Analysis of hospital antimicrobial consumption to identify targets for antimicrobial stewardship

To the Editor — Antimicrobial resistance (AMR) poses a significant threat to health and human development worldwide. 1 Antibiotic consumption has been clearly shown to contribute to the selection and spread of drug-resistant microorganisms. 2,3 In response to the growing threat of antibiotic resistance, the World Health Assembly adopted a global action plan (GAP) on antimicrobial resistance (AMR). 4 Antimicrobial stewardship (AMS) represents a key strategy for promoting responsible antimicrobial use. The of the study was to explore the utility of in identifying AMS quality improvement To the Editor When healthcare-associated pneumonia (HAP) is suspected, broad-spectrum antibiotics, often including vancomycin, are recommended to include coverage for methicillin-resistant Staphylococcus aureus (MRSA). 1 However, a primary goal of antimicrobial stewardship is to rapidly de-escalate these broad-spectrum antibiotics, based on culture results or other clinical data. A causative organism can be identified in some HAP cases and the antibiotics can be appropriately tailored, but in many cases no patho-gen is identified, making de-escalation more challenging. To combat this situation, intranasal MRSA screening has been suggested as a stewardship tool because the absence of MRSA in the nares has been found to have a high negative predictive value for MRSA pneumonia.