Objectives:

• Review trends in antimicrobial resistance and C. difficile infections
• Appraise key challenges to implementing ASPs in transplant patients
• Discuss strategies for implementing antimicrobial stewardship programs in transplant centers
• Analyze the value of early and appropriate diagnostic testing in guiding antimicrobial therapy and minimizing nonessential antimicrobial exposure.

With the current global crisis in antimicrobial resistance and the threat of a return to the preantibiotic era, it is increasingly urgent that physicians recognize the need for, and the value of antimicrobial stewardship programs (ASPs) and support their existence. ASPs can help avoid inappropriate antimicrobial use and help preserve the efficacy of these important resources.

Patients undergoing organ transplantation are frequently exposed to prolonged courses of prophylactic and therapeutic antimicrobial agents, which may contribute to the occurrence of adverse drug events (such as Clostridium difficile infection), the emergence of multidrug-resistant organisms and increased morbidity and mortality. Early initiation of effective antimicrobial therapy is associated with improved patient outcomes, and rapid pathogen identification and notification to the treating clinician is a key component. Thus, efforts to optimize the selection, dosing and duration of antimicrobial therapy both to improve patient outcomes and to minimize selective pressure on antimicrobial resistance are extremely relevant to immunocompromised patients.

This presentation will outline current trends in antimicrobial resistance, examine the challenges and opportunities to improve antimicrobial use and analyze the value of antimicrobial stewardship programs in transplant patients.