A Proposal - Youth Antimicrobial Stewardship Programs

You go to your local pediatrician because you have a sore throat. The doctor pulls out a popsicle stick and tells you to say “ahhh.” You lower your tongue, and the doctor sees some redness and prescribes you some amoxicillin assuming you have pharyngitis, more commonly known as strep throat. Pharyngitis is just one of hundreds of microbial infections. As a result, antibiotics are the second most frequently prescribed class of antibiotics; of all the antibiotics prescribed, approximately one-half of them are inappropriately prescribed. The inappropriate usage of antibiotics only furthers the spread of antibiotic resistance, which is becoming a more prevalent world heath issue today.

Luckily, within some medical environments, antimicrobial stewardship programs (ASPs) are set into place. As mentioned by the Stanford School of Medicine, ASPs use coordinated interventions, designed to improve and measure the appropriate use of antimicrobial agents. Such programs have been shown to optimize antibiotic use, reduce infections with antibiotic resistant pathogens, reduce drug costs, and reduce length of hospital stay. Despite the benefits that come along with an antimicrobial stewardship program, the process of creating one is time consuming. It requires a thorough proposal which often involves convincing hospital personnel as to why establishing an ASP is relevant and a priority on top of other hospital initiatives. Beyond the proposal itself, hospital clinicians, local pharmacists, administrative support, and the nearest microbiology lab must learn to communicate with one another in order to ensure a successful antimicrobial stewardship program. Yet, what if we could convince hospital board members the need for an ASP before they even enter the workforce? What if we could initiate communication and collaboration between clinicians, pharmacists, and laboratory staff earlier in their careers?

The answer to the questions above are in our youth: the aspiring clinicians, pharmacists, laboratory personnel, etc. I believe that a successful curriculum can be designed to educate both high school and college students about the roles ASPs play in antimicrobial practices. Such curriculums would involve both basic lecture and communicative aspects. Basic lecture would involve learning about the history of antimicrobial use, antimicrobial use for specific pathogen-related infections, the essential components and functions of an ASP, and how to establish a successful ASP. Students would then integrate what they learned from the lectures into specific case studies, working in groups as if they were an ASP. Case studies would involve a range of patients with varying patient histories, requirements, and infections. By educating the youth about the roles and purpose of an ASP in addition to allowing them to collaborate as if they were an ASP sets the necessary foundation for them to create their own stewardship programs in the future.

Once entering the medical field, such students are not only able to point out the relevance, necessity, and specific goals of an ASP to a hospital board, but also have the necessary communication and collaboration skills to establish a successful ASP within their local hospitals in a matter of weeks. The process of establishing an ASP if one isn’t already in place is difficult enough; however, if medical personnel obtain the necessary skills to establish an ASP in addition to learning about its function and role prior to entering the medical field, I believe it will have two main effects. One, proposals for an ASP could diminish overtime as its necessity and purpose are already known by hospital personnel, and two, components of an ASP will already have the communication and collaboration skills to establish a successful ASP within a matter of weeks. With successful ASPs established all around the globe, hopefully the inappropriate usage of antibiotics will decrease and the emergence of antimicrobial resistant pathogens will also be reduced. I conclude with a statement from Dr. Hanan Balkhy, the Assistant Director-General for Antimicrobial Resistance in the World Health Organization: “Time is running out, but we still have a window of opportunity to turn the tide on Antimicrobial Resistance and ensure continued effective treatment of bacterial infections for future generations. Let us act now.”