Antimicrobial Stewardship 概述

Antimicrobial resistance happens when bacteria, viruses, fungi or parasites resist the effects of medicines used to treat infections in humans, animals or plants. The ability of these germs to fend off some of our most useful and valuable medicines makes it easier for infectious diseases to cause harm and spread to others.

In the U.S., much like the rest of the world, increasing resistance to antibiotics is a pressing concern. Antibiotics are important medicines that treat infections caused by bacteria. Much of this increasing resistance is due to overuse of antibiotics. Sometimes called superbugs, these antibiotic-resistant germs no longer respond to antibiotics. This makes infections hard or impossible to treat.

Antibiotic resistance is an urgent global health problem. More than 2.8 million antibiotic-resistant infections happen in the U.S. every year. Tens of thousands of these infections end in death, which might have been prevented through more careful use of antibiotic medicines.

The right medicine for the shortest time

Antimicrobial stewardship refers to the careful and correct use of antibiotics, as well as antifungal and antiviral medicines. Mayo Clinic is committed to making sure we prevent as much antimicrobial resistance as we can. This will help our current infection-fighting medicines last longer. Just relying on scientists to develop new medicines won't solve this problem. Medicine development doesn't happen fast enough to keep up with how bacteria evolve and develop resistance.

At Mayo Clinic in Arizona, Florida, Minnesota and all Mayo Clinic Health Systems locations, the antimicrobial stewardship team leads the push for careful and correct use of infection-fighting medicines. The Antimicrobial Stewardship team is working with pharmacists, doctors, nurses and other healthcare professionals to improve how antimicrobial medicines are used. The team works with and encourages healthcare professionals to use the right medicine for the right diagnosis. They help develop guidelines to diagnose and treat infections. And they are educating patients who need infection-fighting medicines to help them understand the risks of overusing them or not using them correctly.

The antimicrobial stewardship team also helps healthcare professionals choose the safest, shortest length of treatment when possible. This helps prevent people from getting too much of an antibiotic. Antibiotics can cause allergies and other adverse effects such as kidney injury or infections in the bowel.

These efforts are only one part of the Antimicrobial Stewardship Program. The team also works on issues related to the treatment of parasites, viruses and fungi.

The program's goals are to:

  • Help healthcare professionals make the best informed decisions so patients receive the right antibiotics, dose and duration.
  • Help people understand the importance of using antibiotics only when they are needed and effective.
  • Limit unintended consequences of giving such medicines, such as adverse effects or creating antibiotic-resistant germs.
  • Improve the quality and safety of patient care.
  • Prevent hospital readmissions.
  • Decrease the length of hospital stays.
  • Decrease deaths from infections.

By focusing on stewardship now, we help future generations by preventing or delaying antibiotic resistance.

The Antimicrobial Stewardship team is working with pharmacists, doctors, nurses and other healthcare professionals to improve how antimicrobial medicines are used. They have developed guidelines to diagnose and treat infections. And they are educating patients who need infection-fighting medicines to help them understand the risks of overusing them or not using them correctly.

We all play a role

You can protect yourself and others by smart use of antibiotics. Here are some things that everyone can do to only use antibiotics when they will be effective.

  • Ask questions. Antibiotics treat infections caused by bacteria and do not have any effect on viruses. Many viral infections look the same as bacterial infections, but your healthcare professional can help tell the difference. Ask your doctor or another healthcare professional if your symptoms are caused by bacteria. If you're prescribed an antibiotic to fight a bacterial infection, ask if the medicine targets the specific bacteria causing your infection. Ask if you'll be taking it for the shortest time possible and that it will still be as effective.

    Taking an antibiotic that you don't need is dangerous. It puts you at risk of reactions or side effects that could require emergency care. Antibiotics also kill good bacteria in your body. This may lead to other problems, such as diarrhea and yeast infections. Taking antibiotics could cause a possibly life-threatening form of diarrhea, caused by Clostridioides difficile or C. difficile. This is commonly called C. diff.

  • Use medicine as directed. Seek medical advice when you're ill. If you're prescribed an antibiotic, use it as directed by your healthcare professional. Report any side effects to your healthcare team.
  • Safely dispose of unused medicines. Don't save leftover antibiotics to take later. Also don't take something that wasn't prescribed to you for your current diagnosis.
  • Don't ask for antibiotics for a viral infection. Understand that antibiotics are not useful in treating conditions caused by viruses. Antiviral medicines may be given instead. Some of the many common viral conditions are the common cold, the flu, COVID-19 and most cases of bronchitis. Antibiotics usually don't help with a sinus infection either since most of them are caused by viruses.

    When your symptoms from a viral condition make you uncomfortable, you might try one of the many symptom-easing medicines available in the store without a prescription. Ask your healthcare professional what they suggest.

  • Try to prevent getting sick. Take steps to reduce the likelihood of infection. You should clean your hands, cover your cough, stay home when sick, prevent sexually transmitted disease, get recommended vaccines and handle food safely.

Expertise and collaborations

The Mayo Clinic Antimicrobial Stewardship Program is made up of a multidisciplinary team of pharmacists, doctors, advanced practice providers and nurses. Together they have made Mayo Clinic a regional, national and international leader in antimicrobial stewardship.

  • Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria. Also known an PACCARB, this council provides advice, information and recommendations to the United States Secretary of Health and Human Services. The council supports and evaluates United States government activities focused on fighting antimicrobial resistance in human health, animal health and environmental health. Mayo Clinic's Robin Patel, M.D., is a voting member on PACCARB.
  • Antibacterial Resistance Leadership Group. Mayo Clinic is a prominent member of the Antibacterial Resistance Leadership Group, also known as ARLG. ARLG includes more than 100 leading experts working together to combat the antibacterial resistance crisis and improve patient care. The ARLG Laboratory Center is at Mayo Clinic in Rochester.

The following groups have recognized Mayo Clinic for its commitment to antimicrobial stewardship and ensuring safe, reliable, high-quality care. Together they work with the clinic on continuous improvement and stewardship of all resources for the benefit of patients and communities:

  • Infectious Diseases Society of America. Mayo Clinic in Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota, along with regional hospitals in Eau Claire, Mankato, and Lacrosse are each designated by the Infectious Diseases Society of America as a Center of Excellence. The Infectious Diseases Society of America recognizes that Mayo Clinic's program has achieved the highest quality and standards aligned with evidence-based national guidelines.
  • Minnesota. Mayo Clinic in Rochester and the Mayo Clinic Health Systems are on the Minnesota Department of Health honor roll for antibiotic stewardship.
  • World Health Organization. Mayo Clinic supports the Go Blue for Antimicrobial Awareness Week, sponsored by the World Health Organization.

Research

Mayo Clinic physician-scientists and other researchers are committed to advancing the science of safe antimicrobial use. We share our knowledge with the world because antibiotic resistance is a global concern that will take a broad and collaborative approach to resolve.

Publications

See a list of publications about antimicrobial stewardship by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine.