APIM223887222 - CME/CMLE - Antimicrobial Stewardship-APIM223887222

APIM223887222 - Educational Activity

Pdf Summary

This educational commentary by Linsey Donner explores the pivotal role of the clinical microbiology laboratory in diagnostic and antimicrobial stewardship. Key learning objectives include understanding antimicrobial resistance, comparing stewardship types, and detailing the contributions of clinical microbiology labs to both diagnostic and antimicrobial stewardship.<br /><br />Antimicrobial resistance (AMR) poses a significant public health risk, exacerbated by inappropriate antibiotic use. The Centers for Disease Control and Prevention (CDC) reports that over 2.8 million Americans are infected with antibiotic-resistant organisms annually, resulting in 35,000 deaths. Both inpatient and outpatient settings report substantial misuse of antibiotics, with many prescriptions deemed unnecessary.<br /><br />Diagnostic stewardship contributes to this issue by promoting appropriate, timely diagnostic testing and accurate reporting to guide patient treatment. Successful antimicrobial stewardship programs (ASPs) are multidisciplinary, typically led by infectious disease physicians and supported by clinical microbiologists, pharmacists, nurses, and IT specialists. They encompass core CDC elements like leadership, accountability, education, and regular tracking of antimicrobial use and outcomes.<br /><br />Rapid diagnostic methods, such as molecular assays and MALDI-TOF mass spectrometry, help expedite pathogen identification and improve treatment decisions. Implementing ASPs along with these technologies can enhance clinical outcomes and reduce healthcare costs by enabling faster, targeted antibiotic therapy.<br /><br />Effective reporting of laboratory results, including the introduction of clinical decision support systems (CDSSs), facilitates better interpretation and application by physicians. CDSS tools help reduce the complexity of understanding laboratory results and optimize antimicrobial therapy.<br /><br />Lastly, microbiology labs must ensure effective communication with healthcare providers to support proper diagnosis and treatment. Interventions such as updated antibiograms, rapid diagnostic testing, optimized reporting, and educational initiatives are integral to improving patient outcomes and combating antibiotic resistance.<br /><br />In summary, confronting AMR requires a multidisciplinary approach, with clinical microbiology laboratories playing a crucial role in fostering both diagnostic and antimicrobial stewardship to improve public health outcomes.

Keywords

clinical microbiology

antimicrobial stewardship

antimicrobial resistance

diagnostic testing

antibiotic misuse

CDC

rapid diagnostics

antibiotic therapy

CDSS

public health