the appropriate dose, duration, and route of administration. The appropriate use of antimicrobials has the potential to improve efficacy, reduce treatment-related costs, minimize drug-related adverse events, and limit the potential for emergence of antimicrobial resistance. OBJECTIVE: To summarize ASP tactics that can improve the appropriate use of antimicrobials in the hospital setting. Several measures can be used to implement such programs and gain multidisciplinary support while addressing common barriers. SUMMARY: Implementation of an ASP requires a multidisciplinary approach with an infectious diseases physician and a clinical pharmacist with infectious diseases training as its core team members. As identified by recently published guidelines, 2 proactive strategies for promoting antimicrobial stewardship include: (1) formulary restriction and pre-authorization, and (2) prospective audit with intervention and feedback. Other supplemental strategies involve education, guidelines and clinical pathways, antimicrobial order forms, de-escalation of therapy, intravenous-to-oral (IV-to-PO) switch therapy, and dose optimization. Several barriers exist to successful implementation of ASPs. These include obtaining adequate administrative support and compensation for team members. Gaining physician acceptance can also be challenging if there is a perceived loss of autonomy in clinical decision making. CONCLUSION: ASPs have the potential to reduce antimicrobial resistance, health care costs, and drug-related adverse events while improving clinical outcomes. The efforts and expense required to implement and maintain ASPs are more than justified given their potential benefits to both the hospital and the patient.

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Published In

J Manag Care Pharm

DOI

ISSN

1083-4087

Publication Date

March 2009

Volume

15

Issue

2 Suppl

Start / End Page

S18 / S23

Location

United States

Related Subject Headings

  • Program Evaluation
  • Practice Guidelines as Topic
  • Pharmacists
  • Infection Control Practitioners
  • Infection Control
  • Humans
  • Health Policy & Services
  • Formularies, Hospital as Topic
  • Drug Utilization
  • Drug Resistance, Bacterial
 

Citation

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Drew, R. H. (2009). Antimicrobial stewardship programs: how to start and steer a successful program. J Manag Care Pharm, 15(2 Suppl), S18–S23. https://doi.org/10.18553/jmcp.2009.15.s2.18
Drew, Richard H. “Antimicrobial stewardship programs: how to start and steer a successful program.J Manag Care Pharm 15, no. 2 Suppl (March 2009): S18–23. https://doi.org/10.18553/jmcp.2009.15.s2.18.
Drew RH. Antimicrobial stewardship programs: how to start and steer a successful program. J Manag Care Pharm. 2009 Mar;15(2 Suppl):S18–23.
Drew, Richard H. “Antimicrobial stewardship programs: how to start and steer a successful program.J Manag Care Pharm, vol. 15, no. 2 Suppl, Mar. 2009, pp. S18–23. Pubmed, doi:10.18553/jmcp.2009.15.s2.18.
Drew RH. Antimicrobial stewardship programs: how to start and steer a successful program. J Manag Care Pharm. 2009 Mar;15(2 Suppl):S18–S23.

Published In

J Manag Care Pharm

DOI

ISSN

1083-4087

Publication Date

March 2009

Volume

15

Issue

2 Suppl

Start / End Page

S18 / S23

Location

United States

Related Subject Headings

  • Program Evaluation
  • Practice Guidelines as Topic
  • Pharmacists
  • Infection Control Practitioners
  • Infection Control
  • Humans
  • Health Policy & Services
  • Formularies, Hospital as Topic
  • Drug Utilization
  • Drug Resistance, Bacterial