Antimicrobial Stewardship and Pandemic Preparedness: Harnessing Lessons Learned to Advance Our Mission

center dot Public health policy addressing the threat of antimicrobial resistance (AMR) has greatly increased momentum for antimicrobial stewardship programs (ASPs) worldwide.center dot ASPs reoriented traditional responsibilities to better serve the COVID-19 pandemic response. Such "pandemic stewardship" functions can be escalated and de-escalated as needed to serve emerging public health emergencies.center dot Although ASPs were assuming functions outside their traditional roles, they were unable to monitor antibiotic use or provide audit and feedback to the usual extent. Increased anti-biotic use, hospital-acquired infections, and AMR were observed during the height of COVID-19. In the event of future pandemics, increased resources for stewardship pro-grams will be required to meet the needs of health systems.center dot ASPs have evolved to offer more robust services within the health care system; as such, current metrics used to measure impact and staffing ratios should be reevaluated.center dot The future of ASP is likely to involve health system expansion, expansion into outpatient and post-acute care settings, and stewarding of immune-based and microbiome therapeutics.