The Infectious Diseases Society of America (IDSA) welcomes the proposed rule released yesterday by the Centers for Medicare and Medicaid Services (CMS) requiring all long-term care facilities to establish an antibiotic stewardship program, including antibiotic use protocols and antibiotic monitoring, as a Condition of Participation in Medicare. IDSA has long led advocacy for this policy to improve patient care and combat the public health crisis of antibiotic resistance. Nationwide, infectious diseases (ID) physicians are serving as leaders of stewardship programs in their institutions and communities and will remain essential to lead implementation of this new policy.
Antibiotic stewardship optimizes the use of antibiotics in order to maximize their benefits to patients, while minimizing both the rise of antibiotic resistance as well as adverse effects to patients from unnecessary antibiotic therapy. Stewardship programs have been shown to reduce the percentage of antibioticresistant organisms in a facility, reduce the occurrence of C. difficile infections, improve patient outcomes, decrease toxicity, and reduce pharmacy costs.
IDSA is committed to ensuring that this important effort is a success. That success will hinge upon strong leadership, adequate reimbursement of stewardship activities, and the setting of appropriate criteria for all stewardship programs to meet. Stewardship programs require multidisciplinary teams (including physicians, pharmacists, nurses, and infection preventionists) implementing coordinated interventions to promote the selection of optimal antibiotic regimens including dosing, duration of therapy and route of administration. And they work best when they’re led by ID physicians — people who possess the specific clinical knowledge and experience in infections and antibiotic use necessary to change prescriber behavior.
A policy statement on antimicrobial stewardship developed by IDSA, the Society for Healthcare Epidemiology of America (SHEA) and the Pediatric Infectious Diseases Society (PIDS) in 2012 should provide useful guidance for implementing this important new policy, along with the Centers for Disease Control and Prevention (CDC) Core Elements of Hospital Antibiotic Stewardship Programs. IDSA is also developing detailed comments to CMS on this proposed rule.