3 years ago

What is antimicrobial stewardship?

The use of the term “antimicrobial stewardship” (AMS) has grown exponentially in recent years, typically referring to programmes and interventions that aim to optimise antimicrobial use. Although AMS originated within human healthcare, it is increasingly applied in broader contexts including animal health and One Health. As the use of the term AMS becomes more common, it is important to consider what AMS is, as well as what it is not. Aims To review the emergence and evolution of the term “antimicrobial stewardship”. Sources We searched and reviewed existing literature and official documents, which mostly focused on antibiotics. We contacted the authors of the first publications that mentioned “antimicrobial stewardship”. Content We describe the historical background behind how antimicrobial stewardship came into use in clinical settings. We discuss challenges emerging from the varied descriptions of antimicrobial stewardship in the literature, including an over-emphasis on individual prescriptions, an under-emphasis on the societal implications of antimicrobial use, and language translation problems. Implications To help address these challenges, we suggest viewing antimicrobial stewardship as a strategy, a coherent set of actions designed to use antimicrobial responsibly. We stress the continuous need for “responsible use” to be defined and translated into context- and time-specific actions. Furthermore, we present examples of actions that can be undertaken within antimicrobial stewardship across human and animal health.

Publisher URL: www.sciencedirect.com/science

DOI: S1198743X17304895

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