Antimicrobial Stewardship

5/31/2017

Antimicrobial stewardship (AMS) is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance and decreases the spread of infections caused by multidrug-resistant organisms. AMS is a Joint Commission Standard for medication management, and as of January, 2017, will be a condition for participation in the CMS program.

Policies are being put in place throughout Lafayette General Health. In essence, if a physician or provider prescribes a restricted antimicrobial, he or she will be contacted by the clinical pharmacist within 24 hours to try to get the discontinuation and substitution of the restricted antimicrobial. If the patient is to remain on the restricted antimicrobial, then an automatic Infectious Disease consultation will be triggered. The ID physician will ensure that the use of antimicrobial is appropriate. The consulting ID physician will also decide when and how long to stay on the case as needed.

Antibiotics are the only drugs where inappropriate use by a single person affects the efficacy of the medication for others. This is the reason why we, as healthcare providers, must become stewards of antibiotics for future generations. Microorganisms are rapidly evolving to become resistant to our current antibiotics. This can be seen from local, state and national levels with the emergence of new multi-drug resistant organisms.

The definition of antimicrobial stewardship is delivering the correct antimicrobial for the appropriate indication at the right dose and route for the right duration. Key factors of Antimicrobial Stewardship involve reviewing specific medications for the ability to de-escalate in a timely manner, establishing a duration of therapy and reviewing microbiology reports to optimize treatment. All of these aspects are performed for the same goal, which is to give the patient the proper medication to treat a specific infection and get him or her back to enjoyable normal daily activities.

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