Antimicrobial Stewardship at the Core of COVID-19 Response Efforts: Implications for Sustaining and Building Programs

• Published in: Current infectious disease reports Vol. 22; no. 9; p. 23
• Main Authors: Mazdeyasna, Hasti, Nori, Priya, Patel, Payal, Doll, Michelle, Godbout, Emily, Lee, Kimberly, Noda, Andrew J., Bearman, Gonzalo, Stevens, Michael P.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2020; Springer Nature B.V
• Subjects: Antibiotics; Antimicrobial agents; Bacterial diseases; Coronaviruses; COVID-19; COVID-19 diagnostic tests; Healthcare Associated Infections (G Bearman and D Morgan; Healthcare Associated Infections (G Bearman and D Morgan, Section Editors); Infectious Diseases; Medicine; Medicine & Public Health; Pandemics; Section Editors; Topical Collection on Healthcare Associated Infections; COVID-19; SARS-CoV-2; Antimicrobial stewardship; Coronavirus disease 2019
• ISSN: 1523-3847; 1534-3146
• DOI: 10.1007/s11908-020-00734-x

We describe traditional antimicrobial stewardship program (ASP) activities with a discussion of how these activities can be refocused in the setting of the COVID-19 pandemic. Additionally, we discuss possible adverse consequences of ASP attention diversion on COVID-19 response efforts and overall implications for future pandemic planning. We also discuss ASP in collaboration with other groups within health systems and how COVID-19 may affect these relationships long term. Despite the paucity of literature on Antimicrobial Stewardship and COVID-19, the potential contributions of ASPs during a pandemic are numerous. ASPs can develop strategies to identify patients with COVID-19-like-illness; this is particularly useful when these patients are missed at the time of health system entry. ASPs can also play a critical role in the management of potential drug shortages, developing local treatment guidelines, optimizing the use of antibiotics, and in the diagnostic stewardship of COVID-19 testing, among other roles. Importantly, it is often difficult to ascertain whether critically ill patients who are hospitalized with COVID-19 have concurrent or secondary bacterial infections—ASPs are ideally situated to help optimize antimicrobial use for these patients via a variety of mechanisms. ASPs are uniquely positioned to aid in pandemic response planning and relief efforts. ASPs are already integrated into health systems and play a key role in optimizing antimicrobial prescribing. As ASPs assist in COVID-19 response, understanding the role of ASPs in pandemic relief efforts may mitigate damage from future outbreaks.