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Revitalizing Antimicrobial Stewardship: Enlisting Nurses, Laboratorian, and Informaticists

Antimicrobial stewardship, a key focus of infection prevention professionals, significantly improved following the recommendation by Centers for Disease Control and Prevention (CDC) in 2014. However, despite successful strides in optimizing the use of antimicrobials, several hospitals battle resource and personnel limitations, thus inhibiting their capacity to fully enforce these improvements. A cross-sectional study involving 192 hospitals in 2021 found that the antimicrobial use in more than half of all patients studied still did not comply with best practice recommendations.

These practices are typically managed by infectious disease–trained physicians and pharmacists. Regardless, the CDC recommends that other healthcare professionals should be utilized for better outcomes. The potential roles of nurses, laboratorian, and informaticists in this matter are particularly emphasized and warrant further exploration.

Nurses often serve as the frontline in patient care, providing the primary interface between patients and other healthcare services, subsequently influencing crucial decisions regarding lab tests and antimicrobial therapy. It is also important to mention that nurses have been instrumental in reducing catheter-associated urinary tract infections and central line–associated bloodstream infections. Various initiatives driven by nurses have achieved success, such as a pilot study conducted in a community regional medical center, which noted significant reduction in antibiotic and acid suppressant use, and urinary catheter use.

Further, laboratory professionals, who are experts in lab-based testing including clinical microbiology, and health informatics are also beneficial in optimizing antimicrobial usage. They can implement systemic interventions, thus enabling appropriate identification of infections through ‘diagnostic stewardship’—a concept that can help reduce costs and prevention of inappropriate antimicrobial prescribing.

In conclusion, the collective expertise of various healthcare professionals can strengthen antimicrobial stewardship. Thus, microbiologists, nurses, and health informaticists—among others—must be engaged in these programs. The adage that ‘teamwork makes the dream work’ certainly applies here, showcasing the importance of multidisciplinary contribution in achieving the goals of optimal antimicrobial use.


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