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Antimicrobial stewardship programs; a two-part narrative review of step-wise design and issues of controversy Part I : step-wise design of an antimicrobial stewardship program

Resman, Fredrik LU (2020) In Therapeutic Advances in Infectious Disease 7.
Abstract

Regardless of one’s opinion of antimicrobial stewardship programs (ASPs), it is hardly possible to work in hospital care and not be exposed to the term or its practical effects. Despite the term being relatively new, the number of publications in the field is vast, including several excellent reviews of general and specific aspects. Work in antimicrobial stewardship is complex, and includes not only aspects of infectious disease and microbiology, but also of epidemiology, genetics, behavioural psychology, systems science, economics and ethics, to name a few. This review aims to take several of these aspects and the scientific evidence of antimicrobial stewardship studies and merge them into two questions: How should we design ASPs based... (More)

Regardless of one’s opinion of antimicrobial stewardship programs (ASPs), it is hardly possible to work in hospital care and not be exposed to the term or its practical effects. Despite the term being relatively new, the number of publications in the field is vast, including several excellent reviews of general and specific aspects. Work in antimicrobial stewardship is complex, and includes not only aspects of infectious disease and microbiology, but also of epidemiology, genetics, behavioural psychology, systems science, economics and ethics, to name a few. This review aims to take several of these aspects and the scientific evidence of antimicrobial stewardship studies and merge them into two questions: How should we design ASPs based on what we know today? And which are the most essential unanswered questions regarding antimicrobial stewardship on a broader scale? This narrative review is written in two separate parts aiming to provide answers to the two questions. This first part is written as a step-wise approach to designing a stewardship intervention based on the pillars of unmet need, feasibility, scientific evidence and necessary core elements. It is written mainly as a guide to someone new to the field. It is sorted into five distinct steps: (a) focusing on designing aims; (b) assessing performance and local barriers to rational antimicrobial use; (c) deciding on intervention technique; (d) practical, tailored design including core element inclusion; and (e) evaluation and sustainability. The second part, published separately, formulates ten critical questions on controversies in the field of antimicrobial stewardship. It is aimed at clinicians and researchers with stewardship experience and strives to promote discussion, not to provide answers.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
antibiotics, antimicrobial stewardship, implementation science
in
Therapeutic Advances in Infectious Disease
volume
7
publisher
SAGE Publications
external identifiers
  • scopus:85089758576
  • pmid:32612826
ISSN
2049-9361
DOI
10.1177/2049936120933187
language
English
LU publication?
yes
id
d1f41987-22f3-4884-83c8-b91e742223ad
date added to LUP
2020-09-08 14:32:14
date last changed
2024-06-12 20:26:04
@article{d1f41987-22f3-4884-83c8-b91e742223ad,
  abstract     = {{<p>Regardless of one’s opinion of antimicrobial stewardship programs (ASPs), it is hardly possible to work in hospital care and not be exposed to the term or its practical effects. Despite the term being relatively new, the number of publications in the field is vast, including several excellent reviews of general and specific aspects. Work in antimicrobial stewardship is complex, and includes not only aspects of infectious disease and microbiology, but also of epidemiology, genetics, behavioural psychology, systems science, economics and ethics, to name a few. This review aims to take several of these aspects and the scientific evidence of antimicrobial stewardship studies and merge them into two questions: How should we design ASPs based on what we know today? And which are the most essential unanswered questions regarding antimicrobial stewardship on a broader scale? This narrative review is written in two separate parts aiming to provide answers to the two questions. This first part is written as a step-wise approach to designing a stewardship intervention based on the pillars of unmet need, feasibility, scientific evidence and necessary core elements. It is written mainly as a guide to someone new to the field. It is sorted into five distinct steps: (a) focusing on designing aims; (b) assessing performance and local barriers to rational antimicrobial use; (c) deciding on intervention technique; (d) practical, tailored design including core element inclusion; and (e) evaluation and sustainability. The second part, published separately, formulates ten critical questions on controversies in the field of antimicrobial stewardship. It is aimed at clinicians and researchers with stewardship experience and strives to promote discussion, not to provide answers.</p>}},
  author       = {{Resman, Fredrik}},
  issn         = {{2049-9361}},
  keywords     = {{antibiotics; antimicrobial stewardship; implementation science}},
  language     = {{eng}},
  publisher    = {{SAGE Publications}},
  series       = {{Therapeutic Advances in Infectious Disease}},
  title        = {{Antimicrobial stewardship programs; a two-part narrative review of step-wise design and issues of controversy Part I : step-wise design of an antimicrobial stewardship program}},
  url          = {{http://dx.doi.org/10.1177/2049936120933187}},
  doi          = {{10.1177/2049936120933187}},
  volume       = {{7}},
  year         = {{2020}},
}