Antimicrobial Stewardship
Antimicrobial stewardship activities have been ongoing since 2000 at NewYork-Presbyterian Hospital (NYP), but a hospital-wide Antimicrobial Stewardship Program (ASP) was formalized in 2007 through a joint effort of the Division of Infectious Diseases, Department of Pharmacy, Department of Infection Prevention and Control, and Department of Microbiology. The program aims to optimize antimicrobial use with the intention of stabilizing antimicrobial resistance, improving patient safety, and decreasing antimicrobial costs.
Adverse outcomes related to antimicrobial use result from inappropriate choice, dose, formulation, or duration of antimicrobials and include increased cost and antimicrobial resistance, along with increased morbidity, mortality, and length of stay. Stabilizing antimicrobial resistance requires a multifaceted approach including formulary restrictions, education and guidelines, review and feedback, and close surveillance of antimicrobial utilization and resistance patterns, with interventions made on a daily basis to optimize antimicrobial therapy. Recent literature demonstrates that these activities are most successful with the implementation of multidisciplinary antimicrobial management teams involving infectious diseases physicians and infectious diseases-trained clinical pharmacists.
Additionally, antimicrobial stewardship often works synergistically with diagnostic stewardship. Members of the ASP are engaged in active research efforts to better optimize both utilization of diagnostic testing antimicrobial prescribing.
Research Opportunities
There are numerous opportunities for clinical research projects related to antimicrobial stewardship and diagnostic stewardship outcomes. Collaborations can occur across both the Columbia and Cornell campuses, resulting in very robust studies with a large and diverse patient population. In addition to ongoing projects conducted by Division of Infectious Disease faculty members, collaborations are possible in partnership with infectious diseases-trained PharmDs from NYP.
