What is the primary role of antibiotic stewardship programs?

• A. Increase antibiotic usage in all situations
• B. Optimize antibiotic use to treat infections effectively while minimizing resistance, adverse events, and costs; includes de-escalation and appropriate duration
• C. Eliminate all antibiotic use
• D. Focus solely on preventing hospital-acquired infections

Answer: (B)

Antibiotic stewardship aims to optimize antibiotic use—selecting the right drug, dose, route, and duration—to treat infections effectively while minimizing resistance, adverse events, and costs. Stewardship programs promote de-escalation and appropriate duration, meaning they start with appropriate empiric therapy when needed but narrow the spectrum and shorten the course as soon as the pathogen and its susceptibilities are known. They also encourage daily reviews of therapy, timely IV-to-oral switches when feasible, and guidelines-based prescribing to reduce unnecessary exposure. The other options describe increasing use, eliminating antibiotics, or focusing only on infection prevention, which miss the goal of balancing effective treatment with minimizing harm and resistance.