Stewardship, stewardship, and more stewardship!

That’s what you’ll find when you read the April issue of ICHE. The entire issue is dedicated to antimicrobial stewardship, and includes several excellent articles. So consider it your Spring Break reading.

There’s even an article from Eli’s old stomping ground, describing what happens when you take an effective antimicrobial stewardship program and flush it (spoiler alert: turns out to be a bad idea). Lest we forget, the Maryland group is still the only one to demonstrate, in a randomized controlled trial, the effectiveness of adding computerized clinical decision support for stewardship efforts. So go back and read that paper too, while you’re at it.

I’ll end with this quote from our friends Arjun Srinivasan and Neil Fishman, from the intro to the special issue:

There has perhaps never been a more critical juncture for antimicrobial stewardship. There is growing interest from key stakeholders—clinicians, healthcare administrators, and policy makers—and a growing body of evidence demonstrating the benefits of stewardship. We now need to harness the interest and the science to move toward making stewardship programs an integral part of all healthcare facilities. Education and messaging will play an important role. For too long, our message on the benefits of stewardship has been too narrowly focused on reducing costs and potentially reducing antibiotic resistance. The former is not compelling to most clinicians, and the latter, while generally accepted, has been difficult to demonstrate clearly since the emergence and spread of resistance is so complicated and multifactorial. Moving forward, we need to emphasize that antibiotic stewardship is, fundamentally, a critical patient safety and public health issue for all healthcare settings that can improve the quality of care.

Photo: Alexander Fleming, from Wikimedia Commons