Key Elements for Antimicrobial Stewardship for the Clinician

Lillian Abbo, MD, Chief Infection Prevention & Control and Antimicrobial Stewardship, Jackson Health System, shares key elements that clinicians should incorporate into antimicrobial stewardship practices.

Interview Transcript (slightly modified for readability)

“The key elements that I would encourage every clinician to practice when they want to do antimicrobial stewardship is, number one: measure, get data. You need to understand what your patterns of resistance [are]; you need to understand what your antimicrobial use [is]. You need to demonstrate that if you’re going to do any intervention, you can change those outcomes, that you can show your data, and you can show that you have acted on it and improved; that’s extremely important. Data is power; so, the more information you have, the better informed you are to change behaviors and practices.

[Number] two: Do not work in silo. You have to partner with your pharmacies; you have to partner with your microbiology lab, your Department of Quality, your chief financial officers, partner with your providers at the bedside, your nurses, engage your students, engage your physicians and surgeons, and everybody in the health system that interacts with patients and prescribes antibiotics. Make them a part of your team; make them your allies, and show them that this is about patient care. This is not about your ego or mine, [or about] trying to be difficult; it’s about getting the right drug for the right patient.

Third, I encourage people to tailor therapy. We need to customize; we need to do population health, but we also need to look at each patient as an individual and the [question of] how [we can] do better prescribing this antibiotic. What’s the right dose? What’s the right time for this particular patient? For this particular infection? For that, sometimes we have guidelines, but some other times, we need to think outside of the box.”