A new Vital Signs report from the Centers for Disease Control and Prevention (CDC) shows that clinicians in some hospitals prescribe three times as many antibiotics than clinicians in other hospitals, although patients were receiving care in similar areas of each hospital. The report also found that, in hospitals, a 30 percent reduction in use of the antibiotics that most often cause deadly diarrheal infections with Clostridium difficile can reduce these infections by more than 25 percent. The same antibiotics also prime patients for future super-resistant infections. Furthermore, approximately one-third of the time, prescribing practices to treat urinary tract infections and prescriptions for the critical and common drug vancomycin included a potential error – given without proper testing or evaluation, or given for too long.
CDC recommends that every hospital implements a stewardship program that includes seven core elements:
1. Leadership commitment: Dedicate the necessary human, financial, and IT resources.
2. Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
3. Drug expertise: Appoint a single pharmacist leader to support improved prescribing.
4. Act: Take at least one prescribing improvement action, such as requiring reassessment of prescriptions within 48 hours to check drug choice, dose, and duration.
5. Track: Monitor prescribing and antibiotic resistance patterns.
6. Report: Regularly report prescribing and resistance information to clinicians.
7. Educate: Offer education about antibiotic resistance and improving prescribing practices.
The Vital Signs report follows several calls to action from CDC on antibiotic resistance including the Antibiotic Resistance Threats to the United States, 2013 report, the 2013 Get Smart about Antibiotics Week, and the upcoming Transatlantic Taskforce on Antimicrobial Resistance 2013 report. Learn more.