The current scientific literature emphasizes on reduction of inappropriate use of antimicrobials in all healthcare settings. Like the hospital setting, 40% to 75% of antibiotics prescribed in nursing homes and LTCF may be unnecessary or inappropriate. CDC also stated that most antibiotics prescriptions include nursing homes and long-term care facilities (LTCF). The main intention of this review is to highlight that it is imperative to make the optimal use of antimicrobials available and ensure to have remaining options to treat infectious agents.Īccording to the Center for Disease Control(CDC), 20 to 50% of all antibiotics prescriptions in the acute care hospital setting in the USA are either unnecessary or inappropriate. With AMS interventions, we aim for sustainable behavior change in an antibiotic prescription. AMS can be fulfilled by prescribing appropriately and educating the patients and colleagues on the proper use of this increasingly scarce medical resource to protect our current and future patients. The principles of AMS also apply to the use of antimicrobials in the animal and agriculture sectors, emphasizing the wise use of the agents.Īll healthcare practitioners must embrace roles as frontline stewards to address this emerging health and economic concern of antimicrobial resistance. The critical components like Antimicrobial Resistance(AMR) surveillance and sufficient supply of quality medicines linked with three pillars help promote equitable and quality health care. The other two include infection prevention and control(IPC) and patient and medicine safety. AMS is one of the three pillars of an integrated approach to strengthening the health care system. In simple terms, it refers to a coherent set of actions to promote the responsible use of antimicrobials. Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis. In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. Stewardship describes the careful and responsible management of something entrusted to one’s care.
With the slow development of antimicrobials, accelerated emergence, and spread of resistant organisms, antimicrobial stewardship is of utmost importance to optimize the use of existing antimicrobials. The likely reason behind this is that the development of antibiotics is risky, expensive, and less profitable than the drugs to treat chronic diseases. They include vaborbactam+meropenem and lefamulin. Only two of them represent a new class and have a new target of action. According to the World Health Organization(WHO), antibiotic pipeline data report 2021, and eleven new antibiotics have been approved since 2017.
Since 1998, only ten new antibiotics were approved, of which only linezolid and daptomycin have new targets of action.
The antimicrobial effect that saves lives also exerts selective pressure on replicating bacteria, leading to the emergence of drug resistance.īetween 19, fourteen new classes of antibiotics were introduced. They are unique in that both the individual patient and the broader society bear the consequences of their use with each prescription. With the discovery of penicillin, antibiotics are a critical part of global health, including cancer chemotherapy and advanced surgical procedures. Antimicrobial agents are not like other drugs.
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