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As part of World Health Day 2011 earlier this month, the World Health Organization (WHO) called on policy makers, providers, the public and the healthcare industry to take action to combat the serious health threat of antimicrobial resistance (AMR). Aligned with these efforts, Hospira is focusing on the growing importance of clinical surveillance systems to help reduce AMR by helping healthcare providers optimize antibiotic therapy and provide the "right drug for the right bug."
Antimicrobial agents, used to treat infections, are one of the most important advances in medicine, alleviating suffering from infectious diseases and saving countless lives over the past 70 years. According to WHO, the world is at risk of losing this critical arsenal of medicines due to the overuse and misuse of antimicrobials, as well as poor infection-control practices, resulting in the spread of healthcare-associated infections (HAIs). These challenges increase antimicrobial use and resistance, and have been linked to patient morbidity and mortality. According to WHO reports, at any given time, approximately 1.7 million people have an HAI, an estimated 60 percent of which are caused by a drug-resistant bacteria.
In the United States, antimicrobial drug resistance is estimated to deliver an incremental cost of $16.6 billion to $26 billion annually. As a result, hospitals are taking steps to address the problem, utilizing clinical surveillance systems to help them identify and prevent HAIs and combat AMR through real-time decision support focused on improving antibiotic use.
Clinical surveillance systems play a key role in the antimicrobial stewardship program at Henry Ford Hospital in Detroit, part of the Henry Ford Health System, helping to replace inefficient, labor-intensive manual methods of antibiotic and antimicrobial monitoring.
"Henry Ford Hospital deployed the TheraDoc clinical surveillance platform to improve the efficiency of the antimicrobial stewardship program," says Ed Szandzik, RPh, MBA, director of pharmacy at Henry Ford Health System. "The technology has helped prevent the overuse and misuse of antibiotics. Our stewardship program has been able to reduce antimicrobial use by 20 percent and help reverse the trend on C. difficile rates (which are currently below the Centers for Disease Control benchmark) through enhanced guidelines, policies, procedures and electronic monitoring."
Policy makers are also taking steps to address the growing problems of HAIs and the potential for associated antimicrobial resistance. For example, U.S. Rep. Jim Matheson (D-Utah) has been a leader in this area with his legislation: "Strategies to Address Antimicrobial Resistance Act" (STAAR Act), which supports many of the WHO AMR policies. In addition, several states have enacted legislation to require statewide reporting of HAIs. Many states now require hospitals to electronically report HAIs through the National Healthcare Safety Network (NHSN).
Reporting HAIs alone, however, is often not enough. Combating AMR requires a comprehensive approach of reducing HAIs through surveillance and the appropriate use of antibiotics. This comprehensive approach is already achieving results in some states. After implementing a mandatory reporting program for HAIs, which also requires use of electronic clinical surveillance systems to track and report infections, the Pennsylvania Department of Health reported a 12.5 percent reduction in HAIs in the states acute-care hospitals in 2009.5
"Reducing HAIs is critical in the fight against antimicrobial resistance, as poor infection prevention and control can increase the spread of antibiotic-resistant infections," says France Pitera, vice president of clinical information technology at Hospira. "Hospitalized patients can be reservoirs for resistant microorganisms, and patients who are carriers of resistant microorganisms can spread infections to other patients. For this reason, electronic clinical surveillance systems that leverage real-time data exchange to help hospitals address both problems -- HAIs and antimicrobial resistance -- are crucial."
TheraDoc systems are actively used in more than 300 U.S. hospitals, making critical patient information and medical knowledge readily available to help clinicians intervene quickly, prescribe appropriately and improve the quality of patient care, as well as facilitate reporting of HAIs via the NHSN. The patented TheraDoc clinical surveillance platform is the engine that powers several knowledge modules, including the Infection Control Assistant,Antibiotic Assistant, ADE Assistant, Clinical Alerts Assistant and Anticoagulation Assistant.
Hospira, Inc., is a global specialty pharmaceutical and medication delivery company dedicated to Advancing Wellness. As the world leader in specialty generic injectable pharmaceuticals, Hospira offers one of the broadest portfolios of generic acute-care and oncology injectables, as well as integrated infusion therapy and medication management solutions.