Department of Critical Care

Antimicrobial Stewardship

Antimicrobial Stewardship Program (ASP)
For decades a large percentage of antimicrobial use in both inpatient and outpatient settings has been unnecessarily or incorrectly prescribed. Since their inception, antimicrobial stewardship programs (ASP) have shown success in improving appropriate antibiotic use. Studies show that ASP can improve patient outcomes, reduce adverse events (including Clostridium difficile infection), reduce readmission rates, and even reduce antibiotic resistance.


Antimicrobial stewardship programs are inter-disciplinary teams, involving pharmacists, infectious disease physicians, infection control specialists, treating physicians, microbiology staff, hospital administrators, and information system specialists. ASP interventions optimize antimicrobial use and include: prospective audit and feedback, a formulary of targeted antimicrobials and approved indications, education, antimicrobial order forms, guidelines and clinical pathways for antimicrobial utilization, strategies for streamlining or de-escalation of therapies, dose optimization, and parenteral to oral conversion of antimicrobials.

References
Dellit TH, Owens RC, McGowan JE, Jr., Gerding DN, Weinstein RA, Burke JP, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2007;44(2):159-77.