title: A call to arms: the imperative for antimicrobial stewardship.
abstract: Antimicrobial resistance is a major public health crisis. The prevalence of drug-resistant organisms, such as the emerging NAP1 strain of Clostridium difficile, now highly resistant to fluoroquinolones, Acinetobacter species, Klebsiella pneumoniae carbapenemase-producing organisms, and methicillin-resistant Staphylococcus aureus, is increasing nationwide. The sources of antimicrobial resistance are manifold, but there is a well-documented causal relationship between antimicrobial use and misuse and the emergence of antimicrobial-resistant pathogens. As the development of new antimicrobial agents is on the decline, the medical community, across all specialties and in conjunction with public health services, must develop and implement programs and strategies designed to preserve the integrity and effectiveness of the existing antimicrobial armamentarium. Such strategies are collectively known as antimicrobial stewardship programs and have the potential to minimize the emergence of resistant pathogens.
authors.affiliation: Department of Medicine and Epidemiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. jb@jhmi.edu
authors.forename: John G
authors.initials: JG
authors.lastname: Bartlett
mesh_terms: D000150:Acinetobacter / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D016360:Clostridioides difficile / Q000187:drug effects*; D024881:Drug Resistance, Bacterial; D016984:Enterococcus faecium / Q000187:drug effects; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D017410:Practice Guidelines as Topic; D011634:Public Health
chemical_list: D000900:Anti-Bacterial Agents