Review
Infections, bacterial resistance, and antimicrobial stewardship: The emerging role of hospitalists†
David J. Rosenberg MD, MPH, FACP, SFHM,
Corresponding Author
David J. Rosenberg MD, MPH, FACP, SFHM
Department of Medicine, Division of General Internal Medicine, North Shore University Hospital, Manhasset, New York
Tel.: 516-562-4500; Fax: 516-562-4758
Department of Medicine, Division of General Internal Medicine, North Shore University Hospital, 300 Community Dr, Manhasset, NY 11030Search for more papers by this authorDavid J. Rosenberg MD, MPH, FACP, SFHM,
Corresponding Author
David J. Rosenberg MD, MPH, FACP, SFHM
Department of Medicine, Division of General Internal Medicine, North Shore University Hospital, Manhasset, New York
Tel.: 516-562-4500; Fax: 516-562-4758
Department of Medicine, Division of General Internal Medicine, North Shore University Hospital, 300 Community Dr, Manhasset, NY 11030Search for more papers by this author†
Disclosure: Dr Rosenberg received an honorarium for this work, which was jointly sponsored by the American Academy of CME and GLOBEX through an unrestricted educational grant from Merck & Co, Inc.
Abstract
The care of patients with serious infections both within and outside healthcare settings is increasingly complicated by the high prevalence of resistant or multidrug-resistant (MDR) pathogens. Moreover, infections caused by MDR versus susceptible bacteria or other pathogens are associated with significantly higher mortality, length of hospital stay, and healthcare costs. Antimicrobial misuse or overuse is the primary driver for development of antimicrobial resistance, suggesting that better use of antimicrobials will translate into improved patient outcomes, more efficient use of hospital resources, and lowered healthcare costs. Antimicrobial stewardship refers to the various practices and procedures utilized to optimize antimicrobial use. The primary goal of antimicrobial stewardship is to improve patient outcomes and lower antimicrobial resistance and other unintended consequences of antimicrobial therapy. Secondary goals are to reduce length of hospital stays and healthcare-related costs. Hospitalists are increasingly involved in the care of hospitalized patients throughout the United States. Expertise in managing conditions requiring hospitalization, and experience in quality improvement across a wide range of clinical conditions, make hospitalists well positioned to participate in the development and implementation of hospital-based antimicrobial stewardship programs designed to improve patient outcomes, reduce antimicrobial resistance, and provide more efficient and lower-cost hospital care. Journal of Hospital Medicine 2012;7:S34–S43. © 2012 Society of Hospital Medicine.
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