Moi Lin Ling1
1Singapore General Hospital, Outram Road, Singapore 169608.
Antimicrobial stewardship programs (ASPs) aim to achieve best clinical outcomes related to antibiotic use while minimizing toxicity and limiting the selective pressure on bacterial populations that drive the emergence of antimicrobial resistance. Implementation of ASP programs alone may not reduce rates of multi-drug resistant organisms (MDROs). Infection prevention measures, including hand hygiene, contact precautions, environmental cleaning, and disinfection, are critical for controlling MDROs in healthcare setting. With IPC as one of the core members in the ASP program, there is a higher likelihood of optimising antimicrobial use with cost-effective interventions. However, there are challenges in getting optimal engagement of IPC in ASP program because of varying perspectives and expectations among ASP clinicians.
IPC and ASP program leaders must work together to align their programs, promoting communication and collaboration, and reducing the likelihood of redundant initiatives. IPC has substantial contact with ward staff, often together reviewing patients who develop HAIs as part of routine daily activities. One should leverage on these strong collegial relationships to influence and facilitate ward staffs’ supporting role in initiating antibiotic reviews, perform antibiotic reconciliation during patient transitions of care, and educate patients and families about safe and appropriate antibiotic use.
Implementation of successful ASP programs is a particularly urgent matter in the Asia Pacific region owing to the high prevalence of MDROs in countries within this region. Both IPC and ASP programs cannot be performed independently and require interdependent and coordinated action across multiple and overlapping disciplines and clinical settings.