What is the primary goal of antimicrobial stewardship in the perioperative period?

• A. Maximize Broad-Spectrum Antibiotic Use.
• B. Avoid Stewardship.
• C. Reducing Monitoring to Save Time.
• D. Selecting Appropriate Agents, Dosing, and Duration to Prevent Resistance and Adverse Effects While Maintaining Prophylaxis Effectiveness.

Answer: (D)

In perioperative care, antimicrobial stewardship aims to use antibiotics in a way that protects the patient and the wider community: provide effective prophylaxis when needed, but minimize harm by avoiding unnecessary exposure. The best approach is to select the most appropriate agent, give the correct dose, and limit the duration to prevent resistance and adverse effects, while still preserving the effectiveness of prophylaxis. This means choosing a drug with the right spectrum for the procedure, adjusting for factors like weight or kidney function, timing it correctly around the incision, and stopping it when continued use offers no additional benefit. It also includes de-escalating or stopping therapy once culture results are available and avoiding unnecessary continuation of antibiotics beyond what the procedure requires.

Options that push broad-spectrum use or reduce oversight run counter to this goal: using unnecessarily broad antibiotics promotes resistance and adverse events; skipping stewardship ignores the need to balance benefit with risk; and cutting back monitoring or safety checks undermines the ability to use antibiotics effectively and safely.