What is antimicrobial stewardship?

In its broadest sense, antimicrobial stewardship encompasses any activity that promotes the judicious use of antimicrobial agents in human medicine, veterinary medicine, and animal agriculture around the globe to help combat antimicrobial resistance and preserve drug effectiveness.

In clinical practice, stewardship focuses on coordinated interventions designed to improve and measure the appropriate use of antibiotic agents by promoting the timely selection of the optimal antimicrobial regimen of dose, duration of therapy, and route of administration.1

The primary goals of antimicrobial stewardship are to:

  • Slow the spread of antimicrobial-resistant organisms.
  • Extend the lifespan of existing antimicrobial agents and protect the effectiveness of new ones.
  • Improve the quality of patient care and minimize adverse effects of antimicrobial therapy, such as toxicity, allergic reactions, and increased risk of Clostridium difficile infection.
  • Enhance capabilities to identify resistant organisms and monitor the prevalence of resistant infections in people and animals.
  • Reduce the use of antimicrobial agents in veterinary medicine and animal agriculture without compromising animal health and the food system’s ability to meet global demands.
  • Decrease environmental contamination and exposure to antimicrobial waste in the environment.
     

While the terms “antimicrobial stewardship” and “antibiotic stewardship” are often used interchangeably, antimicrobial stewardship promotes the appropriate use of all antimicrobials, including antibiotics, antivirals, antiprotozoals, and antifungals. Antibiotic stewardship, a subset of antimicrobial stewardship, comprises interventions to prevent drug-resistant bacterial infections, select antibiotic therapy targeted toward susceptible or resistant bacteria, and reduce unnecessary or inappropriate antibiotic administration and use.2-4


The CIDRAP Antimicrobial Stewardship Project (ASP) offers freely available, high-quality information and educational resources on antimicrobial stewardship practice, research, and policy. It features a dynamic, content-rich Web site designed to actively engage a diverse, international audience. For more information, view our brochures: (1) for healthcare systems and (2) for public health.

1.
Barlam TF, Cosgrove SE, Abbo LM, et al. Executive summary: implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis 2016 May 15;62(10):1197-202 [Abstract]
2. Association for Professionals in Infection Control and Epidemiology. Antimicrobial stewardship. Accessed Apr 16, 2017. [Full text]
3. Infectious Diseases Society of America. New antibiotic stewardship guidelines: focus on practical advice for implementation. Apr 14, 2016 [Full text]
4. US Centers for Disease Control and Prevention. Core elements of hospital antibiotic stewardship programs. May 7, 2015 [Full text]

 

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