Emir Kobic, PharmD

The CDC estimates that nearly 50% of antibiotics prescribed in the United States are unnecessary. From 2006 to 2012, 55% of all hospitalized patients in the U.S. received at least one dose of antibiotics, with broad-spectrum antibiotic use (ie, carbapenems) increasing by nearly 37%. The inappropriate use and overuse of antibiotics remain some of the most crucial drivers of the development of antimicrobial resistance, and we are now in an era when “superbug infections” are emerging. Although congressional initiatives like the GAIN Act have provided incentives for the pharmaceutical industry to expand today’s antimicrobial arsenal, broader quality improvement projects aimed at preventive measures have been proposed by the 2015 White House Forum on Combating Antimicrobial Resistance. These projects are aimed to assist antimicrobial stewardship programs (ASPs), which serve as a mechanism to combat resistance; however, we need to evaluate further strategies to de-escalate and discontinue inappropriate antibiotic therapy. The 2016 antimicrobial stewardship guidelines set forth practical recommendations toward antibiotic de-escalation. One approach is for ASPs to promote allergy assessment and penicillin skin testing (PST) when appropriate.