All over the world, antibiotic resistance is a constant issue. The CDC has issued statements about antibiotic stewardship, and now event the US Government wants to implement programs in hospitals to cut down on overuse of antibiotics. Antibiotic “stewardship” is the description of these programs that will optimize the antibiotic selection process.
The first step is making sure hospitals are transparent and public about the frequency of health-care related infections along with making them commit to establishing these programs. A lot of medical professionals need to be reminded that they are the only pharmacological entity that loses efficacy over extended use, so the the criteria for prescribing them should also be put under scrutiny. If a well-defined system is put in place, with regulations on things like time frames of use or prior authorization for specific antibiotics before use, maybe they can crack down on the complication that is antibiotic resistance.
The article uses the example of fluroquinolones, the only antibiotic that is used to treat gram-negative bacilli. Oftentimes, prescribers just resort to the antibiotic, where there are other treatment options readily available. The more we prescribe antibiotics over other treatments, the more susceptible we make the patient and society in general to infections. Here’s a situation where a guideline could be put in place. Maybe if a diagnosis is reached, there could be a chart with potential action plans that prioritize antibiotics as a last option.
Spellberg B, Srinivasn A, Chambers H. New societal approaches to empowering antibiotic stewardship. JAMA. doi:10.1001/jama.2016.1346 (published 25 February 2016).