Antimicrobial Stewardship: The Rationale

  • The world is now facing the threat that antibiotics will no longer be effective to treat infections.
  • Physicians rely on the ability to treat infections to go forth: extensive abdominal surgery, transplants, intensive care need the certainty of effective weapons against infecting pathogens, or the whole edifice of modern medicine itself will crumble
  • The link between antibiotic use and resistance is clear.
  • Consequently, concerns about inappropriate antibiotic prescribing has never been greater.
  • The role of antimicrobial stewardship combined with other measures has been recognised as pivotal  [Lancet Infect Dis 2013; 13: 1057-98] :  reversal or control of resistance problems is often feasible by changing patterns of antibiotic use.
  • Audits repeatedly show tremendous variations in standards for antibiotic prescription, but the common topic is one of unnecessary use.
  • Unfortunately, there are no reliable comparative data on antibiotic prescribing and control measures, although the importance of collecting such data was emphasised in the recent Copenhagen Declaration.

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