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Antimicrobial Stewardship

"But I would like to sound a note of warning ... It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them and the same thing has occasionally happened in the body."- Sir Alexander Fleming, 1945

Infections due to organisms such as C. difficile, methacillin-resistant S. aureus (MRSA) and multi-drug resistant gram-negative organisms are responsible for significant morbidity and mortality.  By 2050, these and other antimicrobial resistant organisms will kill more people than cancer every year.  Many of these infections are the consequence of inappropriate antimicrobial use. 


It is estimated that up to 50% of antimicrobial use is unnecessary.  Inadequate infection control measures and the transmission of hospital or community-acquired infections contribute to the issue of antimicrobial resistance in our healthcare institutions.  Compounding the problem is the paucity of new antimicrobials in the research and development pipeline.  Optimizing patient outcomes, while minimizing unintended consequences of antimicrobial use through active stewardship, is an important strategy to preserve these precious resources.

What is Antimicrobial Stewardship
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  • The appropriate use of antimicrobials to optimize clinical outcomes, combat resistant infections, avoid adverse drug events, and minimize costs.

  • Uses clinical practice, research, and education to achieve the goal.

  • Employs principles of quality improvement.

  • Relies on data to implement and modify antimicrobial practices.

  • Involves education of healthcare providers.

  • Utilizes pathways, protocols, and care maps to define best practices.

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