What is antimicrobial stewardship?
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
- Misuse and overuse of antimicrobials is one of the world’s most pressing public health problems. Infectious organisms adapt to the antimicrobials designed to kill them, making the drugs ineffective.
- People infected with antimicrobial-resistant organisms are more likely to have longer, more expensive hospital stays, and may be more likely to die as a result of an infection.
- Antimicrobial stewardship interventions have been shown to improve quality of care while reducing costs.
What is antimicrobial resistance and how does it occur?
Antimicrobial resistance is the ability of microbes to resist the effects of drugs – that is, the germs are not killed, and their growth is not stopped.
- Although some people are at greater risk than others, no one can completely avoid the risk of antimicrobial-resistant infections. Infections with resistant organisms are difficult to treat, requiring costly and sometimes toxic alternatives.
- The use of antimicrobials is the single most important factor that contributes to antimicrobial resistance. Unfortunately, antimicrobials are frequently prescribed when they are not clinically indicated. When this occurs, patients receive no clinical benefit but are still at risk of experiencing adverse side effects.
- Taking antibiotics when they are not needed contributes to the development of antibiotic-resistant bacteria which affects everyone in the community. In addition, adverse events from antibiotics can include rashes, diarrhea, and severe allergic reactions. These lead to an average of 143,000 emergency department visits each year and contribute to excess health care costs.
- Antibiotic treatment is the most important risk factor for Clostridium difficile infection, which can cause life-threatening diarrhea. A 2013 study found that over 40% of patients with C. difficile infection visited a dentist or physician’s office in the preceding four months.
- Illinois has high rates of outpatient antibiotic use with 853 prescriptions per 1000 people. Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 will die.
How can antimicrobial resistance be prevented?
- Ask your health care provider if there are other steps you can take to feel better without using an antibiotic. Sometimes the best treatment may be relieving your symptoms.
- Take the antibiotic exactly as your health care provider prescribes. Never skip doses or stop taking an antibiotic early unless your health care provider tells you to do so.
- Only take antibiotics prescribed for you; do not share or use leftover antibiotics.
- Never save antibiotics to use the next time you or someone you know is sick.
- Do not take antibiotics prescribed for someone else.
- Do not ask for antibiotics when your health care provider thinks you do not need them. Antibiotics have side effects. When your health care provider says you don’t need an antibiotic, taking one may do more harm than good.
- Antibiotics only fight infections caused by bacteria. Antibiotics will NOT help you feel better if you have a viral infection like a cold or the flu. To test your knowledge about antibiotics, take a quiz here.
- Prescribe antimicrobial regimens that are consistent with the “5 D’s” of antimicrobial stewardship: Right Diagnosis, Drug, Dose, Duration and De-escalation.
- Document the dose, duration, and indication for every antibiotic prescription.
- Stay aware of antimicrobial resistance patterns in your practice & community.
- Participate in and lead efforts in your practice to improve prescribing practices.
- Follow hand hygiene and other infection control measures with every patient.
- Educate patients and families about appropriate antibiotic use.
What is the Illinois Department of Public Health doing to promote antimicrobial stewardship?
The Illinois Department of Public Health has launched several coordinated efforts to combat antimicrobial resistance and promote judicious antimicrobial use, including: