Antimicrobials: Healthcare's Silver Bullet Against HAIs?

“I’m not aware of any well-done studies indicating a decrease in wound infections by using silver dressings,” says Rupp. “There are some data looking microscopically at colonization and other surrogate markers for their biologic activity, and those show a benefical effect, but I haven’t seen data from an adequately-powered, prospective, randomized study. I don’t think those studies have been done and they probably should be before clinicians widely adopt these as a standard for post-operative dressings.”

Rupp says this is a problem for infection control in general. “There are very significant clinical questions in infection control, and we need the resources to allow us to answer these questions. In the past, for the most part, we have not had the resources to conduct adequately-sized, multi-center studies to answer the real questions of the day. Instead, it has been up to individual investigators working on a shoestring budget to try to pull off a study that is inadequately supported. Folks who have power of the purse strings must be made aware of this and rededicate some resources to address the problem of HAIs.”

Rupp continues, “Its been estimated that there are 100,000 deaths per year in this country linked to HAIs, but how much money is earmarked and how many resources are dedicated at the federal or local levels to address these issues? Unfortunately, very little! For the most part, until very recently, this has been a quiet issue. We have lacked a grass-roots advocacy effort. I mean, you don’t see people wearing colored ribbons or wristbands to draw attention to the problem of HAIs. Folks aren’t going on “fun runs” to generate money to fight HAIs. That is starting to change, but unfortunately the new interest has, in some cases, been diverted into draconian mandates and unwieldy legislation. Rupp relates, “In recent months SHEA and other organizations have been in front of congressional committees in order to educate our elected officials about the importance of this issue and suggest ways to constructively address the problem of HAIs. SHEA and the Infectious Diseases Society of America (IDSA) have partnered with a variety of other organizations including APIC to draft guidelines on how best to introduce and maintain infection preventive measures in healthcare institutions. These guidelines should be out in the Fall of 2008 and we hope they will help mobilize institutions to improve. We fully appreciate that many HAIs can be prevented using current methods and technology.” Rupp continues, “Although we know a lot about preventing HAIs, we have a lot more to learn. We need to set research priorities and then have resources set aside to address these issues.”