Antimicrobial Stewardship: The rationale

  • The world is now facing the threat that antibiotics will no longer be effective to treat infections, due to both the massive misuse of such drugs for too many years and the insufficient attention paid to practices aiming at preventing diffusion and spread of multi drug-resistant organisms (MDRO).
  • Physicians rely on the ability to treat infections to go forth: extensive abdominal surgery, transplants, intensive care need the certainty of effective weapons against infecting pathogens, or the whole edifice of modern medicine itself will crumble.
  • The accountability of performing thorough risk assessment for every single patient, choosing the optimal antimicrobial regimen with the least impact on antimicrobial resistance accordingly, while preserving patients from unintended or toxic events related to inappropriate treatment must be the target for the next future.
  • Among the bacterial pathogens, Staphylococcus aureus, enterococci, a range of enterobacteria (eg, Escherichia coli, Klebsiella spp, Enterobacter app), and nonfermenters (eg, Pseudomonas, Acinetobacter, Stenotrophomonas) have the highest rate of multidrug resistance and are the most difficult to treat. Effective antibacterial treatment of these infections requires informed management of antibacterial treatment options.
  • Beyond the selection of a suitable antibiotic, the administration of an appropriate dosing regimen (dose and schedule) may affect the probability for clinical success.
  • Optimizing antimicrobial therapy considering all, clinical, epidemiological and economical aspects, is therefore becoming increasingly complex. In this setting, antimicrobial stewardship pretends assist clinicians in the optimal use of antimicrobials.

Antimicrobial Stewardship: OVLC

ESGAP/ESCMID-OVLC is being created to provide resources (information & tools) and guidance with an educational focus tofoster antimicrobial stewardship among healthcare professionals. Its aims are to:

  • Provide a platform for showcasing, dissemination and highlighting good practice of antimicrobial use
  • Promote opinion exchanges and debate regarding antimicrobial use, policy and stewardship
  • Facilitate the co-ordination of pragmatic clinical practice surveys of stewardship activity
  • Make this tool available also for other ESCMID study groups