Antibiotic Stewardship


Bacteria are tiny organisms not visible with the human eye. Most bacteria are helpful to us; some are harmful and cause infections. An antibiotic is a prescription drug that can kill or disable disease-causing bacteria.

Antibiotic resistance happens when microbes (germs) develop ways to survive the use of medicines meant to kill or weaken them. When bacteria develop resistance to antibiotics, it is much harder to treat infections that the bacteria cause. Several of the more common bacteria that have developed resistance include Staphylococcus aureus (Staph), and Streptococcus pneumoniae (pneumococcus).

Antibiotic resistance is a growing problem in the U.S., and the main cause of this problem is the misuse of antibiotics. Antibiotics will not treat colds, flu, most sore throats, bronchitis, and many sinus and ear infections. This is because these illnesses are caused by viruses, and antibiotics will only cure bacterial infections, such as strep throat, urinary tract infections, or whooping cough.

It’s important that antibiotics be taken for the right reasons and at the right time, otherwise the antibiotics can cause more harm than good. Incorrect use of antibiotics can increase your risk of getting an antibiotic-resistant infection later. CDC estimates that more than 2 million people are sickened every year in the U.S. with antibiotic-resistant infections, with at least 23,000 dying as a result. In addition, antibiotics can kill the healthy bacteria in the gut, allowing more harmful bacteria, such as Clostridium difficile, to grow in its place.

Antibiotic Stewardship, or the promotion of the appropriate use of antibiotics, has become a national priority. Because antibiotic-resistance has become a problem in both clinical and community settings, it’s important that public health departments, healthcare providers, and the larger community work together to improve antibiotic use. CDC has spearheaded the Get Smart program, which aims to reduce the rate of rise of antibiotic resistance by:

  • Promoting adherence to appropriate prescribing guidelines among healthcare providers
  • Decreasing demand for antibiotics among both healthy adults and parents of young children
  • Increasing adherence to prescribed antibiotics

The links below provide additional resources for learning more about Antibiotic Stewardship and the Get Smart program:

Enterobacteriaceae is a large family of gram negative rods organisms. The most common enterobacteriaceae are Escherichia, Enterboacter and Klebsiella. Other frequently seen genera include Citrobacter, Morganella, Proteus, Providencia and Serratia.

Enterobacteriaceae cause a wide range of clinical infections and are a major cause of healthcare associated infections. CRE are Enterobacteriaceae that are nonsusceptible to carbapenem antibiotics and can cause infections with high rates of morbidity and mortality. CRE infections can have serious implications for persons with prolonged hospitalization, those who are critically ill, and those exposed to invasive devices (e.g., ventilators or central venous catheters). Symptoms may manifest thru respiratory, wound, urinary tract, invasive, tissue, and other infections.  CRE have become resistant to all or nearly all available antibiotics and therefore are classified by the Centers for Disease Control and Prevention (CDC) as an urgent threat.

Since January 2017, Iowa has been tracking CRE infection and colonization.