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Tailored interventions needed to improve antibiotic use in VA hospitals
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DALLAS — The use of antibiotics steadily increased between 2005 and 2009 across Veterans Health Administration acute care facilities — fluoroquinolones accounted for 20% of all antibiotics used. Researchers, therefore, recommend for implementation of tailored interventions to ensure effective and appropriate use of antibiotics to prevent the spread of multi-drug resistant organisms in this setting.
Makoto Jones, MD, of the University of Utah, and colleagues assessed barcode medication administration data for antibiotic use across 110 VA acute-care facilities.
A gradual increase was found in overall antibiotic use during the study period. Specifically, a 102% increase was observed in the use of carbapenems, a 79% increase in vancomycin, and a 41% increase in a penicillin and beta-lactamase inhibitor combination.
“Overall antibiotic use and broad-spectrum antibiotic use in particular seems to be increasing,” Jones told Infectious Disease News. “The increased use of broad-spectrum antibiotics, which also has been reported in non-VA facilities, merits particular attention due to its potential negative impact on the prevalence of multi-resistant pathogens.”
“Since our arsenal of effective and safe antibiotics is limited and unlikely to grow significantly in the near future, there has been increasing interest to keep the currently available antibiotics working by improving antibiotic use through antibiotic stewardship programs,” he said. “For these programs it is of key importance to have access to the type of information provided in this study as a first step to identify potential problems and areas that merit further investigation and eventually interventions.” – by Ashley DeNyse
For more information:
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Jones M. #377. Presented at: SHEA 2011 Annual Scientific Meeting; April 1-4, 2011; Dallas.
Disclosure: Dr. Jones reports no relevant financial disclosures.
In this era of multi-drug resistant organisms, clinicians are placed in a difficult situation. As treatment outcomes of many bacterial infections are influenced by the timing of appropriate therapy, the increasing presence of resistant organisms triggers broader use of these powerful antibiotics for proven or suspected infections when treating patients in the hospital. Clinicians must always put the patient first in treatment decisions, but we must empower effective antibiotic stewardship programs, infection prevention and control efforts, the development of new diagnostic testing to facilitate better treatment decisions as well as support development of new antibiotics. Antibiotic use studies in the US are critical to understanding the basic science of how and why resistance is on the rise. [This] study is a clarion call for a need for better diagnostic tools to identify pathogens and resistance as implementation of effective antimicrobial stewardship.
– Steven Gordon, MD
President, SHEA
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