2 Big Reasons Healthcare Needs Innovative Approaches in Antibiotic Stewardship

By Rosie Lyles, MD, MHA, MSc, FACA | 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, MHA, MSc, FACA

Director of Clinicial Affairs

Rosie Lyles, MD, MHA, MSc, FACA is the director of clinical affairs at Medline. She serves as the infectious disease expert and primary medical lead for numerous healthcare businesses, while developing complex clinical strategies and supporting the product life cycle to post market and clinical follow-up. With over a decade of experience investigating healthcare associated infections (HAIs) with a particular focus on hospital epidemiology and prevention of multidrug-resistant organisms (MDROs) infections across the continuum of care, Dr. Lyles has led breakthrough clinical research, changing national guidelines and recommendations that improved patient care and outcomes for the Centers of Disease Control and Prevention (CDC) and the Chicago Prevention and Intervention 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 (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). Dr. Lyles is a Board Member for the US Department of Veterans Affairs on the Health Services Research & Development Scientific Merit and for the White House Coronavirus (COVID-19) Commission for Safety and Quality for Nursing Homes, served as Medical Advisory Board for C. Diff Foundation, Co-Chairman of the Association for Health Care Environment (AHE) Industry Advisory Council, an Infectious Diseases Expert for the Florida Health Care Association, and participated in White House Forum on Antibiotic Stewardship (2015) for the National Action Plan for Combating Antibiotic-Resistant Bacteria.

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