Potential impact of outpatient stewardship interventions on antibiotic exposures of common bacterial pathogens

• DOI: 10.7554/elife.52307
• Publication Date: 2020-02-05T13:00:20Z
• Authors: Christine Tedijanto; Yonatan H Grad; Marc Lipsitch
• Keywords: Antibiotic Stewardship; Stewardship; Antimicrobial Stewardship

The relationship between antibiotic stewardship and population levels of resistance remains unclear. In order to better understand shifts in selective pressure due stewardship, we use publicly available data estimate the effect changes prescribing on exposures frequently used antibiotics experienced by potentially pathogenic bacteria that are asymptomatically colonizing microbiome. We quantify this impact under four hypothetical strategies. one scenario, elimination all unnecessary outpatient could avert 6% 48% (IQR: 17% 31%) across pairwise combinations sixteen common nine bacterial pathogens. All scenarios demonstrate interventions, facilitated clinician behavior improved diagnostics, have opportunity broadly reduce a range potential Concurrent approaches, such as vaccines aiming infection incidence, needed further decrease occurring ‘necessary’ contexts.