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Select Month: November 2011

Antibiotic Misuse Continues to Threaten Effectiveness by Increasing Resistance

Categories: Antimicrobial Resistance, Healthcare-associated infections

SHEA

SHEA

Author – Sara Cosgrove, MD, MS
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. 

Antibiotic use in the United States: where do we stand?

Categories: Antimicrobial Resistance, Healthcare-associated infections

Ramanan Laxminarayan, PhD.

Ramanan Laxminarayan, PhD

Author – Ramanan Laxminarayan, Ph.D.,
director of Extending the Cure (ETC)

Patients in the United States are among the most intensive users of antibiotics in the world, but you may be surprised to learn that overall per capita outpatient antibiotic prescribing in the United States has decreased in recent years. In fact, between 1999 and 2007, the number of dispensed antibiotic prescriptions per thousand inhabitants dropped from 975 to 858 – a 12% decline.

Extending the Cure’s ResistanceMap shows new visualizations documenting this downward trend in prescribing. But enthusiasm should be tempered by some troubling patterns of antibiotic use.

For example, while penicillins still account for one out of every three antibiotic prescriptions filled, the use of more powerful, broad-spectrum antibiotics is increasingly rapidly. Dispensing of one powerful class of antibiotics, fluoroquinolones, increased by 49% over the time period.

California Initiative Promotes Appropriate Use of Antimicrobials in Healthcare Facilities

Categories: Antimicrobial Resistance, State HAI Prevention

Dr. Trivedi

Dr. Trivedi

Author – Dr. Trivedi,
California Antimicrobial Stewardship Program Initiative,
California Department of Public Health.

In February 2010, the California Department of Public Health (CDPH) launched the country’s first statewide initiative to promote optimization of antimicrobials in healthcare facilities. In less than two years, the cutting-edge California Antimicrobial Stewardship Program (ASP) Initiative is helping California healthcare facilities establish programs to improve patient safety and quality.

The Healthcare Associated Infections (HAI) Program of CDPH developed the statewide California Antimicrobial Stewardship Program (ASP) Initiative as the result of a statutory mandate. California Senate Bill 739 required CDPH to ensure that each general acute care hospital assemble a quality improvement committee to oversee the results of a process for evaluating the judicious use of antibiotics. While hospitals were aware of this mandate, they were left to implement programs on their own. The Initiative offers California healthcare facilities a valuable resource for antimicrobial use education, guidance and consultation.

Using Antibiotics Wisely in Long Term Care Settings

Categories: Antimicrobial Resistance, Healthcare-associated infections, Long Term Care (LTC)

amda Dedicated To Long Term Care Medicine

amda Dedicated To Long Term Care Medicine

AMDA – Dedicated to Long Term Care

Many of us have or will have loved ones in long term care facilities. These healthcare settings are critical to providing healthcare and everyday assistance to people with chronic illnesses or disabilities, who otherwise would be unable to take care of themselves. Like other healthcare settings, antibiotics are not always used correctly or wisely in long term care.  We are glad that CDC is addressing and promoting the appropriate use of antibiotics to ensure the prolonged use of these important drugs and delay the rise of untreatable infections.

We believe that medical directors of long term care facilities can have enormous impact on appropriate antibiotic use.  Here are some things they can do to ensure correct use of antibiotics for your loved ones:

NY State collaborative – a groundbreaking Antimicrobial Stewardship Project for hospitals and long-term care

Categories: Antimicrobial Resistance, Healthcare-associated infections, State HAI Prevention

David P. Calfee, MD, MS

David P. Calfee, MD, MS

Author – David P. Calfee, MD, MS
Associate Professor of Medicine and Public Health at Weill Cornell Medical College,
Chief Hospital Epidemiologist at New York-Presbyterian Hospital/Weill Cornell in New York City

The GNYHA, UHF, and NYSDOH Antimicrobial Stewardship Project

While most discussions of antibiotic resistance and improving antibiotic prescribing practices (“antimicrobial stewardship”) focus on hospitals, antibiotic resistance and inappropriate antibiotic use are also prevalent in long-term care facilities (LTCFs). In fact, antibiotic resistance rates in LTCFs are often higher than in hospitals. Consequently, in 2009 the Greater New York Hospital Association, United Hospital Fund, and New York State Department of Health launched the Antimicrobial Stewardship Project.

The project pursued effective strategies for antimicrobial stewardship programs in LTCFs to demonstrate that beneficial activities could be performed without significant investment in new resources, and to demonstrate the value of hospital-LTCF partnerships in antimicrobial stewardship activities. Another goal was to develop tools and materials to assist project participants and other healthcare facilities to develop and manage their antimicrobial stewardship programs.

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