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2013 ; 2
(3
): 400-18
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Antimicrobial Stewardship: The Need to Cover All Bases
#MMPMID27029310
Friedman ND
Antibiotics (Basel)
2013[Aug]; 2
(3
): 400-18
PMID27029310
show ga
Increasing antimicrobial resistance has necessitated an approach to guide the use
of antibiotics. The necessity to guide antimicrobial use via stewardship has
never been more urgent. The decline in anti-infective innovation and the failure
of currently available antimicrobials to treat some serious infections forces
clinicians to change those behaviors that drive antimicrobial resistance. The
majority of antimicrobial stewardship (AMS) programs function in acute-care
hospitals, however, hospitals are only one setting where antibiotics are
prescribed. Antimicrobial use is also high in residential aged care facilities
and in the community. Prescribing in aged care is influenced by the fact that
elderly residents have lowered immunity, are susceptible to infection and are
frequently colonized with multi-resistant organisms. While in the community,
prescribers are faced with public misconceptions about the effectiveness of
antibiotics for many upper respiratory tract illnesses. AMS programs in all of
these locations must be sustainable over a long period of time in order to be
effective. A future with effective antimicrobials to treat bacterial infection
will depend on AMS covering all of these bases. This review discusses AMS in
acute care hospitals, aged care and the community and emphasizes that AMS is
critical to patient safety and relies on government, clinician and community
engagement.