Antimicrobial stewardship

Antimicrobial stewardship (AMS) refers to coordinated efforts to promote the optimal use of antimicrobial agents, including drug choice, dose, route of administration, and duration of therapy.

Every time an antimicrobial agent is used, whether or not that use is justified, it applies selective evolutionary pressure to microbial populations which can result in acquired antimicrobial resistance. Antimicrobial resistance genes can then spread to other microbes in the host or their environment, including those organisms that can live on your skin or in your body where they coexist with the host. Antimicrobial use can also cause additional unintended consequences, such as disruption to the normal microbiome (i.e., dysbiosis) as well as direct toxic effects on people and animals, including damage to kidneys, liver, teeth and bones. These unintended consequences are often referred to as "collateral damage". Antimicrobial therapy is justified when the benefits outweigh these risks.