Jennifer Emberger1, Dan Tassone2, Michael P Stevens3, J Daniel Markley4. 1. Virginia Commonwealth University Medical Center, VMI Building, 2nd Floor, Room 204, Richmond, VA, 23298, USA. jennifer.emberger@vcuhealth.org. 2. Hunter Holmes McGuire Veterans Affairs Medical Center, Virginia Commonwealth University School of Pharmacy, Richmond, VA, USA. 3. Department of Internal Medicine, Division of Infectious Diseases, Virginia Commonwealth University Medical Center, Richmond, VA, USA. 4. Department of Internal Medicine, Division of Infectious Diseases, Hunter Holmes McGuire Veterans Affairs Medical Center, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
Abstract
PURPOSE OF REVIEW: The aim of this study is to examine the current state of the field of antimicrobial stewardship (AS) by highlighting key challenges and successes, as well as exciting future directions. RECENT FINDINGS: AS mandates from the Centers for Medicare and Medicaid (CMS) and the Joint Commission (TJC) will stimulate increased compliance with current AS standards, but overall compliance is currently poor. Key challenges to progress in the field of AS include insufficient workforce and monetary resources, poorly defined AS metrics, and much needed expansion beyond the inpatient hospital setting. Despite these challenges, massive progress has been made in the last two and a half decades since the field of AS emerged. AS metrics are rapidly evolving and transforming the way antimicrobial stewardship programs (ASPs) measure success. Rapid diagnostics and diagnostic test stewardship are proving to be extremely effective when coupled with an ASP. Telehealth may improve access to ASP expertise in resource poor settings, and the role of bedside nurses as ASP team members has the potential to greatly augment ASP efforts. Allergy testing as an ASP strategy remains largely underutilized. ASPs have made significant gains in the battle against antimicrobial resistance (AR), but considerable advancement is still needed. Awareness of current challenges is critical to ensure progress in the field. The field of AS is expanding and transforming rapidly through integration, technology, and improved processes.
PURPOSE OF REVIEW: The aim of this study is to examine the current state of the field of antimicrobial stewardship (AS) by highlighting key challenges and successes, as well as exciting future directions. RECENT FINDINGS: AS mandates from the Centers for Medicare and Medicaid (CMS) and the Joint Commission (TJC) will stimulate increased compliance with current AS standards, but overall compliance is currently poor. Key challenges to progress in the field of AS include insufficient workforce and monetary resources, poorly defined AS metrics, and much needed expansion beyond the inpatient hospital setting. Despite these challenges, massive progress has been made in the last two and a half decades since the field of AS emerged. AS metrics are rapidly evolving and transforming the way antimicrobial stewardship programs (ASPs) measure success. Rapid diagnostics and diagnostic test stewardship are proving to be extremely effective when coupled with an ASP. Telehealth may improve access to ASP expertise in resource poor settings, and the role of bedside nurses as ASP team members has the potential to greatly augment ASP efforts. Allergy testing as an ASP strategy remains largely underutilized. ASPs have made significant gains in the battle against antimicrobial resistance (AR), but considerable advancement is still needed. Awareness of current challenges is critical to ensure progress in the field. The field of AS is expanding and transforming rapidly through integration, technology, and improved processes.
Authors: Timothy P Gauthier; Marylee Worley; Vanesa Laboy; Luis Hernandez; Nathan R Unger; Elizabeth M Sherman; Corey Frederick; Laura Aragon Journal: Clin Infect Dis Date: 2014-11-18 Impact factor: 9.079
Authors: Peter Davey; Charis A Marwick; Claire L Scott; Esmita Charani; Kirsty McNeil; Erwin Brown; Ian M Gould; Craig R Ramsay; Susan Michie Journal: Cochrane Database Syst Rev Date: 2017-02-09
Authors: Paul E Brumley; Anurag N Malani; Jared J Kabara; Jennifer Pisani; Curtis D Collins Journal: J Antimicrob Chemother Date: 2015-12-11 Impact factor: 5.790
Authors: Eili Y Klein; Thomas P Van Boeckel; Elena M Martinez; Suraj Pant; Sumanth Gandra; Simon A Levin; Herman Goossens; Ramanan Laxminarayan Journal: Proc Natl Acad Sci U S A Date: 2018-03-26 Impact factor: 11.205
Authors: Jean-François Timsit; Matteo Bassetti; Olaf Cremer; George Daikos; Jan de Waele; Andre Kallil; Eric Kipnis; Marin Kollef; Kevin Laupland; Jose-Artur Paiva; Jesús Rodríguez-Baño; Étienne Ruppé; Jorge Salluh; Fabio Silvio Taccone; Emmanuel Weiss; François Barbier Journal: Intensive Care Med Date: 2019-01-18 Impact factor: 17.440
Authors: Christian Pallares; Cristhian Hernández-Gómez; Tobías Manuel Appel; Kevin Escandón; Sergio Reyes; Soraya Salcedo; Lorena Matta; Ernesto Martínez; Sara Cobo; Laura Mora; Adriana Marín; Adriana Correa; Elsa De La Cadena; Jesús Rodríguez-Baño; María Virginia Villegas Journal: BMC Infect Dis Date: 2022-05-02 Impact factor: 3.667
Authors: Huong Thi Lan Vu; Raph L Hamers; Ralalicia Limato; Direk Limmathurotsakul; Abhilasha Karkey; Elizabeth Dodds Ashley; Deverick Anderson; Payal K Patel; Twisha S Patel; Fernanda C Lessa; H Rogier van Doorn Journal: BMJ Open Date: 2022-09-15 Impact factor: 3.006