We all know what happens to the row of dominoes when the first one is pushed over –you get a chain-reaction of fallen dominoes, right? This concept is the same when looking at the relationship between antimicrobial stewardship programs (ASPs) and healthcare-acquired infections (HAIs). Since their development in the 1940s, antibiotics have been used so much and so often that some of the bacteria they are supposed to kill have adapted, making the antibiotics no longer effective. Overuse, or misuse, of antibiotics can cause an individual to become antibiotic resistant.1 With a higher chance of hospitalization, this individual also has a greater chance of spreading the drug-resistant bacteria to others—especially to other patients with compromised immune systems. The CDC estimates about one in 25 hospital patients has at least one healthcare-associated infection, and many of these are either initiated or perpetuated by drug-resistant bacteria that can be reduced by antimicrobial stewardship.

California has become the first state to take antimicrobial stewardship a step beyond evaluating the judicious use of antibiotics. As of July 1 this year, Senate Bill 1311 will require California hospitals to implement an antimicrobial stewardship policy and develop a physician-supervised multidisciplinary antimicrobial stewardship committee or work group which has at least one member trained on the subject.2 California’s new bill joins efforts by the White House which created the National Action Plan for Combating Antibiotic-Resistant Bacteria in March of this year as well as hosted a forum in June to engage in discussion on the dangers of the overuse of antibiotics.3

According to APIC, “Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.” The APIC also states, “The misuse and overuse of antimicrobials is one of the world’s most pressing public health problems. Infectious organisms adapt to the antimicrobials designed to kill them, making the drugs ineffective. People infected with antimicrobial-resistant organisms are more likely to have longer, more expensive hospital stays, and may be more likely to die as a result of an infection.”4

According to the CDC, each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections.5 While antibiotic-resistant infections can happen anywhere, most deaths related to antibiotic resistance happen in inpatient healthcare settings, such as hospitals and nursing homes.6 Hopefully, California will become the first “domino” in a nation-wide chain reaction of antimicrobial stewardship.

By effectively managing people, premises, and protocols, IntelliCentrics helps facilities overcome complex challenges including the burden to reduce HAIs and establishing new policies and programs such as antimicrobial stewardship programs. With the proper distribution of policies and training, your facility can create a safe environment for patients and staff. provides healthcare facilities with benchmarks in order to compare their policies to a comprehensive backdrop of local, national, and international regulations and best practices.


  1. http://www.vdh.virginia.gov/epidemiology/surveillance/hai/AntibioticStewardship.htm
  2. http://patientsafetymonitor.com/California-legislation-makes-antimicrobial-stewardship-a-priority/873-318107
  3. https://www.whitehouse.gov/blog/2015/06/02/white-house-hosts-forum-combating-antibiotic-resistance
  4. http://www.apic.org/Professional-Practice/Practice-Resources/Antimicrobial-Stewardship
  5. http://www.cdc.gov/hai/eip/antibiotic-use_techinfo.html
  6. http://www.cdc.gov/drugresistance/protecting_patients.html

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