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Antibiotics 2013, 2(3), 400-418;

Antimicrobial Stewardship: The Need to Cover All Bases

Barwon Health, Bellerine St, Geelong, VIC 3220, Australia
Deakin University, Geelong, VIC 3216, Australia 
Received: 4 June 2013 / Revised: 18 August 2013 / Accepted: 21 August 2013 / Published: 27 August 2013
(This article belongs to the Special Issue Rational Use of Antibiotics)
Full-Text   |   PDF [359 KB, uploaded 27 August 2013]


Increasing antimicrobial resistance has necessitated an approach to guide the use of antibiotics. The necessity to guide antimicrobial use via stewardship has never been more urgent. The decline in anti-infective innovation and the failure of currently available antimicrobials to treat some serious infections forces clinicians to change those behaviors that drive antimicrobial resistance. The majority of antimicrobial stewardship (AMS) programs function in acute-care hospitals, however, hospitals are only one setting where antibiotics are prescribed. Antimicrobial use is also high in residential aged care facilities and in the community. Prescribing in aged care is influenced by the fact that elderly residents have lowered immunity, are susceptible to infection and are frequently colonized with multi-resistant organisms. While in the community, prescribers are faced with public misconceptions about the effectiveness of antibiotics for many upper respiratory tract illnesses. AMS programs in all of these locations must be sustainable over a long period of time in order to be effective. A future with effective antimicrobials to treat bacterial infection will depend on AMS covering all of these bases. This review discusses AMS in acute care hospitals, aged care and the community and emphasizes that AMS is critical to patient safety and relies on government, clinician and community engagement. View Full-Text
Keywords: antimicrobial; stewardship; resistance; antibiotics antimicrobial; stewardship; resistance; antibiotics
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Friedman, N.D. Antimicrobial Stewardship: The Need to Cover All Bases. Antibiotics 2013, 2, 400-418.

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