Antimicrobial Stewardship Programs Are Vital to Reduce Antibiotic Consumption

Formalized ASPs have been implemented in hospitals and other settings to optimize antimicrobial (including antibiotic) usage and slow the development of resistant organisms. By setting easy-to-follow protocols for clinicians and stakeholders that can be monitored over time and deploying additional initiatives such as patient education, ASPs can support proper hospital prescribing and community consumption of antimicrobials. While ASPs demonstrate variability in structure, function and goal setting – all prioritize patient safety and the minimization of healthcare expenses. Recent studies reveal that across healthcare settings globally, observed ASPs were able to deliver a decrease in antibiotic consumption by 28% and reduce overall antimicrobial prescriptions by 10%. ²  According to Brian Raux, Board-Certified Infectious Diseases Pharmacist and Medical Advisor at bioMérieux, “Every healthcare situation around the globe is unique, but the foundational principles of antimicrobial stewardship programs have led to successes in not only a single clinic but across regions.”

In Colombia, ASPs were implemented in a few institutions according to their available resources. Before the ASPs, there was a trend toward an increase in the antibiotic consumption of the measured antimicrobials. However, afterward, there was an overall decrease in antibiotic consumption — with one institution seeing a reduction of 45%.³

At a hospital in the West Bank, Palestine, a study assessed the effect of ASP on a targeted group of broad-spectrum antibiotics over a period of 20 months before, and 17 months after, an ASP’s implementation. The study demonstrated that the ASP positively reduced both costs and antimicrobial consumption — with no statistically significant effect on the mortality rate.⁴

While the number of hospital-based ASPs is growing internationally, low- and middle-income countries (LMICs) have struggled to reach the equivalent success of more advanced regions. ASPs in these countries face a variety of challenges, from a shortage of human resources and inadequate laboratory infrastructure to limited governmental support and/or a lack of national guidelines. What’s more, physicians in LMICs often have a suboptimal level of knowledge and familiarity with ASPs.⁵ However, most seem eager to receive the necessary training and guidance.

To help address the unique challenges faced in LMICs, public agencies like the World Health Organization (WHO) have developed in-depth resources to support healthcare facilities, including how to get started with an ASP, methods for monitoring performance, as well as activation of training and education. Their most recent publication titled Policy Guidance on Integrated Antimicrobial Stewardship Activities ⁶ profiles proven and practical actions that could accelerate stewardship and bring to the forefront the importance of optimized diagnosis supported by fast and accurate microbiological tests and data. 

While rapid diagnostic tests have generally been undervalued in the preservation of antimicrobials, the growing body of evidence supports the medical and economic value of diagnostics and analytics in addressing AMR at both the patient and population levels. With continued advances in tools such as cloud-based software services, data sharing and analysis are becoming more accessible, affordable, and equitable to institutions of all sizes.⁷  

Research continues to reveal a clear correlation between the implementation of ASPs and the reduction of antibiotic consumption. While some countries are further along in embracing and advancing stewardship in daily practice, ASPs are proving to be a vital tool for combating the progressive threat of AMR.  “With modern solutions and heightened global collaboration, the implementation of stewardship programs becomes more achievable and their outcomes more quantifiable, underscoring their indispensable medical and economic benefits,” Raux concludes.