Preauthorisation of broad-spectrum antibiotics and prospective review after two or three days of treatment should form the cornerstone of antibiotic stewardship programs to ensure the right drug is prescribed at the right time for the right diagnosis. These are among the numerous recommendations included in new guidelines released by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) and published in the journal Clinical Infectious Diseases.
‘Initially, antibiotic stewardship was more focused on cost savings, and physicians responded negatively to that, because they often felt it was best to give patients the newest, most expensive drug. While these programs do save hospitals money, their most important benefit is that they improve patient outcomes and reduce the emergence of antibiotic resistance. When we say stewardship, we really mean stewardship, and increasingly, doctors are realising it’s important and necessary,’ commented Tamar Barlam, MD, lead co-author of the guidelines, Director of the antibiotic stewardship program at Boston Medical Center and Associate Professor of Medicine at Boston University Medical School.
The new guidelines replace original, outdated guidelines focus instead on specific strategies that the evidence suggests are most beneficial to ensure the program will be effective and sustainable. They also note that it is key that these programs tailor interventions based on local issues, resources and expertise. To ensure this, the guidelines recommend the programs be led by physicians and pharmacists and rely on the expertise of infectious diseases specialists.
