U.S. hospitals participating in Medicare or Medicaid programs are now required to have antimicrobial stewardship programs in place, which exist to decrease the spread of infections caused by multidrug-resistant organisms. The Centers for Medicare & Medicaid Services (CMS) first issued the requirement in September 2019, and gave hospitals until March 30, 2020 to put programs in place.
In the midst of the ongoing Covid-19 pandemic, antibiotic-resistant bacteria and fungi have taken a backseat, but their threat still persists and can impact patients with respiratory illnesses like those caused by Covid-19. Yet while promising vaccines and antiviral treatments are being developed to address Covid-19, the same can’t be said for many of the infections caused by multi-drug resistant organisms. According to former CDC director Dr. Julie Gerberding, “the pipeline of drugs to manage these deadly infections is nearly dry,” but antibiotic-resistant bacteria still present a global threat.
Misuse of antibiotics contribute to the rise of the deadly infections cause by multi-drug resistance, which impact more than 2.8 million Americans each year, according to the Center for Disease Control and Prevention (CDC). The agency states that round 30% of antibiotics are unnecessarily or sub-optimally prescribed in the U.S. but antimicrobial stewardship programs can help reduce that number while also helping improve clinical outcomes, and reduce hospital costs and lengths of stay.
“Antimicrobial stewardship programs are a critical part of facility’s universal infection control strategies to combat antibiotic resistance,” Dr. Rosie D. Lyles, clinical affairs director at Medline. “We’re relying on this preventive approach even more during this COVID-19 pandemic because clinically we know that individuals who are at higher risk from antibiotic-resistant organisms are more susceptible to illness from viral lung infections (i.e. influenza and COVID-19). One study found that many of the deaths from the 2009 H1N1 influenza pandemic was caused by secondary bacterial pneumonia.”
To help facilities stay vigilant in fighting antimicrobial resistance, the CDC developed guidelines for hospital antibiotic stewardships programs, known as The Core Elements of Hospital Antibiotic Stewardship Programs. The most recent version of the guidelines, updated in 2019, highlight seven core elements needed for a successful programs:
- Commitment from leadership –the need for support from senior leaders to deliver the necessary resources for a stewardship program
- Program leadership – leaders or co-leaders, like a physician and pharmacist, to manage the program
- Pharmacy expertise (previously called “drug expertise”) – an appointed pharmacist to help implement actions
- Action – interventions like prospective audit and feedback, and pre-authorization
- Tracking – ways of monitoring antibiotic use and the impact of interventions
- Reporting – the practice of sharing information on antibiotic use and resistance with leaders and providers that can use it for action
- Education – education for healthcare providers as well as patients on antibiotics and their potential adverse events
Learn about the ways Medline is helping hospitals fight healthcare-associated infections.