Antimicrobial Stewardship: A Call to Action for Surgeons.
Despite current antimicrobial stewardship programs (ASPs) being advocated by infectious disease specialists and discussed by national and international policy makers, ASPs coverage remains limited to only certain hospitals as well as specific service lines within hospitals. The ASPs incorporate a variety of strategies to optimize antimicrobial agent use in the hospital, yet the exact set of interventions essential to ASP success remains unknown. Promotion of ASPs across clinical practice is crucial to their success to ensure standardization of antimicrobial agent use within an institution. To effectively accomplish this standardization, providers who actively engage in antimicrobial agent prescribing should participate in the establishment and support of these programs. Hence, surgeons need to play a major role in these collaborations. Surgeons must be aware that judicious antibiotic utilization is an integral part of any stewardship program and necessary to maximize clinical cure and minimize emergence of antimicrobial resistance. The battle against antibiotic resistance should be fought by all healthcare professionals. If surgeons around the world participate in this global fight and demonstrate awareness of the major problem of antimicrobial resistance, they will be pivotal leaders. If surgeons fail to actively engage and use antibiotics judiciously, they will find themselves deprived of the autonomy to treat their patients.
1 Department of Surgery, Macerata Hospital , Italy.
Massimo
M
Sartelli
2 Department of Surgery, John Peter Smith Health Network , Fort Worth, Texas.
Therese M
TM
Duane
3 Department of Emergency Surgery, Maggiore Hospital , Parma, Italy .
Fausto
F
Catena
4 Department of Infectious Diseases, John Peter Smith Health Network , Fort Worth, Texas.
Jeffrey M
JM
Tessier
5 Department of Surgery, Papa XXIII Hospital , Bergamo, Italy .
Federico
F
Coccolini
6 Department of Surgery, McGovern Medical School, University of Texas Health Science Center , Houston, Texas.
Lillian S
LS
Kao
3 Department of Emergency Surgery, Maggiore Hospital , Parma, Italy .
Belinda
B
De Simone
7 Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health , UNIVPM, Ancona, Italy .
Francesco M
FM
Labricciosa
8 Department of Surgery, Vanderbilt University Medical Center , Nashville, Tennessee.
Addison K
AK
May
5 Department of Surgery, Papa XXIII Hospital , Bergamo, Italy .
Luca
L
Ansaloni
9 Department of Surgery, Section of Acute and Critical Care Surgery, Washington University School of Medicine , St. Louis, Missouri.
John E
JE
Mazuski
D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D004352:Drug Resistance, Microbial; D004363:Drug Utilization; D006761:Hospitals; D006801:Humans; D059413:Intraabdominal Infections / Q000188:drug therapy; D010818:Practice Patterns, Physicians'; D000067490:Prescription Drug Overuse; D066231:Surgeons; D013530:Surgical Wound Infection / Q000188:drug therapy*
D000890:Anti-Infective Agents
antibiotic prophylaxis; intra-abdominal infection; necrotizing soft tissue infection; surgical site infection; trauma