Legal implications of antibiotic stewardship programs

Abstract

Infectious diseases professional societies, public health agencies, and healthcare regulatory agencies call for antibiotic stewardship programs (ASP) in many healthcare settings. However, medical legal implications of these programs remain largely uncharted territory. Although there is no legal precedent addressing issues of liability and standards of care on this subject, anticipating how the courts may assess questions of medical liability with respect to the various components of ASPs is important to define best practices in ASP operations, not only to manage the potential risk but also to improve patient care. This article seeks to address some of the common processes and interventions involved in antibiotic stewardship and the potential professional liability implications of these activities.

How Might Antibiotic Stewardship Programs Influence Clinicians’ Autonomy and Organizations’ Liability?

“…2 Without clearer prospective laws, regulations, or other standards, the inevitable controversies arising from ASP implementation-with implications for clinician autonomy and the professional and medico-legal allocation of responsibility between primary clinicians and ASPs and their personnel-will be shuttled to other fora, such as trial courts that litigate malpractice claims on an ad hoc, case-bycase basis. 3 This article explores existing legal authorities concerning antibiotic stewardship and analyzes the implications that ASP implementation might have for clinician autonomy and malpractice liability, especially in light of the potentially unpredictable ways that rules or standards derived from malpractice suits may develop.…”

“…Since ASPs can influence patient care and outcomes, it would be reasonable to believe that ASPs would be liable for those actions and subject to malpractice litigation. 3 However, because members of ASPs often do not interact directly with patients and because a clear standard of care has yet to be established by case law, each one of these elements could be contested.…”