neutrophil interacting with two pink-colored multidrug-resistant Klebsiella pneumoniae bacteria

Although most nurses are aware of the urgent problem of antibiotic overuse in hospitals, some may be unfamiliar with terms like “antibiotic stewardship.” This is partly because few nurses besides those working as infection control preventionists have had a formal role in stewardship programs, explain authors Rita D. Olans, Richard N. Olans, and David J. Witt in “Good Nursing Is Good Antibiotic Stewardship,” which appears in this month’s issue as a Special Feature. In the article, the authors detail how bedside nurses are vital to the success of these efforts.

What Is Antibiotic Stewardship?

Antibiotic stewardship programs offer a formal approach to addressing the current crisis, in which an increasing number of organisms are developing resistance to antimicrobial medications. In the absence of new drugs, stewardship programs have been established to improve the way currently available antibiotics are used in hospitals. These programs aim to:

  • optimize antibiotic therapy.
  • shorten the duration of use of broad-spectrum antibiotics.
  • reduce the number of adverse events.

According to the authors, “because nurses are not typically prescribers of antibiotics, they often don’t see themselves as participants in antimicrobial stewardship programs.” Yet, even though they may not know it, “staff nurses are already performing many critical antimicrobial stewardship functions.” For example, nursing practices directly relevant to antibiotic stewardship include:

  • verifying a patient’s penicillin allergy (in the absence of which allergy the use of broad-spectrum antibiotics might not be necessary).
  • monitoring a patient’s response to treatment to detect a superinfection or drug-resistant infection.
  • educating patients and their families about the optimal use of medications to avoid misuse of antibiotics.

Improving the Use of Antibiotics

Last month a white paper, Recommendations from the American Nurses Association/Centers for Disease Control and Prevention Workgroup on the Role of Registered Nurses in Hospital Antibiotic Stewardship Practices, was released, offering additional information about how nurses can help to improve the use of antibiotics.

International efforts are underway to develop new antibiotics. But in the meantime, stewardship programs remain the most effective way to address the antibiotic crisis. The authors make a good case that this crisis presents an important opportunity for nurses, who are “ideal ambassadors and communicators to the American public regarding the importance of antibiotic stewardship.”