Antibiotic Stewardship to Combat Antimicrobial Resistance Menace: Present Updates, Challenges, and Future Directions

The increasing trend in resistance to antimicrobial agents is a major threat to the management of infectious diseases. If nothing is done, we may return to a pre-antibiotic era where a minor infection is potentially fatal. Therefore, it is important to use antibiotics judiciously to prevent serious public health threats. To this day, many policies and guidelines have been laid out to define the ideal selection, the correct dosing, and the appropriate duration of antibiotic therapy. Unfortunately, their adaptation still leaves much to be desired. We suspect that demand for inappropriate or unnecessary use represents a major cause of emerging resistance. The consequence is that broadening the antimicrobial spectrum leads to never-decreasing antibiotic exposure, which differentiates these drugs from other substances and increases the selection pressure that leads to the emergence of antimicrobial resistance and indirectly raises the cost. In the face of these threats, the principle of "maximum therapeutic effect with minimal risk" must drive the antimicrobial strategy. It is essential that evidence-based interventions be integrated by all hospitals, physicians, and other health professionals into daily practice.