Antimicrobial stewardship – new guidelines proposed

A new study from the Center for Disease Dynamics, Economics & Policy (CDDEP; DC, USA) and the Université de Lorraine (France) has identified seven core elements they believe to be fundamental to effective antimicrobial stewardship programs in all settings.

Antimicrobial stewardship programs in healthcare facilities are critical to in managing the threat of antimicrobial resistance and in order for these to be maximally effective, essential elements must be identified and standardized.

However, previous efforts to assess and standardize such programs have been confined to high-income countries. This is a concern after news from the CDDEP last week highlighted that the global consumption of antibiotics is rising, with the largest increases in low- and middle-income countries.

In this study, published Clinical Microbiology and Infection, researchers identified essential elements of antimicrobial stewardship programs that could be applicable to all hospitals, regardless of economic or geographic setting.

The work was conducted with help of 15 experts from 13 countries across six continents. Using a consensus process, the team identified seven core elements – leadership commitment, accountability, drug expertise, action, tracking, reporting and education – that are relevant across both high-income and low-income settings.

CDDEP fellow and study co-author Sumanth Gandra commented: “An agreement of this nature will make a major contribution to slowing the spread of antibiotic resistance. It will also facilitate the development of each nation’s antimicrobial stewardship guidelines, especially in low income countries.”

The next steps for this research will be to evaluate these seven core elements in a range of settings with broader stakeholder groups. Author, Celine Pulcini (Université de Lorraine) concluded: “With standardized antimicrobial stewardship program guidelines, analysis and evaluation of the programs will also be possible, which is an essential part of fine-tuning the practices and learning from one another.”

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Sources: Pulcini C, Binda F, Lamkang AS et al. Developing core elements and checklist items for global hospital antimicrobial stewardship programmes: a consensus approach. Clin. Microbiol. Infect. doi:10.1016/j.cmi.2018.03.033 (2018) (Epub ahead of print);


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