Antimicrobial Stewardship Programs (ASPs) are becoming increasingly prevalent in the United States as concerns continue to mount regarding antimicrobial resistance and the lack of new, novel antibiotics being introduced. There are a multitude of factors that have contributed to the escalation in antimicrobial resistance, with some of the more common concerns being overly broad antimicrobial coverage and prolonged antimicrobial treatment amongst others. While antimicrobial resistance is a problem of international proportion, each health care institution remains responsible for assessing its own protocols pertinent to antimicrobial usage. ASPs have had unparalleled success in achieving their goals due to the collaboration of health care personnel, informatics, data collection, and effective policies being employed. While the pharmaceutical industry struggles with the development of novel antimicrobials, ASPs are a critical component to promote the continued efficacy of currently available antimicrobials.
A considerable number of strategies have been established to implement and manage an effective institutional ASP, including educational programs, the development of institutional antimicrobial and disease state guidelines, prior approval for certain broad-spectrum agents, post-prescription review, and computer-based decision support. However, resources are often limited thus creating barriers for institutional ASP success. Some common barriers include a lack of fundraising, inadequate or absent diagnostic facilities, poor data collection, variation in data collection, a lack of communication among various health care professionals and a lack of cooperation among health care facilities.
ASPs have the potential to reduce antimicrobial resistance evolution and therefore improve patient outcomes. The involvement of multiple health care professionals, including pharmacists, is imperative to the success of an ASP.