Antimicrobial Stewardship

What are the benefits of antibacterials?

prevents spread of infections, socioeconomic value due to health benefits

What are the levels of bacterial acquired resistance?

no acquired resistance, multi-drug resistance, extensive drug resistance, pan drug resistance

Define multi drug resistance.

The isolate is non-susceptible to at least 1 agent in more than 3 antimicrobial categories

Define extensive drug resistance

The isolate is non-susceptible to at least 1 agent in all but 2 or fewer antimicrobial categories

Define pan drug resistance.

The isolate is non-susceptible to all agents in all antimicrobial categories

Example of antimicrobial resistance.

Klebsiella pneumoniae carbapenem resistance in Europe, 2012 to 2022 onwards

What causes carbapenem resistance?

carbapenemase production which inactivates carbapenem antibiotics, rendering the bacteria resistant to these powerful drugs. They do this by hydrolyzing, or breaking down, the carbapenem molecule, preventing it from effectively inhibiting bacterial cell wall synthesis.

Give examples of significant multi-drug resistant pathogens.

ESBL, MRSA, MDR Mtb, candida auris.

What are the elements of antimicrobial stewardship?

Governance, Education and training, audit and surveillance, targeted quality improvement interventions

For antimicrobial stewardship to be effective it must:

have broad support across the healthcare organisation, be systematically planned and delivered, be integrated with microbiology, laboratory and intervention prevention activity

Define antimicrobial stewardship.

Antimicrobial stewardship (AMS) refers to an organisational or healthcare system-wide approach to promoting and monitoring judicious use of antimicrobials to preserve their future effectiveness.