Antimicrobial Resistance and Stewardship

​​​​​Antimicrobial resistance is the ability of microbes such as bacteria, viruses, fungi and parasites to resist the effects of drugs that were once effective in treating the diseases they cause. When these microbes acquire resistance, standard treatments become ineffective, making infections more difficult to treat and increasing the risk of spread, serious illness and death. Antimicrobial resistance is a critical global health concern because it limits the available therapeutic options and effectively undermines the ability to control and prevent infectious illnesses. While antimicrobial resistance is a broad term that includes resistance in all types of microbes, such as bacteria, viruses, fungi and parasites, antibiotic resistance refers explicitly to the resistance of bacteria to antibiotics. ​

What causes antimicrobial resistance?​

Antimicrobial resistance is a natural phenomenon that occurs over time as microbes evolve. However, overuse and misuse of antimicrobials in humans and animals significantly accelerate this process. When antimicrobials are administered unnecessarily or inappropriately, microbes can adapt and acquire resistance mechanisms, making them more challenging to treat with standard medications.​

​What is antimicrobial stewardship?​

Antimicrobial stewardship refers to a coordinated effort within healthcare systems to optimize the use of antibiotics and other antimicrobial agents to address antimicrobial resistance. It involves health care providers, patients, public health professionals and policymakers. Antimicrobial stewardship aims to ensure the optimal use of antibiotics and other antimicrobial drugs, reduce microbial resistance, decrease the spread of infections caused by multidrug-resistant organisms and improve patient outcomes.​​

​According to CDC, over 2.8 million antimicrobial-resistant infections occur annually in the U.S., resulting in more than 35,000 deaths. The primary driver of antimicrobial resistance is the inappropriate use of antibiotics and other antimicrobials. In Kentucky, antibiotic prescription rates are significantly higher than the national average. Since CDC began publicly reporting annual statewide data in 2011, Kentucky has consistently ranked among the nation's highest outpatient antibiotic prescribing rates (CDC: Outpatient antibiotic prescribing in the United States​). Hence, antimicrobial stewardship is a health care priority for Kentucky.

KPDH Antimicrobial Stewardship Efforts​​

The health care associated infection prevention program of the Kentucky Department for Public Health leads the effort to promote antimicrobial stewardship in Kentucky in collaboration with our partners, including the Kentucky Antibiotic Stewardship Innovation Consortium (KASIC) and CDC.


For more information, please contact:
Aravind Pillai MBBS, MPH, PhD
Antimicrobial Stewardship Lead
The Healthcare-Associated Infection and Antibiotic Resistance Prevention Program




Resource and Education

Health Care Providers

Patients
Data Tracking and Monitoring
  • Acute Care
    • As of 2024, all acute care hospitals, including critical access hospitals, must report their inpatient antibiotic usage to CDC's National Healthcare Safety Network (NHSN).​ The HAI program uses NHSN data from Kentucky hospitals to monitor and track antibiotic use in inpatient settings across the state. The program provides hospitals with detailed feedback on their antimicrobial use biannually, comparing it to state and regional averages based on NHSN data. Additionally, the program offers feedback on hospitals' antimicrobial stewardship activities based on NHSN’s annual hospital survey.​
  • Outpatient

Additional Information