Antibiotic stewardship programmes-what's missing?

Esmita Charani, Jonathan Cooke, Alison Holmes

    Research output: Contribution to journalArticlepeer-review


    Inappropriate antibiotic use and antibiotic resistance are now major global issues. Antimicrobial stewardship programmes are increasingly being used to optimize antibiotic prescribing in acute care. The central tenet of these programmes tends to be policy and guidelines aimed at prescribers. However, rules and guidelines alone may not be sufficient to bring about effective and sustainable optimization of practice. Best practice needs to be positively reinforced by an environment that facilitates and supports optimal prescribing choices, i.e. a 'choice architecture' that makes prudent antibiotic prescribing the path of least resistance. To make prudent antibiotic management an integral part of the behaviour of all healthcare professionals and to bring about quality improvement it is necessary to adopt a whole-system approach. To do this it is necessary first to understand the factors that influence antibiotic management and prescribing. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
    Original languageEnglish
    Article numberdkq357
    Pages (from-to)2275-2277
    Number of pages2
    JournalJournal of Antimicrobial Chemotherapy
    Issue number11
    Publication statusPublished - 16 Sept 2010


    • Antibiotics
    • Choice architecture
    • Prescribing


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