Journal
MEDICAL CLINICS OF NORTH AMERICA
Volume 102, Issue 5, Pages 805-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.mcna.2018.04.004
Keywords
Antimicrobial resistance; Antimicrobial stewardship; Interventions; Antimicrobial restriction; Antimicrobial cycling; Decision support
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Antimicrobial stewardship programs aim to reduce costs, optimize therapeutic outcomes, and reduce antimicrobial resistance. Reductions of antimicrobial resistance are the most elusive because emergence and spread of resistant bacteria involves antimicrobial selective pressure and lapses in infection control techniques. The relationship between antimicrobial usage and resistance is not always direct. The understanding of which techniques are most effective is limited because many studies are descriptive or quasiexperimental. Recent meta-analyses or systematic reviews of stewardship programs offer encouragement that some interventions reduce overall antimicrobial selective pressure and, where associated with infection control interventions, affect resistance rates in individual institutions.
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