Title
Implementing an Antibiotic Stewardship Program
Authoring Organizations
Publication Month/Year
April 13, 2016
Last Updated Month/Year
October 9, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
The purpose of this guideline is to comprehensively evaluate the wide range of interventions that can be implemented by Antibiotic Stewardship Programs (ASPs) in emergency department, acute inpatient, and longterm care settings as they determine the best approaches to influence the optimal use of antibiotics within their own institutional environments.
PICO Questions
Does the Use of Preauthorization and/or Prospective Audit and Feedback Interventions by ASPs Improve Antibiotic Utilization and Patient Outcomes?
Is Didactic Education a Useful Antibiotic Stewardship Intervention for Reducing Inappropriate Antibiotic Use?
Should ASPs Develop and Implement Facility-Specific Clinical Practice Guidelines for Common Infectious Diseases Syndromes to Improve Antibiotic Utilization and Patient Outcomes?
Should ASPs Implement Interventions to Improve Antibiotic Use and Clinical Outcomes That Target Patients With Specific Infectious Diseases Syndromes?
Should ASPs Implement Interventions Designed to Reduce the Use of Antibiotics Associated With a High Risk of CDI?
Do Strategies to Encourage Prescriber-Led Review of Appropriateness of Antibiotic Regimens, in the Absence of Direct Input From an Antibiotic Stewardship Team, Improve Antibiotic Prescribing?
Should Computerized Clinical Decision Support Systems Integrated Into the Electronic Health Record at the Time of Prescribing be Incorporated as Part of ASPs to Improve Antibiotic Prescribing?
Should ASPs Implement Strategies That Promote Cycling or Mixing in Antibiotic Selection to Reduce Antibiotic Resistance?
In Hospitalized Patients Requiring Intravenous (IV) Antibiotics, Does a Dedicated Pharmacokinetic (PK) Monitoring and Adjustment Program Lead to Improved Clinical Outcomes and Reduced Costs?
In Hospitalized Patients, Should ASPs Advocate for Alternative Dosing Strategies Based on PK/Pharmacodynamic Principles to Improve Outcomes and Decrease Costs for Broad-Spectrum ß-Lactams and Vancomycin?
Should ASPs Implement Interventions to Increase Use of Oral Antibiotics as a Strategy to Improve Outcomes or Decrease Costs?
In Patients With a Reported History of ß-Lactam Allergy, Should ASPs Facilitate Initiatives to Implement Allergy Assessments With the Goal of Improved Use of First-Line Antibiotics?
Should ASPs Implement Interventions to Reduce Antibiotic Therapy to the Shortest Effective Duration?
Should ASPs Work With the Microbiology Laboratory to Develop Stratified Antibiograms, Compared With Nonstratified Antibiograms?
Should ASPs Work With the Microbiology Laboratory to Perform Selective or Cascade Reporting of Antibiotic Susceptibility Test Results?
Should ASPs Advocate for Use of Rapid Viral Testing for Respiratory Pathogens to Reduce the Use of Inappropriate Antibiotics?
Should ASPs Advocate for Rapid Diagnostic Testing on Blood Specimens to Optimize Antibiotic Therapy and Improve Clinical Outcomes?
In Adults in Intensive Care Units (ICUs) With Suspected Infection, Should ASPs Advocate Procalcitonin (PCT) Testing as an Intervention to Decrease Antibiotic Use?
In Patients With Hematologic Malignancy, Should ASPs Advocate for Incorporation of Nonculture-Based Fungal Markers in Interventions to Optimize Antifungal Use?
Which Overall Measures Best Reflect the Impact of ASPs and Their Interventions?
What is the Best Measure of Expenditures on Antibiotics to Assess the Impact of ASPs and Interventions?
What Measures Best Reflect the Impact of Interventions to Improve Antibiotic Use and Clinical Outcomes in Patients With Specific Infectious Diseases Syndromes?
Should ASPs Develop Facility-Specific Clinical Guidelines for Management of Fever and Neutropenia (F&N) in Hematology-Oncology Patients to Reduce Unnecessary Antibiotic Use and Improve Outcomes?
In Immunocompromised Patients Receiving Antifungal Therapy, do Interventions by ASPs Improve Utilization and Outcomes?
In Residents of Nursing Homes and Skilled Nursing Facilities, do Antibiotic Stewardship Strategies Decrease Unnecessary Use of Antibiotics and Improve Clinical Outcomes?
In Neonatal Intensive Care Units (NICUs), do Antibiotic Stewardship Interventions Reduce Inappropriate Antibiotic Use and/or Resistance?
Should ASPs Implement Interventions to Reduce Antibiotic Therapy in Terminally Ill Patients?
Inclusion Criteria
Male, Female, Adolescent, Adult, Child, Infant, Older adult
Health Care Settings
Hospital, Outpatient, Operating and recovery room
Intended Users
Epidemiology infection prevention, nurse, nurse practitioner, health systems pharmacist, physician, physician assistant
Scope
Management, Prevention
Keywords
Antibiotic Stewardship, Antimicrobial Stewardship, ASP, Antibiotic Resistance
Source Citation
Tamar F. Barlam, Sara E. Cosgrove, Lilian M. Abbo, Conan MacDougall, Audrey N. Schuetz, Edward J. Septimus, Arjun Srinivasan, Timothy H. Dellit, Yngve T. Falck-Ytter, Neil O. Fishman, Cindy W. Hamilton, Timothy C. Jenkins, Pamela A. Lipsett, Preeti N. Malani, Larissa S. May, Gregory J. Moran, Melinda M. Neuhauser, Jason G. Newland, Christopher A. Ohl, Matthew H. Samore, Susan K. Seo, Kavita K. Trivedi, Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America, Clinical Infectious Diseases, Volume 62, Issue 10, 15 May 2016, Pages e51–e77, https://doi.org/10.1093/cid/ciw118