Guest Author – Neil Fishman, M.D.
Associate Chief Medical Officer for the University of Pennsylvania Health System,
Associate Professor of Medicine at the University of Pennsylvania School of Medicine.
I have noticed more conversations at hospitals, in the community, and even among policy makers about the importance of preserving our antibiotic supply in the setting of rapidly emerging resistance, and about the role of antimicrobial stewardship programs in helping to achieve this goal. Antimicrobial resistance is a critical issue that significantly impacts healthcare quality, patient safety and public health. Most people in the healthcare industry “know” we need to practice stewardship to address the problem. But, as they say, talk is cheap.
On one hand, I am thrilled about the growing recognition of the importance of antimicrobial stewardship. Suddenly, it seems, my lifelong commitment to this issue has a receptive audience. On the other hand, truly effective stewardship means more than just an acknowledgement of its importance. Healthcare practitioners, administrators, and policymakers need real tools to put effective antimicrobial stewardship strategies into place.
Antimicrobial Stewardship is designed to promote the appropriate use of antibiotics. Antimicrobial Stewardship programs help prescribers choose the optimal antimicrobial drug regimen at the correct dose, and to administer it via the correct route for the correct duration. Therefore, effective stewardship programs not only improve the quality of care but also can reduce wasteful spending.
My friend and colleague, Dr. Arjun Srinivasan from the Centers for Disease Control and Prevention, and I were honored to serve as guest editors for the April 2012 issue of Infection Control and Hospital Epidemiology (ICHE), the journal of the Society for Healthcare Epidemiology of America (SHEA). The issue is dedicated to the emerging science that supports better antimicrobial stewardship as powerful and immediate interventions to improve patient safety and health outcomes.
The special issue of ICHE highlights 24 articles, selected from the nearly 80 submitted for the issue, ranging from analyses of the economic impact of stewardship and a multi-center intervention trial funded by the CDC Prevention Epicenter Program to the implementation of antimicrobial stewardship programs in alternate care settings. Over and over, these studies show that investing in antimicrobial stewardship makes clinical and financial sense.
The issue also includes a joint policy statement from SHEA, IDSA and PIDS defining a national approach to antimicrobial stewardship, as well as a joint policy statement with APIC on the role of the Infection Preventionist in stewardship. These statements can help organizations frame the infrastructures needed to establish effective stewardship programs.
The science showcased in ICHE will help all of us move from merely talking about stewardship to actually putting these strategies into action. My colleagues at SHEA and I have been talking about stewardship for a long time. Now it’s time for all of us to act.