Antimicrobial stewardship gets most of the attention, but its close partner, diagnostic stewardship, is just as important. The idea is simple: order the right test, for the right patient, at the right time, and interpret it correctly.
Consider urine cultures. Ordering them in patients without urinary symptoms frequently detects asymptomatic bacteriuria, which usually should not be treated. The positive result then drives antibiotics the patient never needed.
Tools such as reflex testing, algorithms, and thoughtful order sets help steer testing toward situations where it will actually change management.
When testing is disciplined, downstream antibiotic use falls almost automatically. Diagnostic and antimicrobial stewardship are two sides of the same coin, and neither reaches its potential without the other.