Antibiotic stewardship

Charani and Holmes (2019) explain that the first time the word ‘stewardship’ appeared in connection with antibiotic use was when McGowan and Gerding (1996) highlighted an urgent need to address the increasing challenge of antimicrobial resistance (AMR) in hospitals.

They ‘concluded that more evidence in the shape of large-scale trials were [sic] required to establish how best to control the problem and optimise antimicrobial use “stewardship’” (Charani and Holmes, 2019).

The recommendations of the 1998 Copenhagen Declaration were central to combating AMR, and while the Declaration doesn't refer to ‘stewardship’ as a concept, it indicates the components of what later became defined as antibiotic stewardship (Charani and Holmes, 2019). Thus, the Declaration recommends that antimicrobial teams ‘“should have the authority to modify antimicrobial prescriptions of individual clinicians, in accordance with locally accepted guidelines, always taking into account the needs of the patient”’ (Charani and Holmes, 2019).