Antimicrobial Resistance and Antibiotic Stewardship

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Epidemiology and Informatics
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What you need to know

​​​​​​​​​​​​​​​​​​What is Antimicrobial Resistance?

Antimicrobial resistance results when bacteria or other microorganisms become able to resist the killing activity of antimicrobials. Microorganisms become resistant due to excess use of antimicrobials. Use antimicrobials only for conditions where there is evidence that antibiotics are effective. Avoid them for conditions where they do not help, such as the common cold.


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What is Multi-Drug Antimicrobial Resistance?

Multi-drug resistant organisms or MDROs are bacteria that can resist several kinds of antibiotics. MDROs are harder to treat. Examples of MDROs include:

  • MRSA (methicillin-resistant Staphylococcus aureus)
  • Vancomycin-resistant Enterococcus (VRE)
  • Vancomycin intermediate or resistant S. aureus (VISA or VRSA)
  • Carbapenem-resistant enterobacteriaceae (CRE)
  • CRPA (Carbapenem Resistant Pseudomonas aeruginosa and CRAB (Carbapenem Resistant Acinetobacter baumanii)
  • Candida auris.

What is the Nebraska HAI Program Doing to Decrease Antimicrobial Resistance?

  • Promoting Antibiotic Stewardship to reduce use of unneeded antibiotics.
  • Promoting proper use of precautions in hospitals, such as:
    • Hand washing,
    • Gowns and gloves, and
    • Special cleaning and disinfection procedures.
  • Using reports of resistant organisms to track resistance patterns and to target reduction efforts.
  • Developing procedures and tools to reduce the transfer of resistant bacteria between sites, including this suggested Interfacility Infection Control Transfer Form.
  • Advising healthcare providers about changing resistance patterns. See Health Alert Network Advisory on Antibiotic Resistance.

What Can I Do to Reduce Resistance to Antimicrobials?

  • Wash your hands. Hand washing is the simplest but most effective way of reducing spread of resistant bacteria.
  • Ask your prescriber if you need antibiotics. Do not insist on antibiotics if he or she does not recommend them.
  • Take antibiotics for as long as your prescriber said. Do not stop without notifying your prescriber. This way, any leftover resistant bacteria will not have a chance to develop.

Antibiogram: Statewide and Regional (Gram Negative Bacteria)

​​Additional Information

Antibiotic stewardship is the overall effort and programs that promote appropriate and correct antibiotic prescribing. 

Why Antibiotic Stewardship?

  • Antibiotic resistance is a real and increasing problem.
  • 30-50% of antibiotic use in hospitals is unnecessary or inappropriate.
  • Excess use of antibiotics also adds to the growing problem of Clostridioides difficile infections.

Advantages of reducing the use of antibiotics when there is no need for them:

  • Decrease resistance to antibiotics.
  • Fewer Clostridioides difficile infections.
  • Reduction in healthcare costs.
  • Better patient outcomes

Efforts in Nebraska to Promote Antibiotic Stewardship

Stewardship Resources from CDC



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