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Antibiotic Stewardship Programs in the Hospital Setting: Guidance from the Centers for Disease Control and Prevention

Now more than ever, Antibiotic Stewardship Programs (ASPs) are garnering attention throughout healthcare. It has been well documented that approximately 20-50% of all antibiotics prescribed in the hospital setting are unnecessary1-4. While antibiotics serve a meaningful purpose in treating infections, appropriate use of these agents in order to minimize adverse events, including the development of C. difficile infection (CDI), and reduce the development of drug-resistant organisms is vital.
In 2014, the Centers for Disease Control and Prevention (CDC) recommended the implementation of ASPs for acute care hospitals and published a document highlighting the recommend core elements for these programs1. These elements include:   

Leadership Commitment:

This is critical to ensure the success of ASPs. Programs may consider including formal statements at their facility supporting efforts to improve antibiotic use. There should be participation from various groups across the institution to further the program’s activities. Additionally, financial support from hospital administration should be present to ensure necessary resources for the success of the ASP are available. 

Accountability & Drug Expertise:

Accountability for ASP outcomes is recommended in the form of a single leader (i.e., physician champion). Additionally, a pharmacy leader should be identified to co-lead the program. Formal training in infectious diseases and/or antibiotic stewardship benefits program leaders. Other key personnel who should be targeted for engagement in ASPs and activities include:
  • Clinicians and department heads
  • Infection preventionists and hospital epidemiologists, who can coordinate facility-wide monitoring and prevention of healthcare-associated infections
  • Laboratory staff can guide proper use of tests and the flow of results. They can also guide empiric therapy by creating and interpreting a facility’s antibiogram.
  • Information technology staff, whose collaboration is important to improve workflow for ASP team members and provider assistance with development of clinical decision support tools. 

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