Antimicrobial stewardship programs (ASPs) are programs designed to improve antibiotic use. They help to ensure that patients receive the right antibiotic, in the right dose, at the right time, and for the right length of time in order to improve patient outcomes, reduce antibiotic resistance, and save healthcare costs. In 2014, the Centers for Disease Control and Prevention (CDC) recommended that all hospitals implement ASPs.
Seven Core Elements for Successful Hospital ASPs
•Leadership commitment: Dedicating necessary human, financial, and information technology resources.
•Accountability: Appointing a single leader responsible for program outcomes. Experience with successful programs has shown that a physician leader is effective.
•Drug expertise: Appointing a single pharmacist leader responsible for working to improve antibiotic use.
•Action: Implementing at least one recommended action, such as systemic evaluation of ongoing treatment need after a set period of initial treatment (i.e., "antibiotic time out" after 48 hours).
•Tracking: Monitoring antibiotic prescribing and resistance patterns.
•Reporting: Regular reporting information on antibiotic use and resistance to doctors, nurses and relevant staff members.
•Education: Educating clinicians about resistance and optimal prescribing.
Source: CDC. Core elements of hospital antibiotic stewardship programs. Atlanta, GA: US Department of Health and Human Services, CDC; 2014.
ASPs can be implemented in any healthcare setting; how they are implemented will vary based on the type of setting, types of patients, and available resources and expertise.
The CDC has compiled evidence to support ASPs. This evidence highlights the impact of ASPs on costs, reduction of Clostridium difficile infections, antibiotic use, and more.
Resources for Developing and Implementing an ASP
CDC Antimicrobial Stewardship for the Community Hospital: Practical Tools & Techniques for Implementation (see "Slide Sets")
CDC Assessment Tools for Antibiotic Use (see "Implementation Resources")
CDC Checklist for Core Elements of Hospital Antibiotic Stewardship Programs
CDC Core Elements of Hospital Antibiotic Stewardship Programs
CDC/Institute for Healthcare Improvement (IHI) Antibiotic Stewardship Drivers and Change Package
Outpatient Antibiotic Stewardship
Stewardship Program Examples
Continuing Education and Curriculum Opportunities
CDC: Continuing Education and Curriculum Opportunities
Weighing in on Antibiotic Resistance: Community Pharmacists Tip the Scale