The discovery of antibiotic treatments transformed healthcare, and dramatically improved our ability to reduce morbidity and mortality for all clinical areas, especially in surgery, transplant medicine, oncology and intensive care medicine.

Yet, early medical practitioners and researchers soon discovered that bacteria exposed to antimicrobials quickly developed a resistance to those treatments.1  By 1968, researchers estimated that 50 percent of antimicrobial use was either unnecessary or inappropriate.2

Today, resistance to antimicrobial treatment is a critical issue, contributing to rapid spread of multiple organisms for which few treatments are available.  The dramatic drop in the development and approval of new antibacterial agents complicates this global health problem and portends a future in which many more infections have no effective treatment option.3

SHEA supports the consistent management of antimicrobials in all healthcare settings as a fundamental step in slowing resistance and improving patient health.

Antimicrobial Stewardship refers to coordinated interventions designed to improve and measure the appropriate use of antimicrobials by promoting the selection of the optimal antimicrobial drug regimen, dose, duration of therapy and route of administration.

The major objectives of antimicrobial stewardship are to achieve optimal clinical outcomes related to antimicrobial use, to minimize toxicity and other adverse events, and to limit the selection for antimicrobial resistant strains. Antimicrobial stewardship may also reduce excessive costs attributable to suboptimal antimicrobial use.


  1. Fleming, Alexander (June 25, 1945). The Penicillin Finder Assays its Future. The New York Times (p. 21).
  2. Reimann & D’Ambola. JAMA 1968: 205: 537.
  3. Boucher, HW, Talbot GH, Bradley JS, Edwards JE, Gilvert D, Rice LB, Schedul M., Spellberg B., Bartlett J.  Bad buds, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America.  Clinical Infectious Disease (2009); 48: 1-12.