Antimicrobial Stewardship News and Resources
Antibiotic & Antimicrobial Stewardship Resource Center
Medical professionals are working to slow the spread of antimicrobial resistance, and small hospitals can perform many of the same stewardship activities as larger facilities. While critical access hospitals (CAH) face unique stewardship challenges because of their often-limited resources, they can address antimicrobial use patient by patient. We work closely with the Colorado Hospital Association, the CDC, University of Colorado, and community agencies to develop strategies that combat antibiotic resistance.
Antibiotic and Antimicrobial Stewardship News and Resources
Kay Miller Temple, Rural Monitor, March 22, 2017
The Rural Monitor details the contributions made to antibiotic stewardship by Marc Meyer, R. PH, BPharm, CIC, FAPIC. Author Kay Miller Temple, said that Marc is “what we writers refer to as “the glue” that made the story work: you were the one with the national expertise, state expertise and the boots-on-the-ground in small hospitals.” SHS is proud of Meyer’s contribution to reducing antibiotic resistance in our organization and at a national level.
Meyer, the Southwest Memorial Hospital pharmacist, says AS programs have to be community programs where all antibiotic prescribers in and outside hospital walls work together. Meyer said the main focus of this collaboration is an AS goal that shouldn’t be forgotten: decreasing bacterial resistance.
“To me, stewardship means community. It means clinics, ambulatory surgical centers, nursing homes, dentists and veterinarians, anyone prescribing antibiotics, cutting down on antibiotic days when appropriate,” he said.
The Journal, January 11, 2016
“If the health-care profession does not act decisively to deal with antibiotic resistance, we could start to see patients dying from bacterial illnesses that right now are easily treated with antibiotics,” Meyer said. “Essentially we would return to a pre-antibiotic era.”
Antibiotics are not effective against viruses, yet it is commonly prescribed for that. For example, although most upper respiratory infections are viral, many patients demand antibiotics for such conditions. The CDC estimates that as many as 60 percent of antibiotic prescriptions for upper respiratory symptoms do not target the cause of the infection and may contribute to antibiotic resistance and other problems.
Other problems also result from overprescribing antibiotics, which destroy the normal bacteria present in the body. In the United States each year, more than $3 billion is spent treating Clostridium difficile, an opportunistic pathogen that causes severe diarrhea and results in death in approximately 5-10 percent of patients who develop a C. difficile infection. Between 1999 and 2011, the mortality rate of C. difficile has increased tenfold.
A key component of the playbook are the five Ds of effective antibiotic use: diagnosis, drug, dose, duration of therapy, and de-escalation.
“One lesson I learned was that as a small hospital, Southwest Memorial can move more rapidly than larger organizations when it comes to effectively choosing the best medication for each individual patient,” Meyer said.
Tyler Smith, UCHealth, May 11, 2016
“It’s vital that hospitals, whatever their size, focus attention on how they administer antibiotics, the conference participants agreed. For one, Colorado has seen an increase in the incidence of C. diff, a gut-dwelling, toxin-producing bacterium that causes severe diarrhea and colitis and is especially dangerous to already weakened patients, such as the elderly and the immunocompromised. Overprescribing antibiotics opens the door to C. diff by wiping out “good bacteria” and allowing the rogue intruders to take over.” (Smith, 2016).
Antibiotic Stewardship in Long-Term Care
Presentation materials can be downloaded here:
- CHA UTI Prescribing Guidance – LTC
- Mcgeer UTI 2014
- Patient Assessment forms for LTC 2015
- McGeer Respiratory 2014
- CG Health Stewardship Project March 2016
- References for CG Health UTI project
- CHA UTI Diagnosis Guidance – LTC March 2016
- CHA UTI Dosing Table – LTC Feb 2016
- CHA LTC ASP 2016
- ASM in LTC – Bridget Olson
- CDC Core Elements – Nimalie Stone
- Teamwork for UTI – Heidi Wald
- CDI – Telligen
Video presentations are available on YouTube:
- CDC Core Elements PT 1 (of 5) CDCCDC
- Teamwork for UTI Diagnosis PT 2
- A Case Study
- Presentations Of Guidelines Pt 4
- Clostridium Difficile Infections CDI PT 5