Antimicrobial Stewardship: Inpatient

General medical conditions continue to grow more complex over time, causing patients to become hospitalized with complicated care. There is also a rising trend of elderly patients admitted to the hospital with multiple medical problems. Surveys have shown that 50% of all hospitalized patients receive an antibiotic during their stay. Per the Centers for Disease Control and Prevention (CDC), about 30% of all antibiotics prescribed in US acute care hospitals are either unnecessary or suboptimal.

While antibiotics can be beneficial for those patients with active bacterial infections, separating out patients who are colonized, but not actively infected with bacteria, remains problematic. Antibiotics may kill the targeted bacterial pathogen, but also have an effect on other bacteria in the body. This has led to a worldwide problem with antibiotic resistant bacteria. Bacteria resistance can lead to difficulties in treating a patients’ condition and sometimes serious, life-threatening illness.

Oversight of antibiotics in the hospital, through antibiotic stewardship programs, is essential to help guide the benefits and risks of inpatient antibiotic treatment. Several national organizations, including the federal Centers for Medicare and Medicaid Services (CMS), have mandated that hospitals implement antibiotic stewardship programs.

Antibiotic stewardship programs combine data review and prescriber education to reinforce evidence-based practices among clinicians and promote more effective use of antibiotics.

A patient's health form on a clipboard is used at a hospital.

Many programs utilize CDC's Core Elements of Hospital Antibiotic Stewardship Programs as a roadmap. These elements include hospital leadership commitment, accountability, pharmacy expertise, action, tracking, reporting, and education.

In Wisconsin, 95% of acute care hospitals reported adopting all seven inpatient core elements in 2020.

 

Resources

Antibiotic Allergies

De-Labeling Penicillin Allergies

Evaluation and Diagnosis of Penicillin Allergy for Health Care Professionals

Health Care Providers

Educational Resources for Health Care Professionals

Grand Rounds Video Series: Clinical Pearls in the Hospital Management of Infectious Disease

Editable Poster Templates

Last Revised: October 11, 2021