This paper focuses on antimicrobial stewardship in human healthcare, and some concepts possibly transferable to veterinary medicine. Antimicrobial stewardship is a multidisciplinary effort to reduce antimicrobial resistance in human pathogens, when future drug development is dwindling. These strategies encourage healthcare staff to use antimicrobials prudently and, when needed, for as short a duration and with as narrow a spectrum as possible. Various methods are involved in stewardship within the healthcare setting, often implemented simultaneously, which sometimes makes evaluation of specific measures difficult. All healthcare workers must accept responsibility for stewardship, although the role of infectious diseases physicians, microbiologists, pharmacists and infection control practitioners is crucial, as are appropriate surveillance systems and information technology. Support from management and government is also beneficial. Considering the frequent use of antimicrobials in animals, it would seem sensible to apply a similarly critical approach to conserve the efficacy of the antimicrobials still available, now and in the future.
Antimicrobial agents – De-escalation – Healthcare-associated infection – Human healthcare – Rational prescribing – Resistance – Stewardship – Surveillance.