Ask the care expert ... about antibiotic stewardship

Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA

I keep hearing our director of nursing talk about antibiotic stewardship. I have no idea what this is, but don't want to ask for fear she will think badly of me. Can you help?

According to SHEA (Society for Healthcare Epidemiology of America) antibiotic stewardship refers to “a set of coordinated strategies to improve the use of antimicrobial medications with the goal of enhancing patient health outcomes, reducing resistance to antibiotics, and decreasing unnecessary costs.”

Antibiotics have transformed healthcare over the years. Today, resistance to antimicrobial treatment is a critical issue, contributing to rapid spread of multiple organisms for which few treatments are available.

The major objectives of antimicrobial stewardship are to achieve optimal clinical outcomes related to antimicrobial use, to minimize toxicity and other adverse events, and to limit the selection for antimicrobial resistant strains. Antimicrobial stewardship also may reduce excessive costs attributable to suboptimal antimicrobial use.

Think of it like this: When you have a family member approach the nurses station at 5 p.m. and tell you their loved one is “acting funny” and they want you to call the doctor to get an antibiotic order. This is now your opportunity to start assisting the family member to understand antibiotic stewardship. Antibiotics should be used only if there is an infection or an actual documented issue that requires their use. We have used antibiotics too much and now we are dealing with C.diff and MRSA, to name just two possible, if not probable, outcomes of excess antibiotic use.

I encourage you to look at www.CDC.gov, www.shea-online.org and www.apic.org for more information on antibiotic stewardship.