Rational use initiatives work to prevent harm, improve patient safety and work to reverse increasing rates of antibiotic resistance.
Rational use and antibiotic stewardship programs
Up to 50% of the use of antibiotics is inappropriate, adding considerable costs to patient care and increasing both morbidity and mortality. Rational use (or antibiotic stewardship) programs are coordinated interprofessional efforts to improve and measure the appropriate use of antibiotics in order to optimize clinical outcomes, minimize unintended consequences such as toxicity, and reduce the selection pressure on bacterial populations that lead to the emergence of resistance. They can focus on for example antibiotic selection, dosing, route, and duration of therapy, which are primarily decisions undertaken by prescribers.
Rational use initiatives have demonstrated that it is possible to improve use of antibiotics, patient care, provide cost savings and in some cases reduce resistance levels. While initial financial support is crucial for developing initiatives, programs can become self supporting over time.
Many initiatives can be taken within individual health care facilities to improve the use of antibiotics. However, a formally organized rational use program has greater chances for a longer lasting effect. National guidelines, when they exist, can form the basis for and facilitate the development and implementation of programs at health care-facilities.
Core components outlines basic, overarching elements recommended to include in a rational use program or effort.
Set up a program describes the use of a five-step project management process to establish rational use programs in health care facilities.
Interventions provides information and resources on possible interventions for the rational use of antibiotics.
Want to keep up to date and learn about relevant rational use initiatives?
The Center for Infectious Disease Research and Policy (CIDRAP) has compiled a variety of online resources on antimicrobial stewardship. Here, they link to relevant initiatives, projects, organizations and more (US and international).
You can also sign up to CIDRAP’s weekly newsletter on antimicrobial stewardship here.
|How to start an antimicrobial stewardship programme in a hospital||Review that gives a “How-to” guide for health care professionals to set up an antibiotic stewardship program. Provides step-by-step guidance through a 6-month process and links to relevant resources. Suitable for use worldwide.|
|Antibiotic stewardship – the ultimate return on investment||Factsheet about the benefits of antibiotic stewardship programs, part of the CDC Get Smart about Antibiotics Week 2014.|