Antimicrobial stewardship programs; a two-part narrative review ofstep-wise design and issues of controversy Part I: step-wise design of anantimicrobial stewardship program

摘要

Regardless of one’s opinion of antimicrobial stewardship programs (ASPs), it ishardly possible to work in hospital care and not be exposed to the term or itspractical effects. Despite the term being relatively new, the number ofpublications in the field is vast, including several excellent reviews ofgeneral and specific aspects. Work in antimicrobial stewardship is complex, andincludes not only aspects of infectious disease and microbiology, but also ofepidemiology, genetics, behavioural psychology, systems science, economics andethics, to name a few. This review aims to take several of these aspects and thescientific evidence of antimicrobial stewardship studies and merge them into twoquestions: How should we design ASPs based on what we know today? And which arethe most essential unanswered questions regarding antimicrobial stewardship on abroader scale?