Categories: Antibiotic use, Healthcare-associated infections, Long Term Care (LTC)
December 9th, 2010 3:21 pm ET -
Nimalie Stone, MD
Author — Nimalie Stone, M.D.
CDC’s Division of Healthcare Quality Promotion
As a healthcare professional, I have had the opportunity to work in nursing homes for many years both as a physician, as well as a consultant for infection control programs. When we say “nursing home,” many of us imagine communal living environments where frail elders receive basic support and assistance with activities like bathing, dressing, and preparing meals. However, much of this type of care has shifted to assisted living facilities. At the same time, nursing homes have undergone an extreme make-over; I have witnessed this transformation firsthand. The resident population and the care they receive are rapidly changing. And we must keep up.
Each year, more than 3 million people receive care in nursing homes – a 10% increase over the past 10 years. As this population has grown, we have seen a decline in another area – a 16% drop in the number of nursing home beds. How can more people be receiving care when beds are decreasing?
One explanation is that a growing proportion of people come to nursing homes directly from hospitals not to live, but for temporary care to gain strength and complete therapy before returning back to the community. For this “short-stay” population, nursing homes are not a destination, but a bridge along the journey from the hospital to home.
14 Comments -
Categories: Antibiotic use, Antimicrobial Resistance
November 19th, 2010 12:11 pm ET -
Ramanan Laxminarayan, Ph.D.
Guest author - Ramanan Laxminarayan, Ph.D.
Director of the Center for Disease Dynamics, Economics & Policy and an associate research scholar and lecturer at Princeton University.
Through Get Smart, CDC has raised awareness of antibiotic resistance as a serious public health concern that requires action. But where is resistance changing and at what rates? Is any region at particular risk? Are there patterns to its emergence that vary among different combinations of bacteria and antibiotics?
It is with these questions in mind that Extending the Cure has launched ResistanceMap—a new tool for visualizing resistance over time. Our beta version of ResistanceMap takes four common antibiotics (imipenem, methicillin, trimethoprim sulfa, and ciprofloxacin) and charts the resistance of common bacteria (Acinetobacter baumannii, Staphylococcus aureus, and Escherichia coli) over the first decade of the 21st century. Each progression shows how resistance has changed from year to year, by U.S. census divisions.
10 Comments -
Categories: Antibiotic use, Antimicrobial Resistance, NHSN
November 17th, 2010 4:39 pm ET -
Elizabeth S. Dodds Ashley, PharmD, MHS, BCPS
Guest author - Elizabeth Dodds Ashley, PharmD, MHS, FCCP, BCPS
Associate Director of Clinical Pharmacy Services and Antimicrobial Stewardship Pharmacist – University of Rochester Medical Center, Rochester, NY
Although this question sounds simple on the surface, answering it is one of the biggest challenges to stewardship programs both old and new. Unlike our infection prevention colleagues, antimicrobial stewards lack a uniform tool to measure and report antimicrobial utilization in a consistent way that facilitates benchmarking with similar institutions. Knowing how utilization compares with other centers is an invaluable tool in a field such as antimicrobial stewardship where utilization is driven by trends in resistance and changed by emerging infections making goal utilization an ever moving target.
4 Comments -
Categories: Antibiotic use, Clostridium difficile, Gram negatives, Healthcare-associated infections
November 16th, 2010 3:44 pm ET -
Arjun Srinivasan MD
Author - Arjun Srinivasan, MD
CDC – Medical Director, Get Smart for Healthcare Program
Over the past 2 years, I have brought together experts on antibiotic resistance to discuss how CDC can assist in efforts to improve antibiotic use in hospitals and nursing homes. My colleagues have published numerous studies demonstrating that inappropriate antibiotic use in hospitals and nursing homes results in increased resistance, worse patient outcomes, and increased costs. It is also helping drive the national epidemic of Clostridium difficile infections. This year, we have watched as deadly new mechanisms of antibiotic resistance were discovered in U.S. hospitals, mechanisms that will undoubtedly challenge our healthcare system and affect patient safety (see NDM-1, VIM). Clearly, we have a serious problem.
Those initial discussions with colleagues resulted in an expansion of CDC’s Get Smart programs, which target antibiotic use in outpatient clinics and pediatrician’s offices, to include a comprehensive program targeting inpatient settings. This week, CDC launched the Get Smart for Healthcare program aimed reducing inappropriate antibiotic use in hospitals and nursing homes. The foundation of this program is the concept that everyone plays a role in improving antibiotic use.
5 Comments -
Categories: Antibiotic use, Healthcare-associated infections
November 11th, 2010 8:38 am ET -
Get Smart: Know When Antibiotics Work
Author – Lauri Hicks, DO
CDC – Medical Director, Get Smart: Know When Antibiotics Work
As an infectious diseases physician and the medical director of CDC’s Get Smart: Know When Antibiotics Work program, I’ve repeatedly encountered patients with antibiotic-resistant infections. When antibiotics fail to work, the consequences are longer-lasting illnesses, more doctor visits or extended hospital stays, and the need for more expensive and stronger medications that may have side effects.
Much of this resistance is due to the repeated and often unnecessary use of antibiotics. Inappropriate prescribing and antibiotic use is particularly common during cough and cold season. Colds, most coughs and bronchitis, sore throats (except strep throat), and some ear infections, collectively known as upper respiratory infections, or URIs, are the main culprits behind inappropriate antibiotic treatment. Did you know that URIs account for over half of all antibiotics prescribed by office-based physicians? Most URIs are caused by viruses, and antibiotics are completely ineffective for treatment of viruses. Healthcare providers cite diagnostic uncertainty (uncertainty whether an illness is viral or bacterial), time pressure, and patient demand and expectations as the primary reasons why antibiotics are over-prescribed.
24 Comments -