Attendees of a White House-organized forum on the growing threat of antimicrobial resistance said the gathering of multiple stakeholders was productive and may quicken advances in the battle to prevent this resistance.

After an introductory session that was streamed, a number of the meetings focused on the problem among different care settings, including a heavy dose of interactive discussion.

"The rest of the forum was really quite energizing," said James Hunter, M.D., chief medical officer for the Carolinas HealthCare System in Charlotte, N.C. "To have all the different constituencies there and all committed to and frankly speaking about how we can advance antibiotic stewardship, and the importance of it, really worked out well," Hunter said.

Carolinas, which has worked actively to reduce antibiotic overuse since 2009, set some additional goals for antibiotic stewardship, as have other participants. Among them, Carolinas committed to incorporating antibiotic indicators and therapy guidelines within its electronic health records, and to developing disease-specific care pathways that provide best practices for antibiotic prescribing.

Carolinas also plans to implement stewardship programs in all inpatient locations within three years, and in ambulatory care and long-term care facilities over five years.

Another attendee, Rosie Lyles, M.D., head of clinical affair for Clorox Healthcare, said that long-term care is an area that lags the inpatient setting in antibiotic stewardship, partly for structural reasons. One of the barriers focused on in the forum, was the high turnover rate among staffers, which makes it more difficult to maintain stewardship programs, Lyles said. Generally, LTC facilities don't have the resources needed to educate the staff that might be found in the acute care hospital setting, she said.

More broadly, collaboration like the kind taking place at the forum and further standardization of how to manage antibiotics will be needed to succeed in keeping antibiotics effective. "Whatever you're doing in New York City, you should be doing the same thing in Chicago," Lyles said. "Stewardship is a partnership," she said.

And Carolinas' Hunter said the forum will contribute to heightened success in improving stewardship. Accelerating change was on the agenda, he said. "It's going to accelerate; I'm confident in that," Hunter said.