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Controversies in Antimicrobial Stewardship

  • Graeme N. Forrest
Chapter
Part of the Current Clinical Oncology book series (CCO)

Abstract

Antimicrobial stewardship programs are ­recommended by the Infectious Diseases Society of America as a method to control antimicrobial costs and resistance. These programs are usually implemented hospital wide, but there is little evidence on their effects in oncology units. Three controversial areas of antimicrobial stewardship in oncology units include whether these programs decrease antimicrobial resistance when antimicrobial restriction is implemented, the role of antimicrobial cycling on Gram-negative resistance and that these programs rarely control outpatient antimicrobial therapy. This review will discuss these controversial areas with regard to the evidence, strength of trial design, and the generalizability of their outcomes.

Keywords

Antimicrobial management Antimicrobial resistance Antibiotic cycling Outpatient antibiotic therapy VRE Clostridium difficile 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of Infectious DiseasePortland VA Medical CenterPortlandUSA

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