Antibiotic stewardship in critical care

<span class="paragraphSection"><div class="boxedTextSection">Key pointsAlthough antibacterial resistance is growing, development of new antibiotics is in decline. Therefore strategies are needed to maintain the effectiveness of current antibiotics for as long as possible.<ul><li class="bullet">Infections due to resistant organisms are associated with higher mortality, morbidity, longer hospital stays, and higher health care costs.</li><li class="bullet">An Antibiotic Stewardship Program is overseen by a multidisciplinary team consisting of clinicians, clinical pharmacists, and clinical microbiologists. Unusual infections may benefit from additional investigation and treatment advice from an infectious disease clinician and infection control specialists may provide advice relating to reducing spread.</li><li class="bullet">The key aims of antibiotic stewardship are to ensure the right drug is given at the right time, at the right dose and for the right duration, aiming to eradicate infection whilst minimizing collateral damage.</li><li class="bullet">Key components include: Prospective audit and feedback, antibiotic restriction, de-escalation, education, guideline use, optimal dosing and duration, microbiologist, and computer aided clinical support.</li><li class="bullet">Restrictive antibiotic policies are shown to improve antibiotic prescribing and resistance patterns. Antibiotic stewardship has not been shown to increase patient mortality, hospital length of stay or readmission.</li></ul></div></span>

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