The quiet creep of antibiotic resistance is an increasing danger to public health. Over the last several decades, the protection against deadly infections has become limited, and in some cases, non-existent with eight known pathogens resistant to available antibiotics. Aided by the inappropriate use of antibiotics, these so-called superbugs, once considered rare, are becoming common in healthcare facilities throughout the United States. To bring awareness to this health emergency, the Society for Healthcare Epidemiology of America (SHEA) is partnering with the Centers for Disease Control and Prevention (CDC) and others for Get Smart about Antibiotics Week.
Over time our arsenal against infections has dwindled, but we continue to assume another, stronger antibiotic will be available to take its place. With little investment in new antibiotics, we must work to reevaluate how we use antibiotics we have available to prolong the efficacy of these medications, says Sara Cosgrove, MD, MS, associate professor of medicine at Johns Hopkins University School of Medicine and a SHEA board member.
Drug-resistant bugs are associated with increased patient morbidity, mortality and higher healthcare costs spent on futile use of antibiotics and longer, more intensive hospital stays. One tool to combat the rise of antibiotic-resistant bacteria is antimicrobial stewardship programs and interventions. Antimicrobial stewardship helps prescribers know when antibiotics are needed and what the best treatment choices are for a particular patient to help improve the use of these drugs. The goal is to ensure patients receive antibiotics only when needed and in the safest way possible.
Recent studies published in the journal Infection Control and Hospital Epidemiology demonstrate the need for stewardship programs to provide safe, high quality and cost-effective care:
Antibiotic use can put patients at risk of serious infections. Up to 85 percent of patients with potentially fatal Clostridium difficile-associated diseases have been exposed to antibiotics in the preceding 28 days.
In a study in 128 veterans hospitals, switching from IV to oral antibiotics was found to be safe, to potentially reduce costs and to increase hospital staff awareness of appropriate antibiotic use. Antibiotics administered by IV are known to hinder patients through longer hospital stays.
Restricting ciprofloxacin in hospital units has been linked to a decrease in multi-drug resistant bacteria.
By closely monitoring antibiotic use, an antimicrobial stewardship program at a university medical center cut costs for antimicrobials nearly $3 million. After the program was ended, costs increased again by $2 million in two years.
Visit the SHEA website for more information on the appropriate use and management of antimicrobials in all healthcare settings to help slow resistance and improve patient care. Among the resources available are a comprehensive resource page and an online training for health professionals.