Antimicrobial Stewardship Programs as a Means to Optimize Antimicrobial Use Insights from the Society of Infectious Diseases Pharmacists

Owens, Robert C.; Fraser, Gilles L.; Stogsdill, Patricia

doi:10.1592/phco.24.9.896.36101

Cited by 78 publications

(43 citation statements)

References 35 publications

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“…However, as noted, many programs use a combination of such strategies. Thus, strict classification of studies of antimicrobial stewardship programs is not always possible, and previous reviews have used different methods of classification (80,120,121). Table 1 provides brief summaries of the strategies according to the classification we will use here, while Fig.…”

Section: Classification Of Programs and Review Of Selected Studiesmentioning

confidence: 99%

Antimicrobial Stewardship Programs in Health Care Systems

2005

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SUMMARY Antimicrobial stewardship programs in hospitals seek to optimize antimicrobial prescribing in order to improve individual patient care as well as reduce hospital costs and slow the spread of antimicrobial resistance. With antimicrobial resistance on the rise worldwide and few new agents in development, antimicrobial stewardship programs are more important than ever in ensuring the continued efficacy of available antimicrobials. The design of antimicrobial management programs should be based on the best current understanding of the relationship between antimicrobial use and resistance. Such programs should be administered by multidisciplinary teams composed of infectious diseases physicians, clinical pharmacists, clinical microbiologists, and infection control practitioners and should be actively supported by hospital administrators. Strategies for changing antimicrobial prescribing behavior include education of prescribers regarding proper antimicrobial usage, creation of an antimicrobial formulary with restricted prescribing of targeted agents, and review of antimicrobial prescribing with feedback to prescribers. Clinical computer systems can aid in the implementation of each of these strategies, especially as expert systems able to provide patient-specific data and suggestions at the point of care. Antibiotic rotation strategies control the prescribing process by scheduled changes of antimicrobial classes used for empirical therapy. When instituting an antimicrobial stewardship program, a hospital should tailor its choice of strategies to its needs and available resources.

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Section: Classification Of Programs and Review Of Selected Studiesmentioning

confidence: 99%

Antimicrobial Stewardship Programs in Health Care Systems

2005

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“…Principles of programmatic approaches and implementation should also be included. [11][12][13][14] After completion of a PGY2 residency in infectious diseases, individuals should exhibit competency in the educational domains outlined by the ASHP Commission on Credentialing, and they should possess the knowledge base and practice skills needed to practice as a clinical specialist in infectious diseases. At present, the availability of accredited PGY2 residencies in infectious diseases is limited.…”

Section: Formalized Training For Pharmacists In Infectious Diseasesmentioning

confidence: 99%

Recommendations for Training and Certification for Pharmacists Practicing, Mentoring, and Educating in Infectious Diseases Pharmacotherapy

et al. 2009

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Recently created guidelines for the development of institutional antimicrobial stewardship programs recommend that a pharmacist with infectious diseases training be included as a core member of the antimicrobial stewardship team. However, training and certification requirements for infectious diseasestrained clinical pharmacists have not been established. Although pharmacists have nurtured their interest in infectious diseases by self-directed learning or on-the-job experiences, this mode of training is not considered feasible or sufficient for reliable training of future clinical specialists in infectious diseases. This document, therefore, is forward looking and provides overarching recommendations for future training and certification of pharmacists practicing, mentoring, and educating in infectious diseases pharmacotherapy, with the recognition that full implementation may take several years. We recommend that future pharmacists wishing to obtain a clinical position as an infectious diseases-trained pharmacist should complete a postgraduate year (PGY) 1 residency and a PGY2 residency in infectious diseases, that practitioners become board-certified pharmacotherapy specialists, that a certification examination in infectious diseases be developed, that practitioners maintain a portfolio of educational experiences to maintain qualifications, that current nonaccredited training programs seek accreditation, and that employers and academicians recognize the desirability of these qualifications in hiring decisions.

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“…3,31,[33][34][35] Creating an ASP involves multiple steps. 32 Baseline information should be obtained pertaining to antimicrobial use, expenditure, and institutional bacterial susceptibilities derived from the hospital antibiogram.…”

Section: Implementing An Aspmentioning

confidence: 99%