Stephen M. Smith, MD

The Infectious Diseases Society of America has advocated for the implementation of antimicrobial stewardship programs (ASPs) in every hospital. This year, CMS, under rule 3346-F, agreed, and now requires, that even previously exempt critical access hospitals implement an ASP. CMS is vague on what an ASP is or means and states: “For the implementation of antibiotic stewardship programs, guidance is available from several organizations, including IDSA, [Society for Healthcare Epidemiology of America (SHEA)], American Society for Health System Pharmacists (ASHP) and CDC.” The documents issued by ASHP and CDC are not true guidelines. Essentially, CMS leans heavily on the joint IDSA/SHEA guidelines, first published in 2007 and updated in 2016.

Recently, the Canadian HIV Trials Network published its guidelines for pre-exposure prophylaxis, or PrEP, and nonoccupational post-exposure prophylaxis.