In 2010, we established the Antimicrobial Stewardship Program in response to the increasing epidemic of drug resistant organisms in the hospital setting. Stewardship programs were formed in many hospitals in the country at this time, as the largely educational approach to use antibiotics rationally failed to reduce antibiotic overuse. The genesis of the program nationwide was to curb unnecessary antimicrobial use in order to reduce wasteful use of limited and non-renewable resources (e.g., antibiotics that are active against bacteria as they exist today), minimize harm to the patient (by avoiding unnecessary adverse reactions, superinfections, and Clostridia difficile infection) and avoid the never ceasing process of resistant microbes.
Our program received the Antimicrobial Stewardship Centers of Excellence designation from the Infectious Diseases Society of America, which recognizes institutions that achieve standards established by the Centers for Disease Control and Prevention for antimicrobial stewardship programs led by infectious diseases physicians and infectious diseases-trained pharmacists.
Dr. Tejal Gandhi serves as the medical director of our Antimicrobial Stewardship Program. The program provides general education services to clinical teams throughout the hospital, as well as individual feedback to physicians who have prescribed an antibiotic that does not meet established indications and advice on administering an effective, alternate antibiotic. Moreover, using a formulary of restricted antibiotics, the program has reduced inappropriate use of newer agents through a process of prior authorization. The program has resulted in a substantial reduction of inappropriate antibiotic use.