This article is more than 5 years old. Information may no longer be current.
Hospitals support antimicrobial stewardship, but practice falls short
Click Here to Manage Email Alerts
An overwhelming majority of lead infection control coordinators at hospitals see the need for antimicrobial stewardship, yet nearly half of their facilities do not regularly use such practices to help prevent Clostridium difficile infections, according to a recent study.
“The gap between our respondents’ reported regular use of antimicrobial stewardship and their perceived strength of evidence to support antimicrobial stewardship was the highest of any practice [we studied],” Sanjay Saint, MD, MPH, chief of medicine at the Veterans Affairs Ann Arbor Healthcare System, and colleagues wrote in Infection Control and Hospital Epidemiology.
In a survey of 398 hospitals, 97% had an established facilitywide surveillance system for monitoring rates of C. difficile. However, only 24% had a written policy to routinely test for the infection when patients have diarrhea while on antibiotics or within several months of taking them, according to the researchers.
Ninety-one percent of respondents rated strength of evidence for antimicrobial stewardship as high for preventing antibiotic-resistant infections such as C. difficile, but only 52% of respondents reported regular use of antimicrobial stewardship by their institutions. The researchers noted that more than 60% of hospital patients receive antibiotics, with as much as half of antibiotic use in hospital settings deemed inappropriate.
More than 90% of respondents reported that their hospitals regularly use several practices to prevent C. difficile, including contact precautions; private rooms or cohorting of infected patients; enhanced room cleaning of infected patients; and use of soap and water for hand hygiene for infected patients. Perceived strength of evidence was within a few percentage points of reported use for each of these practices.
Reported regular use of disposable thermometers for patients with C. difficile infection was 69%, compared with a perceived strength of evidence of approximately 80%.
“While nearly all US hospitals report using surveillance to detect C. difficile infection (CDI), the use of antimicrobial stewardship programs to prevent CDI is lacking in about half of hospitals despite the perceived high strength of evidence to support such programs,” Saint told Infectious Disease News. “Hospitalists, pharmacists, infectious diseases physicians, and other clinicians can, and should, take a leading role in developing and implementing antimicrobial stewardship programs in their own hospital” – by David Jwanier
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts