The following checklist is a companion to Core Elements of Hospital Antibiotic Stewardship Programs. This checklist should be used to systematically assess key elements and actions to ensure optimal antibiotic prescribing and limit overuse and misuse of antibiotics in hospitals. CDC recommends that ...all hospitals implement an Antibiotic Stewardship Program.
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International Perspectives and Future Directions
Unite for Children
First Edition
Stewardship is defined as “the careful and responsible management of something entrusted to one’s care”. It was originally applied in the health-care setting as a tool for optimizing antimicrobial use, termed “antimicrobial stewardship” (AMS). Stewardship has since be...en applied in the context of governance of the health sector as a whole, taking responsibility for the health and well-being of the population and guiding health systems at the national and global level.
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The systematic surveillance of antibiotic use and antibiotic re-sistance prevalence in humans and animals is imperative for managingbacterial infectious disease (JPIAMR, 2019;WHO, 2015). Many low-income countries currently face substantial challenges in building national surveillance systems due to ...a lack of infrastructure and resources,resulting in a shortage of systematic data (FAO/OIE/WHO, 2018)
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An essential participant in antimicrobial stewardship who has been unrecognized and underutilized is the“staff nurse.”Although the role of staff nurses has not formally been recognized in guidelines for implementing and operating antimicrobial stewardship programs (ASPs) or defined in the medica...l literature, they have always performed numerous functions that are integral to successful antimicrobial stewardship. Nurses are antibiotic first responders, central communicators, coordinators of care, as well as 24-hour monitors of patient status, safety, and response to antibiotic therapy. An operational analysis of inpatient admissions evaluates these nursing stewardship activities and analyzes the potential benefits of nurses’formal education about, and inclusion into, ASPs.
Clinical Infectious Diseases - CID 2016:62 (1 January)•CLINICAL PRACTICE
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The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. This report augments existing guidance for other clinical settings. In 2014 and 2015, respectively, CDC release...d the Core Elements of Hospital Antibiotic Stewardship Programs and the Core Elements of Antibiotic Stewardship for Nursing Homes. Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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The Transatlantic Task Force on Antimicrobial Resistance (TATFAR) fosters cooperation between the European Union (EU) andthe United States (US) on the issue of antimicrobial resistance. The first TATFAR recommendation refers to appropriate use of antimicrobials in human medicine through hospital Ant...imicrobial Stewardship Programs (ASPs) and, specifically, to the development of common structure and process indicators of ASP. These indicators should allow characterization of programs and comparisons among healthcare systems in EU and US.
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Using antimicrobials responsibly is an essential component ofefforts to contain antimicrobial resistance (AMR), and to ensurethat patients receive appropriate treatment. The WHO global action plan on AMR emphasizes the importance of training healthcare professionals in antimicrobial prescribing and ...stew-ardship (AMPS). There are several challenges, however, such asthe wide range of healthcare professionals involved in the pre-scribing process, and the heterogeneity of prescribing rights and practices of different professional groups within and between countries. One way to address these challenges is through developing competencies, which define the minimum standards that all antimicrobial prescribers should reach.
Clinical Microbiology and Infection 25 (2019) 13e19
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A guide for practical implementation in adult and pediatric emergency department and urgent care settings
Haematologica has published European guidelines for empirical and targeted antibacterial therapy forfebrile neutropenic patients in the era of emerging resistance (ECIL-4). Indeed, collateral damage by broad-spectrum antibiotic therapy includes selection of multidrugresistant pathogens, and incr...eased predisposition to infec-tion by fungi and Clostridium difficile. Antibiotic resistance has become a major public health concern, with fears expressed that we will soon run out of antibiotics.
Haematologica December 2013 98: 1821-1825; doi:10.3324/haematol.2013.091769
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The World Health Organization’s comprehensive antenatal care (ANC) guideline WHO recommendations on antenatal care for a positive pregnancy experience was first published in 2016 with the objective of improving the quality of routine health care that all women and adolescent girls receive during p...regnancy. The overarching principle – to provide pregnant service users with a positive pregnancy experience – aims to encourage countries to expand their health-care agendas beyond survival, with a view to maximizing health, human rights and the potential of their populations. Recognizing that ANC provides a strategic platform for important health-care functions, including health promotion and disease prevention, 14 out of the 49 recommendations in the WHO 2016 ANC guideline relate to nutritional interventions in pregnancy.
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J Antimicrob Chemother https://doi.org/10.1093/jac/dkab423
Antibiotic stewardship is absolutely crucial in the fight to control antimicrobial resistance. Everyone has a part to
play. Grassroots action is essential; it is no good sitting back and waiting for world leaders to solve this problem.
In... this article I outline some of the challenges and the steps that everyone can take to do their part in tackling
the slow-moving crisis of AMR.
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Objective: To review the effectiveness of antibiotic stewardship interventions in hospitals in low- and middle-income countries.
Ces orientations relatives à la prescription par les infirmières sont destinées à aider les infirmières, les équipes, les associations, les organisations, les enseignants, les organismes de réglementation et les gouvernements du monde entier. Les nations et les régions peuvent évaluer les b...esoins de leur population, tout en équilibrant les capacités des infirmières. La planification, la mise en œuvre, le maintien et le suivi de résultats ciblés nécessitent d’adopter une stratégie réfléchie.
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L'objectif de cette publication est de fournir une approche pratique et progressive pour la mise en œuvre des plans d'action nationaux sur la RAM dans le secteur de la santé humaine ; et de fournir un processus et une compilation des outils existants de l'OMS pour prioriser, chiffrer, mettre en œ...uvre, suivre et évaluer les activités des plans d'action nationaux. Le public cible de cette publication est constitué des parties prenantes nationales/subnationales travaillant sur la RAM dans le secteur de la santé humaine. Il s'agit notamment des autorités sanitaires nationales, des groupes nationaux de coordination multisectorielle, des experts techniques de haut niveau et des décideurs impliqués dans la mise en œuvre des activités liées à la RAM à tous les niveaux du système de santé, ainsi que des partenaires de mise en œuvre afin d'accélérer la mise en œuvre, le suivi et l'évaluation durables des plans d'action nationaux sur la RAM.
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La Plateforme de partenariat multipartite sur la résistance aux antimicrobiens a pour mission de catalyser une action mondiale de lutte contre la résistance aux antimicrobiens en favorisant la coopération, à tous les niveaux, entre des partenaires très variés qui soutiennent l’approche «Une... seule santé» afin de bâtir, pour les générations actuelles et futures, un monde plus sain, plus durable et plus résilient où les médicaments d’importance vitale que sont les antimicrobiens sont préservés et accessibles à tous et à toutes.
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Antimicrobial resistance (AMR) as a serious public health threat was globally acknowledged by WHO in 2015, through the launch of the Global Action Plan (GAP). With a limited number of new antibiotics in the developmental pipeline, many countries are in the process of establishing strategies for anti...microbial stewardship (AMS). Within each country, different healthcare challenges have
contributed to AMR. This has also shaped individual AMS strategies and policies. In South Africa (SA), there is a high burden of infectious diseases, mainly of bacterial origin. In addition, SA also has the highest number of people living with
human immunodeficiency virus (HIV) globally. According to the 2019 statistics, there are approximately 7.97 million people living with HIV in SA. Together with this, SA has the fourth largest tuberculosis population globally.
Other important challenges include poverty, malnutrition, a high burden of non-communicable diseases, and a dire shortage of trained healthcare professionals (e.g. clinicians, pharmacists, and nurses).
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