Antimicrobial Stewardship Programs

Elizabeth Monsees, PhD, RN, CIC, FAPIC Antibiotic Stewardship Program Manager

Senior Patient Care Services Researcher
Patient Care Services Research
Children’s Mercy Kansas City
Kansas City, MO
Assistant Professor
University of Missouri – Kansas City, School of Medicine

Jennifer Goldman, MD, MSCR Director, Antimicrobial Stewardship Program

Director, Drug Safety Service
Division of Pediatric Infectious Diseases and Clinical Pharmacology
Children’s Mercy Kansas City
Kansas City, MO

Original Publication:
April 11, 2019
Declarations of Conflicts of Interest:
  • Elizabeth Monsees reports no conflicts of interest.


Antimicrobials are one of the most commonly used types of therapeutic drugs; however, antimicrobial prescribing is often either excessive or suboptimal. Worldwide concerns about antimicrobial resistance have prompted the development of antimicrobial stewardship programs (ASPs) to improve prescribing practices and reduce the unnecessary use of antimicrobials and the emergence of resistant bacteria. Literature suggests that hospital-based ASPs led by infectious disease physicians and pharmacists have been influential in improving patient outcomes. There is a growing need to expand the ASP team, particularly in settings where infectious disease experts are not readily available, such as long-term care, critical access, and ambulatory care sites. This chapter offers an overview of current regulations, reviews stewardship strategies for infection preventionists, and identifies opportunities to expand the breadth of the ASP team to leverage different perspectives in the fight against antimicrobial resistance.