Antibiotic-resistant “superbugs” pose a serious threat to public health. Each year, drug-resistant bacteria:
- Infect more than 2 million people nationwide
- Kill at least 23,000 people
- Add an estimated $20 billion in excess direct healthcare costs
The battle against antimicrobial resistance is ongoing and includes implementation of public health and antibiotic stewardship programs.
Key to addressing the crisis is a set of policy recommendations published by the Infectious Diseases Society of America (IDSA) in 2011. According to the IDSA, “If such initiatives are not implemented now by the U.S. government and healthcare providers around the country, an increasing number of lives will be lost and families devastated.”
Where are we now?
Four years after publication of IDSA’s policy recommendations, there is growing recognition that antimicrobial stewardship programs are critical to reducing infections caused by multi-drug resistant organisms.
Impending federal action would make antimicrobial stewardship programs a requirement for participation in Medicare. However, staffing and resource challenges can slow implementation for many healthcare facilities. For example, pharmacists, infectious diseases physicians and infection control professionals at smaller hospitals may be motivated to create a program but need help with training and implementation.
To solve this, hospitals should have access to funding that could be used to hire a consultant to help establish an antimicrobial stewardship program.
In addition, IDSA said in its policy recommendations that more research is needed to define inappropriate antimicrobial prescribing and to better understand the primary drivers of such use, which could include:
- Comfort level with specific antibiotics
- Patient demands for antibiotics
- Failure to distribute patient education materials about the importance of appropriate antibiotic use
- Resistance to changing clinical practice for common infections
- i.e., ear infections
- Prescriber belief that their actions are too far removed from long-term impact
- “Prescribing this broad-spectrum antibiotic just this once can’t really make things worse… can it?”
In the end, the only way to address these important issues is to establish an antimicrobial stewardship program. Premier’s TheraDoc clinical surveillance system is a neutral 3rd party system that helps hospitals optimize anti-microbial agent selection and dose, timely initiation of therapy, therapeutic monitoring and de-escalation of therapy. TheraDoc was recently named the best-performing clinical surveillance solution by KLAS, an independent research firm that incorporates feedback from healthcare organizations across the country.
Antimicrobial stewardship programs work because they aren’t impacted by patient demands and can consider the long-term impact of inappropriate antibiotic use. I look forward to seeing new stronger action-oriented recommendations from IDSA as we continue to battle superbugs in healthcare facilities across the country.