Antimicrobial Stewardship: Strategies for Optimizing Antimicrobial Use and Combating Resistance

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Antimicrobial Agents and Resistance".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 1859

Special Issue Editor


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Guest Editor
Interdisciplinary Center for Modern Technologies, Nicolaus Copernicus University in Torun, 87-100 Torun, Poland
Interests: microorganisms (isolation, identification); antimicrobial activity/cytotoxicity (clasical methods, e.g., well diffusion method, fluorescence microscope as well as modern techniques such as flow cytometry); use of microorganisms for searching of innovative agents (e.g., Me/MeO nanoparticles, nanocomposites) and their application in medicine, veterinary, cosmetics and food industry
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Special Issue Information

Dear Colleagues,

Antimicrobial stewardship is a critical strategy for optimizing the use of antimicrobial agents and combating the global threat of antimicrobial resistance. As the overuse and misuse of antibiotics and other antimicrobial drugs have contributed to the rise of drug-resistant pathogens, healthcare providers and institutions are implementing comprehensive stewardship programs to ensure the appropriate, safe, and effective utilization of these vital medical resources. Optimizing antimicrobial therapy is a critical component of antimicrobial stewardship programs. By carefully selecting the appropriate antimicrobial agent, dosage, and duration of treatment, healthcare providers can help improve patient (human and animals) outcomes, minimize the development of antimicrobial resistance, and reduce the risk of adverse drug events.

In this Special Issue, we will discuss how maintaining the long-term success and effectiveness of an antimicrobial stewardship program (ASP) requires a commitment to continuous quality improvement and sustainability. This involves regularly evaluating the program's impact, identifying areas for optimization, and implementing data-driven changes to ensure the program continues to meet the evolving needs of the healthcare facility and patient population.

Key strategies for continuous quality improvement and sustainability include the following:

Implementing Stewardship Programs: This includes implementing guidelines, policies, and protocols to standardize antimicrobial prescribing practices, as well as education and training for healthcare providers on appropriate antimicrobial use. Ongoing monitoring and surveillance of antimicrobial utilization and resistance patterns are also crucial elements of a successful ASP.

Strategic Stewardship Interventions: These interventions aim to promote the optimal selection, dosing, duration, and route of antimicrobial administration. Effective implementation of these strategies can lead to improved patient outcomes, reduced antimicrobial resistance, and cost savings for healthcare systems.

Multidisciplinary Collaboration: Successful antimicrobial stewardship requires a collaborative, multidisciplinary approach involving a variety of specialists as well as scientific researchers and other healthcare professionals. By leveraging the expertise of this team, ASPs can effectively implement evidence-based interventions, provide tailored education, and foster a culture of responsible antimicrobial use within the healthcare organization.

Dr. Viorica Railean
Guest Editor

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Keywords

  • antimicrobial stewardship
  • antimicrobial agent
  • antimicrobial therapy
  • dosing optimization
  • healthcare
  • antimicrobial surveillance and monitoring
  • human medicine
  • veterinary medicine
  • multidisciplinary
  • stewardship programs

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Published Papers (2 papers)

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Research

13 pages, 4837 KiB  
Article
Genetic Characterization, Transmission Pattern and Health Risk Analysis of Intestinal Colonization ESBL-Producing Escherichia coli in Vegetable Farming Population
by Fanghui Yao, Qian Zhao, Di Wang and Xuewen Li
Microorganisms 2024, 12(12), 2646; https://doi.org/10.3390/microorganisms12122646 - 20 Dec 2024
Abstract
The surging prevalence rates of ESBL-producing Escherichia coli (ESBL-Ec) pose a serious threat to public health. To date, most research on drug-resistant bacteria and genes has focused on livestock and poultry breeding areas, hospital clinical areas, natural water environments, and wastewater treatment plants. [...] Read more.
The surging prevalence rates of ESBL-producing Escherichia coli (ESBL-Ec) pose a serious threat to public health. To date, most research on drug-resistant bacteria and genes has focused on livestock and poultry breeding areas, hospital clinical areas, natural water environments, and wastewater treatment plants. However, few studies have been conducted on drug-resistant bacteria in vegetable cultivation. In this study, a total of vegetable farmers (n = 59) from six villages were surveyed. Fecal samples were collected from vegetable farmers; we also collected environmental samples, including river water, well water, soil, river sediment, vegetable surface swabs, and fish intestinal tracts. The ESBL-Ec intestinal colonization rate in vegetable farmers was 76.27%. PFGE results indicated two patterns of ESBL-Ec transmission within the vegetable cultivation area: among vegetable farmers, and among river water, river sediments, and vegetable farmers. Based on the phylogenetic analysis, three transmission patterns of ESBL-Ec outside the vegetable cultivation area were inferred: human–human, human–animal–human, and human–animal–environment. Twelve of the isolates carried closely related or identical IncF plasmids carrying blaCTX-M. Whole genome sequencing (WGS) analysis showed that ST569-B2-O134:H31 and ST38-D-O50:H30 were associated with high disease risk. We assessed the health risks of the farming population and provided a reference basis for public health surveillance and environmental management by monitoring the prevalence and transmission of ESBL-Ec in vegetable areas. Full article
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12 pages, 599 KiB  
Article
Evaluation of the Impact of Antibiogram Availability and Utilization on Antibiotic Use among Healthcare Providers in Saudi Arabia: A Cross-Sectional Study
by Haytham A. Wali, Hassan Ali Alhajji, Ridha Alsaeed, Abdullah Aldughaim, Rakan Almutairi and Amira S. Radwan
Microorganisms 2024, 12(7), 1444; https://doi.org/10.3390/microorganisms12071444 - 16 Jul 2024
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Abstract
Antibiotic resistance is a significant global health issue, exacerbated by the indiscriminate use of antibiotics without antibiograms. Implementing appropriate stewardship programs that monitor and control antibiotic use is essential to minimize resistance development and ensure optimal patient outcomes. This study aims to assess [...] Read more.
Antibiotic resistance is a significant global health issue, exacerbated by the indiscriminate use of antibiotics without antibiograms. Implementing appropriate stewardship programs that monitor and control antibiotic use is essential to minimize resistance development and ensure optimal patient outcomes. This study aims to assess the impact of antibiogram availability and utilization on antibiotic use among healthcare providers in Saudi Arabia, focusing on whether antibiogram data and utilization influence the appropriateness of antibiotic prescribing practices. A cross-sectional study design was employed, utilizing a self-administered online survey distributed to physicians, pharmacists, and other healthcare providers across various healthcare settings in Saudi Arabia. Data were collected over a 90-day period, from 1 December 2023 to 29 February 2024. Descriptive statistics were used to summarize participants’ characteristics, and data were analyzed based on geographical region, participants’ positions, and other predetermined differences. Out of 23,860 contacted individuals, 333 responded, and 283 were included in the analysis. The majority (62.2%) reported the availability of antibiograms at their facilities, with 84.1% utilizing them in clinical practice. The frequency of consulting antibiograms varied, with only 21.6% doing so daily. Key barriers to antibiogram availability included lack of expertise, technological infrastructure, and funding. Most participants (68.8%) observed changes in antibiotic prescription practices post-antibiogram introduction, and 86.9% believed antibiograms could shorten patients’ length of stay and improve outcomes. However, only 40.9% had received training on antibiogram use. While healthcare providers in Saudi Arabia have a relatively high level of antibiogram availability and utilization, several barriers hinder their consistent use. Enhancing accessibility, promoting frequent use, and providing targeted training could strengthen the impact of antibiograms on antibiotic prescribing practices and antimicrobial stewardship efforts. Full article
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