Antimicrobial Stewardship: Leveraging the “Butterfly Effect” of Hand Hygiene

Abstract

It is vital that there are coordinated, collaborative efforts to address the threat of antimicrobial resistance (AMR) and to prevent and control the spread of hospital-onset infections, particularly those due to multidrug-resistant (MDR) pathogens. The butterfly effect is a concept in which metaphorically speaking, small, seemingly trivial events ultimately cascade into something of far greater consequence, more specifically by having a non-linear impact on very complex systems. In this regard, antimicrobial stewardship programs (ASP), when implemented alongside infection prevention control (IPC) interventions in hospitals, particularly hand hygiene (HH), are significantly more effective in reducing the development and spread of AMR bacteria than implementation of ASP alone. In this perspective, we briefly review the evidence for the combined effect, and call for closer collaboration between institutional IPC and ASP leadership, and for well-functioning IPC programs to ensure the effectiveness of ASP.

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

“…Integrating these interventions may reduce redundancy and align forces for maximal influence on HCWs. ASPs, when implemented in concert with IPC interventions in hospitals, particularly hand hygiene, are significantly more effective in reducing the development and spread of MDR bacteria than ASPs alone [ 115 ].…”

Ten golden rules for optimal antibiotic use in hospitals: based on the publication statement of the International Network Group of the World Antimicrobial Resistance

“…Institutional leadership support is crucial for the success of each programme. An effective microbiology laboratory is necessary to ensure [115].…”