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Antimicrobial stewardship: 5 things you should know
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The CDC estimated that every year, 2 million people will become ill with an antibiotic-resistant infection, of which approximately 23,000 will die. Antimicrobial stewardship programs have been implemented across US hospitals in response to this growing health threat.
Infectious Disease News presents 5 “fast facts” about antimicrobial stewardship and antimicrobial resistance.
1. The presence of gram-negative organisms resistant to all antibiotics is increasing.
The organisms of greatest concern are carbapenem-resistant Enterobacteriaceae (CRE). These organisms are not only highly resistant to antibiotics, but are also easily spread. In some cases, CRE has been impossible to treat.
2. Antibiotic resistance is not new.
In an article published in The New York Times in 1945, the scientist behind the discovery of penicillin warned about the development of antimicrobial resistance. Yet, in a perspective published in The New England Journal of Medicine in 2013, 3 million kilograms of antibiotics were administered to patients in the US alone.
3. Antimicrobial stewardship programs reduce costs.
In a study that assessed the implementation of an antimicrobial stewardship program at the University of Maryland Medical Center, researchers found that the program resulted in a $3 million cost reduction during the first 3 years of implementation. However, once the program was cancelled, costs increased by $2 million within 2 years.
4. The CDC released a guideline of core elements of an antimicrobial stewardship program.
These core elements include: leadership commitment, accountability, drug expertise, action, tracking, reporting and education. While the guideline establishes what a successful program does, the program is not a “one-size-fits-all” and facilities should have flexibility in how programs are established at their hospital.
5. California law helped establish antimicrobial stewardship programs.
The legislation, passed in 2006, was the first legal force in the United States that required acute care hospitals to create processes that ensured the appropriate use of antibiotics — required to be in place by January 2008. The law was nonspecific, which allowed the flexibility of hospitals to implement processes that work best for them.