The inappropriate and unnecessary overuse of antibiotics within hospital and outpatient settings has led to the rise of drug-resistant strains of bacteria over the past several decades. These “super” bugs cause 2 million illnesses and over 23,000 deaths in the U.S. alone, according to the Centers for Disease Control and Prevention (CDC)1. In March of 2015, the White House issued a National Action Plan for Combating Antibiotic-Resistant Bacteria. The goals of the plan include1:
- Slow the emergence of resistant bacteria and prevent the spread of resistant infections.
- Strengthen national one-health surveillance efforts to combat resistance.
- Advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria.
- Accelerate basic and applied research and development for new antibiotics, therapeutics, and vaccines.
- Improve international collaboration and capacities for antibiotic-resistance prevention, surveillance, control, and antibiotic research and development.
By 2020, a primary outcome of Goal 1 will be the establishment of antibiotic stewardship programs in all acute care hospitals and across all healthcare settings2. The core elements of hospital antibiotic stewardship programs will include1,2:
- Establishing leadership commitment by dedicating necessary human, financial and information technology resources.
- Appointing a single physician leader, ideally formally trained in infectious diseases, responsible for program outcomes.
- Appointing a single pharmacist leader with drug expertise, responsible for working to improve antibiotic use.
- Securing support from the multidisciplinary team, including infection prevention control, nursing, information technology, laboratory and quality improvement.
- Implementing policies and interventions to improve antibiotic use, ensuring that patients receive the right antibiotic at the right time at the right dose for the right duration.
- Implementing at least one recommended action, such as systemic evaluation of ongoing treatment after a set period of initial treatment (i.e. “antibiotic time out” after 48 hours).
- Monitoring antibiotic prescribing and resistance programs.
- Educating clinicians about resistance and optimal prescribing.
Healthcare leaders and clinicians in all settings should focus efforts on implementing these recommendations in order to decrease antibiotic resistant bacteria.