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Antimicrobial stewardship, surveillance of antimicrobial consumption, and its consequences 

Antimicrobial stewardship, surveillance of antimicrobial consumption, and its consequences
Chapter:
Antimicrobial stewardship, surveillance of antimicrobial consumption, and its consequences
Author(s):

Peter Davey

, Mark Wilcox

, William Irving

, and Guy Thwaites

DOI:
10.1093/med/9780199689774.003.0020
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date: 21 April 2021

Surveillance of antimicrobial use and infections are critical to the control of resistance and Clostridium difficile infection. There is increasing evidence that national campaigns and targeted interventions have been successful in reducing both resistance and C. difficile infection. The twin goals of antibiotic stewardship are first to ensure effective, timely treatment of infection and second to minimize collateral damage from unnecessary use. Prescribers must take responsibility for both prompt initiation of antimicrobial treatment and for review of the continuing need and outcomes of treatment. Clinical teams and health-care organizations must take responsibility for transparent data monitoring that measures antimicrobial prescribing processes and outcomes, with balancing measures to address unintended consequences. There is clear international consensus about the role of doctors in antibiotic stewardship. However, sustainable increase in the availability of expertise at the point of care will require involvement and training of nurses in antimicrobial stewardship.

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