2 Big Reasons Healthcare Needs Innovative Approaches in Antibiotic Stewardship

By Rosie Lyles, MD, MHA, MSc | April 11, 2018

At least two million people face an infection due to antibiotic resistant bacteria every year. The CDC statistics have it documented that at least 23,000 die each year as a result of these infections. We have to evolve past these statistics and change. Since 2011, the FDA listed out ways to combat this constantly growing public health concern. Our efforts in the medical community must go beyond labeling for the proper use of antibiotics or even public awareness. We’ve been doing that.

This is why we need alternatives and innovative approaches.

1. Missing the Infection Iceberg

Facilities need to implement horizontal approaches when reducing healthcare-associated infections. What I’ve seen in my experience is that those who are focused on one pathogen and screening for a targeted decolonization are simply missing the huge iceberg in front of them. We know people are coming into our facilities with multiple multidrug resistant organisms (MDROs), particularly those coming from nursing homes and other long-term care facilities. These patients are frequent flyers, bouncing to and from facilities. So if you’re only honing in on one pathogen, you’re missing all the others.

Chlorohexidine gluconate and povidone-iodine are effective topical antiseptics that reduce (decolonize) body surface bacteria to prevent carriage and infection. They are used in high risk patient populations, active against MDROs, used in healthcare for over 50 years and there is no data to show they increase antibiotic resistance.

2. Empower Patients

The majority of patients who have Staphylococcus aureus in their nasal cavity will be infected with methicillin-resistant Staphylococcus aureus (MRSA). These same bacteria are very common to surgical site infections (SSIs). More than 30 percent of the population is colonized with the bacteria that could lead to the antibiotic resistant infection.¹

Let’s look at products that target the bacteria in such an easily accessible place for patients. In the United Kingdom, it’s recommended that some carriers of MRSA ahead of surgery are to undergo nasal decolonization.²We’ve, however, seen application can vary from patient to patient. We have to make sure our patients have a full understanding of the colonization, their risk of infection and use of the product. We should provide materials that are as simple as pictures with step by step instructions that can give them that power for protection.

On top of proper hand hygiene, thorough daily environmental cleaning, appropriate gloves and gowns, antibiotic stewardship programs; we must realize there are new ways to reduce the spread of pathogens…without prescribing more antibiotics.

This is why I believe fighting HAIs effectively is a horizontal approach. The responsibility isn’t just on clinicians or front-line staff. Our c-suite leaders and administrators must realize new solutions are available and they-re cost-effective as well.

You can learn more about innovative approaches in antibiotic stewardship and reducing healthcare-associated infections with proven products and solutions.

Sources:

1. MRSA and the Workplace. https://www.cdc.gov/niosh/topics/mrsa/. The National Institute for Occupational Safety and Health (NIOSH). Page accessed March 16, 2018.

2. Nasal decolonization of Staphylococcus aureus with mupirocin: strengths, weaknesses and future prospects.  T. Coates, R. Bax, and A. Coates. Journal of Antimicrobial Chemotherapy. Published May 18, 2009.

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Rosie Lyles, MD

Director of Clinical Affairs

Rosie Lyles, MD, MHA, MSc is the director of clinical affairs at Medline. She was previously the head of clinical affairs at Clorox Healthcare where she served as the medical/clinical expert and primary medical science liaison for three healthcare businesses, supporting all scientific research, as well as clinical and product intervention design and development. Lyles has more than a decade of experience investigating hospital-associated infections (HAIs) with a particular focus on the epidemiology and prevention of multidrug-resistant organisms such as C. difficile, MRSA and CRE infections in acute care hospitals and long-term acute care hospitals as a physician-researcher at Cook County Health and Hospitals System. Lyles has also directed numerous clinical studies and interventions for the CDC and the Chicago Antimicrobial Resistance and Infection Prevention Epicenter with numerous authored peer-reviewed journal articles related to infectious disease epidemiology. She is an active member of the Infectious Disease Society of America, Association for Healthcare Environment and the Society for Healthcare Epidemiology of America. Currently she serves as a grant reviewer for the National Institutes of Health/National Institute of Allergy and Infectious Diseases (NIH / NIAID), manuscript reviewer for New England Journal of Medicine, American Journal of Infection Control, medical reviewer for U.S. Department of Veterans Affairs for HSR&D Scientific Merit Board, and Medical Advisory Board for C. Diff Foundation. Rosie received her medical degree from St. Matthew's University School of Medicine and completed a master's in Health Service Administration at St. Joseph College and a master's of Science in Clinical Research and Translational Sciences at the University of Illinois at Chicago.

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