Antimicrobial Stewardship: Critical to Patient Safety

ANTIMICROBIAL RESISTANCE IS ONE OF OUR MOST SERIOUS HEALTH THREATS1

More than 2 million people are infected with resistant organisms, resulting in approximately 23,000 deaths annually

Patients with resistant infections are more likely to die, and those who survive have longer hospital stays, delayed recuperations, and more long-term disability

And yet 30-50% of antibiotic prescriptions are unnecessary or inappropriate

With a diminishing pipeline of new antibiotics, we risk an increasing number of untreatable infections

Annual impact of antibiotic-resistant infections

  • $20-35 billion in excess direct health care costs
  • Additional costs for lost productivity up to $35B
  • 8 million additional days in hospitals

Why Do Stewardship?2

To improve outcomes for individual patients. Better antibiotic therapy means both a shorter hospital stay and a better chance of going home alive.

To reduce the growth of antibiotic resistance in hospitals and the community. If resistance keeps growing we will reach a point where we no longer have effective therapies for common infections -- not a future we want to see. Reducing and better focusing antibiotic use will slow the rate of growth while we develop other drugs and approaches to resistance.

To reduce costs for hospitals and healthcare. While optimizing antibiotic therapy can mean spending more on antibiotics for some hospitalized patients, it generally means spending less on the vast majority of patients. Antimicrobial stewardship programs have been repeatedly shown to save hospitals hundreds of thousands of dollars or more each year. That is not only better for the hospital's bottom line, it is better for all of us who pay the bill for healthcare.

Not everything in healthcare lines up so nicely, where what is best for the patient has been so clearly shown to be better for the hospital, the community, and the payers. It's the type of quality improvement activity that not only pays for itself, but also generates extra savings that can be used for other initiatives.

A NATIONAL PRIORITY

CDC report on Antibiotic Resistance Threats in the US, 2013, identifies resistance as one of our greatest threats to health and recommends priority actions1


President's Council of Advisors on Science and Technology Report to the President on Combating Antibiotic Resistance in September 2014 outlines a national strategy3



Major recommendations for stewardship and reporting

  • By the end of 2017, CMS should add requirements for stewardship programs to the Medicare Conditions for Participation
  • CMS should expand Physician Quality Reporting System to include quality measures that discourage inappropriate antibiotics for non-bacterial infections
  • CMS should include reporting of antibiotic use and resistance to the NHSN in the Inpatient Quality Reporting program and reporting on Hospital Compare by 2018
  • Federal health care delivery facilities should implement stewardship programs and report antibiotic use and resistance to NHSN

References
1. Centers for Disease Control, Antibiotic Resistance Threats in the United States, 2013
2. Centers for Disease Control, Core Elements of Hospital Antibiotic Stewardship Programs, 2014
3. President’s Council of Advisors on Science and Technology, Report to the President on Combating Antibiotic Resistance, 2014

 

Download the Teqqa Antibiotic Stewardship Brochure