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Saul R. Hymes, Jason G. Newland, Boiling Over: The Antimicrobial Stewardship Stew May Finally Be Ready, Journal of the Pediatric Infectious Diseases Society, Volume 4, Issue 4, December 2015, Pages 394–396, https://doi.org/10.1093/jpids/piv063
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Beginning in September 2013 with the release of the Centers for Disease Control and Prevention (CDC) threat report on antimicrobial resistance, the federal government and the Obama administration have been paying ever-increasing attention to the looming specter of antibiotic resistance and the increasing danger it poses. There were 23 000 deaths in 2013 as a result of antibiotic-resistant infections [ 1 ], and there is potential for an estimated 10 million deaths per year by 2050 if nothing is done [ 2 ]; these are not small numbers. Antimicrobial stewardship programs (ASPs) have been working to ultimately prevent these deaths by curtailing and optimizing antibiotic use, but at times, stewardship has been a tough sell to treatment-desiring patients and parents, our fellow anxious physicians and surgeons, and cost-conscious hospital administrators. Earlier this year, the Obama administration gave ASPs a tremendous boost.
On June 2, 2015, the White House convened a forum on antibiotic stewardship. This forum was the culmination of a process that began with Executive Order 13676: Combating Antibiotic-Resistant Bacteria (CARB) [ 3 ], which then led to a national CARB strategy in the fall of 2014 [ 4 ] and a national CARB plan in March 2015 [ 5 ]. Although the overall CARB plan is broad and addresses many aspects of resistance, from infection prevention to drug development and farm use, antibiotic stewardship was emphasized as a major piece of the plan, as we saw in the June 2 White House forum. More than 150 people representing stakeholders in the area of antibiotic stewardship—from hospitals and hospital organizations to nongovernmental organizations, pharmaceutical companies, and those involved in antibiotic use in animals—were invited to the White House to make commitments to a variety of activities related to antibiotic stewardship. The forum's emphasis on antibiotic stewardship specifically, and not simply all aspects of antibiotic resistance, was an incredible opportunity for those groups involved in promoting antibiotic stewardship to not only come into the limelight but also to share it.
