Antimicrobial stewardship_.pptx full understanding

More understanding of antimicrobial

1. Antimicrobial stewardship Prof. Joel Manyahi Department of Microbiology and Immunology

2. Introduction Stewardship: Supervising; managing something or the careful and responsible management of something

3. Antimicrobial stewardship refers to coordinated interventions designed to: “Improve and measure the appropriate use of antimicrobial agents by promoting the selection of an optimal drug regimen including dosing, duration of therapy and route of administration.”

4. Global burden of antimicrobial resistance

5. Nature Reviews: Drug Discovery . 2007: 6; 8-12.

6. Number of new approved antibiotics over time

7. Appropriate use of Antibiotics Inappropriate use of antibiotics results in the emergence and spread of multi-drug resistant organisms Global problem Responsible use of antibiotics is essential to preserve their potency for future generations Few antimicrobials being developed by drug companies

8. Antimicrobial use in Hospitalized Patients Studies indicate that 30-50% of antibiotics prescribed in hospitals are unnecessary or inappropriate. There is no doubt that overprescribing and mis prescribing is contributing to the growing challenges posed by Clostridium difficile and antibiotic-resistant bacteria. Studies demonstrate that improving prescribing practices in hospitals can help reduce rates of Clostridium difficile infection and antibiotic resistance https://www.cdc.gov/antibiotic-use/healthcare/index.html

9. What is the Solution to Fight the AMR Crisis? Antimicrobial Stewardship (AMS) is a commitment to preserve antibiotic efficacy for future generations through appropriate use of antimicrobial drugs

10. The goal antimicrobial stewardship To ensure that the right antibiotic is given to the right patient at the right time, right dose a via the right route and frequency De-escalation to pathogen-directed therapy causing the least harm to the patient.

11. Principles of Prudent Antimicrobial Prescribing 

12. The AMS programs have the following goals To work with healthcare practitioners to prescribe  5 ”D”s  of antimicrobial therapy, which is the right  D rug, correct  D ose, right  D rug-route, suitable  D uration, timely  D e-escalation to pathogen-directed therapy.  Optimize treatments and clinical outcome To prevent antimicrobial overuse, misuse, and abuse in inpatient, outpatient, and community settings, including the agriculture industry.  To reduce antibiotic-related adverse effects, for example, C.difficile To minimize resistance To reduce healthcare-associated cost.

13. AMS Core Elements Leadership commitment: human, financial, Information Technology resources Accountability : single leader responsible for programme outcomes - Physician Drug expertise: single pharmacist leader Action: implement at least 1 recommended action Monitoring: prescribing, resistance patterns Reporting: doctors on antibiotic use/resistance Education : doctors on optimal prescribing, resistance SOPs: Quality / Action starts with “being on the same page”

14. AMS Program Partners Physicians Pharmacists Microbiologists/laboratory Infection control professional IT specialist Hospital epidemiologist Collaboration as part a comprehensive regional initiative

15. IMPACT OF ANTIMICROBIAL STEWARDSHIP (AMS) PROGRAMS 

16. Antibiotic Stewardship Improves Clinical Outcomes RR 2.8 (2.1-3.8) RR 1.7 (1.3-2.1) RR 0.2 (0.1-0.4) Percent AMP = Antibiotic Management Program UP = Usual Practice Fishman N. Am J Med 2006;119:S53 .