New Societal Approaches to Empowering Antibiotic Stewardship.

Substantial concern regarding the ever-worsening crisis of antibiotic resistance has been raised by theWorld HealthOrganization,USCenters forDiseaseControl and Prevention (CDC), EuropeanCentre forDiseasePrevention and Control, European Medicines Agency, Institute of Medicine, World Economic Forum, and the US Presidential Advisory Council on Science and Technology. The question is no longerwhether to act, but how. Antibiotic stewardship is the termused todescribe efforts to optimize selection of antibiotic therapy. Formalantibioticstewardshipprogramsareessential tohelp societyaddressantimicrobial resistanceby reducing the estimated more than 50% of antibiotic use that is unnecessaryor inappropriate.1 TheUSgovernmenthas recently emphasized the need for implementation of antibiotic stewardship programs at all hospitals.2 To be effective, antibiotic stewardship programs must incorporate best practices, which include dedicating sufficient resourcestotheprogram,appointingasingle leader tobe accountable for performance, having appropriate antibiotic expertise, implementing action plans, monitoringbacterial resistance, reportingantibiotic usage to staff, and providing education.3 However, further improving antibiotic use will require increasedaccountabilityandtransparencyatthesocietal level.2 A parallel can be drawn between antibiotic stewardship and infection prevention. Hospitals have beenrequired tohave infectionpreventionprograms for