Antibiotic Misuse Continues to Threaten Effectiveness by Increasing Resistance
Categories: Antibiotic use, Healthcare-associated infections
November 21st, 2011 3:37 pm ET - .
SHEA
Johns Hopkins University School of Medicine
Antibiotic resistance isn’t a scare tactic or a doomsday scenario; it’s a real and present danger confronting hospitals and healthcare facilities throughout the world. From 2006 to 2008, rates of resistance to imipenem, an antibiotic used to treat resistant organisms, among the bacteria Acinetobacter doubled[i]. And that’s just one example.
In our consumer-driven society, the answer of many would be to create new drugs. Yet, only two new antibiotics have been approved by the FDA since 2008[ii] and the pipeline of new drugs is nearly dry. Even if a company was to begin developing a new drug today, barring any development issues it would not reach the market until 2020.
While this problem diminishes the arsenal of antibiotics healthcare professionals have at their disposal, there are strategies and programs in use in hospitals and healthcare facilities that have been shown to slow resistance and reduce the cost of care. Called antimicrobial stewardship programs
, these practices help healthcare professionals reevaluate antibiotic use, better utilizing the right drug, with the right dose, for the right duration at the right time.The Society for Healthcare Epidemiology of America
(SHEA) believes CDC’s Get Smart About Antibiotics Week is a timely framework within which to discuss antibiotic resistance and raise awareness of appropriate antibiotic use. Effective antibiotics are a community resource that must be preserved, because the way we use antibiotics today will impact how effective they will be in the future.Stewardship has long been thought of as common sense advice for the appropriate use of antibiotics. However, recent studies presented at the Infectious Diseases Society of America (IDSA) annual meeting
in October have started to show evidence of the value of these programs both in patient outcomes and cost of care. For example, research showed that:- Hospital antimicrobial stewardship programs are prompting more appropriate prescribing of antibiotics, leading to improved patient care.
- Since stewardship programs have been implemented, antibiotic resistance and costs at some hospitals are down.
- However; a survey of 274 U.S. hospitals found that while all have implemented stewardship programs, fewer than one in three are fully compliant with the 2007 IDSA/SHEA Antimicrobial Stewardship Guidelines. [Better uptake of recommended stewardship practices is still needed.]
In April, SHEA will also hold a leadership forum devoted to antimicrobial stewardship
at its spring 2012 conference, Advancing Healthcare Epidemiology and Antimicrobial Stewardship. As program co-chair, I look forward to this unique opportunity to bring together prominent leaders in the field to assess strategies to improve our use of antibiotics, and learn together about the best AS strategies to reduce hospital-wide resistance.Antibiotic resistance might seem like a slow motion car wreck that we can’t stop, but it doesn’t have to be. If we all work together to evaluate antibiotic use and reduce misuse, we can work to reverse this trend and improve patient care.
[i] Center for Disease Control and Prevention, National Healthcare Surveillance Network
[ii] The Epidemic of Antibiotic-Resistant Infections, CID 2008:46 (15 January) Clin Infect Dis. (2011) May 52 (suppl 5):S397-S428. Doi:10.1093/cid/cir153
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