About Antibiotic Stewardship
What is antibiotic stewardship?
- Antibiotic stewardship refers to a set of coordinated approaches to measure and improve how antibiotics are prescribed by clinicians and used by patients. Making sure antibiotics are prescribed for the right diagnosis at the right dose and for the right treatment duration is critical to effectively minimize the spread of antibiotic resistant bacteria.
Why do we need antibiotic stewardship?
- Antibiotic resistance is an expected consequence with administration of any antibiotic for any length of time. Over time antibiotic resistance has emerged to affect all antibiotics in use today, rendering them less effective (or ineffective for certain infections). The more antibiotics are administered, the greater the risk of emergence and spread of resistant bacteria. Unfortunately, research and development of new, novel antibiotics has slowed over the past several decades; therefore, new antibiotics will not be available to us for several years, if at all. Because antibiotics serve as an important supportive care measure throughout medical and surgical care, the lack of availability of new antibiotics to treat evolving resistant bacteria is a serious threat to public health.
- Antibiotics are a limited resource that must be used fairly. Antibiotic stewardship can help ensure that vulnerable populations and communities have access to them, according to best practices, regardless of social determinants of health.
Who is responsible for antibiotic stewardship?
- Everyone is responsible for antibiotic stewardship including healthcare leadership, prescribers, care givers, and patients. Public health investment in antibiotic stewardship is important as well.
How should we incorporate antibiotic stewardship into clinical practice and healthcare decisions?
- Establish and support a culture of antibiotic stewardship within every healthcare facility or clinical practice setting
- Institute processes that take into consideration the risk of emergence of resistance with every decision to prescribe an antibiotic
- Monitor antibiotic use, and bacterial resistance
Programs, Guides and Toolkits
Information for each program can be found below.
Acute Care Settings
Long Term Care Settings
Outpatient Settings
The Targeting Appropriate Prescribing in Outpatient Settings (TAP OUT) program was designed to assist ambulatory healthcare settings in Los Angeles County meet the CDC Core Elements of stewardship through adherence to evidence-based best practices. See our TAP OUT Playbook and slide presentations for information.
Implementation of TAP OUT at a large medical group in Los Angeles resulted in a substantial reduction in unnecessary treatment for acute bronchitis.
Resources