Hello. Sign In
Standards Store

Antibiotic Optimization: Concepts and Strategies in Clinical Practice

2004 Edition, November 4, 2004

Complete Document

Detail Summary

Active, Most Current

Additional Comments:
ISBN: 978-0-8247-5431-0
Price (USD)
Add to Cart

Product Details:

  • Revision: 2004 Edition, November 4, 2004
  • Published Date: November 4, 2004
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 683
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


Institutionally acquired infections impact approximately 2,000,000 people annually in the United States alone. An increasing percentage of these infections are attributed to antimicrobial resistant organisms. Considering that 25 million pounds of antibiotics are produced yearly for human consumption and are administered to 30-50% of hospitalized patients, the utilization of these miracle drugs is of significant health and economic importance. All the while, studies and surveys suggest that as much as 50% of all antimicrobial use is inappropriate. The problem of increasing antimicrobial resistance, due in part to suboptimal antimicrobial use, coupled with the fact that a growing number of pharmaceutical companies have abandoned antiinfective research and development, has resulted in an emerging public health crisis. As hospitals are characterized by high-density antibiotic use, they are target-rich venues for proactive interventions to improve antimicrobial stewardship. ‘‘Antimicrobial stewardship,'' a term coined by Dale Gerding, describes the optimal selection, dose, and duration of an antimicrobial that results in the best clinical outcome for the treatment or prevention of infection, with minimal toxicity to the patient, and minimal impact on subsequent resistance.

Recognizing the importance of drug resistant organisms, the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America published recommendations for preventing and reducing antimicrobial resistance in hospitals in 1997. Two years later, the Interagency Task Force on Antimicrobial Resistance, co-chaired by the Centers of Disease Control and Prevention, Food and Drug Administration, and the National Institutes of Health, assembled a more global document addressing the threat of increasing resistance. Both documents stress the importance of improving the use of antimicrobials, or antimicrobial stewardship, at the institutional level in combating antimicrobial resistance.

We have condensed issues stressed by the aforementioned agencies and societies and expanded the content to incorporate emerging data related to the use of antimicrobial agents in the institutional setting. This book is intended to be of relatively broad interest while focusing on contemporary principles essential to optimizing the use of antimicrobial agents. The first section addresses fundamental concepts including the role of the Pharmacy and Therapeutics Committee, antimicrobial resistance, health economics, pharmacodynamics, and benchmarking antimicrobial use, to name a few. The second section reviews practical applications of science, providing examples of programs and strategies designed to foster good antimicrobial stewardship. Issues addressed include antimicrobial stewardship programs, role of computer-assisted decision support, infection control programs, short course therapy, and the institutional use of antifungal agents, among others.

This book is a collaborative effort among recognized authorities in the areas of infectious diseases, hospital epidemiology, medical informatics, clinical pharmacology, and health economics. It is intended to be of interest and value to all clinicians who practice in the institutional setting and prescribe or evaluate antimicrobials. In addition, policy makers and administrators within these institutions will find this book a valuable resource for understanding the crucial interactions of these disciplines, which should help them foster the appropriate development, implementation, and analysis of policies and procedures related to antimicrobial use. While this book is focused on the individual institution, it is hoped that it will encourage the coordination of scientific and practical efforts on regional, national, and global levels that are aimed at the optimal development of current and future antimicrobial strategies.