CMS proposes LTC facilities establish antimicrobial stewardship programs; IDSA supports requirement
CMS has proposed a rule that would require long-term care facilities to establish antimicrobial stewardship programs in order to participate in Medicare.
“Since the current requirements were developed [and published in 1989], significant innovations in resident care and quality assessment practices have emerged,” according to the 403-page document. “In addition, the population of nursing homes has changed, and has become more diverse and clinically complex. Over the last 2 to 3 decades, extensive, evidence-based research has been conducted and has enhanced our knowledge about resident safety, health outcomes, individual choice, and quality assurance and performance improvement.
The Infectious Diseases Society of America strongly approves of the proposal by CMS. IDSA, along with the Society for Healthcare Epidemiology of America and the Pediatric Infectious Diseases Society, created a policy statement on antimicrobial stewardship in 2012. The CDC also provides “Core Elements of Hospital Antibiotic Stewardship Programs.”
“Certainly within long-term care facilities there is a very high rate of antibiotic use,” Amanda Jezek, vice president of public policy and government relations for IDSA, told Infectious Disease News. “IDSA has been advocating for many years that we need antibiotic stewardship programs in all health care facilities, and so we certainly see this proposed rule as an important step in the right direction.
“There is tremendous evidence that stewardship programs reduce inappropriate antibiotic use, which is a key driver of [antibiotic] resistance.”
Jezek said the proposal could help reduce the number of Clostridium difficile infections and other adverse events that can be caused by inappropriate use of antibiotics, and it could improve patient outcomes.
“The focus is really about getting the right drug, to the right patient, right dose, right duration, right time,” she said. “We’re excited about this.”
Jezek said IDSA feels strongly that physicians specializing in infectious diseases should head these antimicrobial stewardship programs.
“Ultimately, the [programs] are about changing prescriber behavior to make sure antibiotics are prescribed appropriately,” Jezek said. “Physicians who have in-depth training and expertise in treating infections and using antimicrobial drugs, we think, are the best [individuals] to be leading these efforts.”
According to the CDC, antibiotic resistant bacteria are responsible for at least 2 million illnesses and 23,000 deaths annually in the United States, as well as $20 billion in excess direct health care costs and up to $35 billion in lost productivity each year. – by David Jwanier
Disclosure: Jezek reports no relevant financial disclosures.