The aim of this review is to describe new and evolving legislation concerning antimicrobial stewardship at both the state and national level.
Antimicrobial resistance is a challenge to health worldwide. Recently, the US federal government has issued reports recognizing it as a serious threat to public health and national security acknowledging the need for judicious antimicrobial use. California has been a pioneer in mandating and implementing antimicrobial stewardship initiatives in healthcare institutions. With the White House Executive Order 13676, a number of healthcare organizations have committed to making antimicrobial stewardship policy and regulatory changes, and it will likely soon be mandatory for all states to comply with a newly created set of standards relating to antimicrobial stewardship in US hospitals and nursing homes.
With numerous changes, including governmental and organizational mandates, on the horizon, it is crucial for healthcare institutions to understand and be prepared for this new era in antimicrobial stewardship. The adoption of these new standards by institutions is of an imminent nature.
Key Points:• United States federal agencies and the executive branch have recently issued reports characterizing antimicrobial resistance as threats to public health and national security.• The state of California has implemented regulations requiring the establishment of antimicrobial stewardship programs (ASPs) in all acute-care hospitals and long-term care facilities.• A goal of the National Action Plan for Combating Antimicrobial Resistance is establishment of ASPs in acute care hospitals.• Veterans Affairs and Department of Defense facilities have already adopted the ASP requirement; for non-federal hospitals, this mandate will likely be achieved through regulators such as the Centers for Medicaid and Medicare Services.
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References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance
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California Legislative Counsel. Senate Bill No. 361. Antimicrobial stewardship: education and policies. 2015; Available at: http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB361. Accessed Oct 2015.
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Executive Order 13676: combating antibiotic-resistant bacteria. Sep 2014; Available at: http://www.gpo.gov/fdsys/pkg/FR-2014-09-23/pdf/2014-22805.pdf. Accessed August 2015.
National action plan for combating antibiotic-resistant bacteria. Mar 2015; Available at: https://www.whitehouse.gov/sites/default/files/docs/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf. Accessed August 2015. This document provides step-by-step guidance to healthcare organizations and agencies for decreasing antimicrobial resistance by the year 2020.
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National Quality Forum. Antibiotic stewardship action team. 2015; Available at: http://www.qualityforum.org/News_And_Resources/Press_Releases/2015/NQF_Launches_Antibiotic_Stewardship_Initiative.aspx. Accessed Oct 2015.
Kristi Kuper, PharmD and Arjun Srinivasan, MD
Conflict of Interest
Dr Linda S. Johnson declare that she has no conflict of interest.
Dr Conan MacDougall declare that he has no conflict of interest.
Dr Kavita K. Trivedi declare that she has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by the authors.
This article is part of the Topical Collection on Antimicrobial Stewardship
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Johnson, L.S., MacDougall, C. & Trivedi, K.K. The Legislative Momentum of Antimicrobial Stewardship: the US Perspective. Curr Treat Options Infect Dis 8, 93–101 (2016). https://doi.org/10.1007/s40506-016-0076-6
- Antimicrobial stewardship
- National legislation
- Centers for medicare and medicaid services