Twenty to 50 percent of all antibiotics prescribed in U.S. acute care hospitals are either unnecessary or inappropriate. Antibiotic Stewardship refers to a set of coordinated strategies to improve the use of antimicrobial medications with the goal of enhancing patient health outcomes, reducing resistance to antibiotics and decreasing unnecessary costs. (SHEA: The Society for Healthcare Epidemiology of America).
Antibiotic Stewardship encourages health care providers to use the right dose and duration of antibiotics that will have the least amount of adverse reaction to achieve the best possible care for the patient. When this is achieved, the likelihood of developing antimicrobial resistance will be drastically minimized and will also decrease the spread of infections caused by multidrug-resistant organisms. The misuse and overuse of antimicrobials is one of the world’s most pressing public health problems.
The Delaware Division of Public Health (DPH) and the Healthcare-Associated Infections Advisory Committee (HAIAC) support a coordinated statewide program to promote the appropriate use of antibiotics across the healthcare continuum, thus improving patient outcomes and decreasing the spread of multidrug-resistant bacteria.
The National Action Plan for Combating Antibiotic-Resistant Bacteria, issued by President Obama on September 18, 2014, provides a road map to guide the nation in rising to this challenge. It outlines steps for implementing the National Strategy for Combating Antibiotic-Resistant Bacteria and addressing the policy recommendations of the President’s Council of Advisors on Science and Technology (PCAST).
Although its primary purpose is to guide activities by the U.S. Government, the National Action Plan is also designed to guide action by public health, health care, and veterinary partners in a common effort to address urgent and serious drug-resistant threats that affect people in the U.S. and around the world. Implementation of the National Action Plan will also support World Health Assembly resolution 67.25 (Antimicrobial Resistance), which urges countries to take urgent action at the national, regional, and local levels to combat resistance.
Antibiotic resistance is a growing problem and the main cause of this problem is misuse of antibiotics. The Centers for Disease Control and Prevention (CDC)’s Get Smart: Know When Antibiotics Work program works to make sure antibiotics are prescribed only when they are needed and used as they should. The Get Smart program focuses on common illnesses that account for most of the antibiotic prescriptions written for children and adults in doctors’ offices and other outpatient settings.
Common infections, whether caused by bacteria or viruses, are often painful and can get in the way of our well-being and everyday lives. Many infections do not require antibiotics, but there are other actions you can take to lessen symptoms.
CDC’s Get Smart program has resources for healthcare professionals working in outpatient and inpatient healthcare settings, as well as community pharmacies.
Recommendations for appropriate antibiotic prescribing, including clinical practice guidelines, have been developed to improve outpatient treatment of common infections in children and adults. CDC’s Get Smart: Know When Antibiotics Work program has developed materials that outpatient healthcare professionals can use to educate their patients about when antibiotics treatment is appropriate.
Working with a wide variety of partners is critical to the success of the Get Smart: Know When Antibiotics Work program. Learn more about what partners are doing to combat antibiotic resistance in their communities and how you can become a partner.
Since their discovery in the 1920s, antibiotics have transformed our ability to treat infections. As antibiotic resistance increases, these lifesaving drugs do not work as well as they once did, and successfully treating common infections becomes more difficult.
These educational resources provide information on antibiotics and antibiotic resistance. They are intended for use by educators, health care professionals, and consumers.
Get Smart Week is an annual observance to raise awareness of the threats of antibiotic resistance and the importance of appropriate antibiotic prescribing and use. The last Get Smart Week was November 12 to 18, 2017.
There are many helpful resources for both practitioners and consumers. Providers working with Quality Insights have access to additional resources, including free e-learns for staff on infections. Nursing CEUs are provided.
On January 19, 2016, CDC and the American College of Physicians (ACP) issued new guidelines to help prevent inappropriate prescriptions of antibiotics.
Antibiotics have transformed the practice of medicine, making once lethal infections readily treatable.
The Core Elements of Hospital Antibiotic Stewardship Programs cover these 6 important areas:
Acute respiratory tract infection (ARTI) is the most common reason for antibiotic prescription in adults. Antibiotics are often inappropriately prescribed for patients with ARTI. This article presents best practices for antibiotic use in healthy adults (those without chronic lung disease or immunocompromising conditions) presenting with ARTI.
The Core Elements of Antibiotic Stewardship for Nursing Homes adapts the CDC Core Elements of Hospital Antibiotic Stewardship into practical ways to initiate or expand antibiotic stewardship activities in nursing homes. Nursing homes are encouraged to work in a step-wise fashion, implementing one or two activities to start and gradually adding new strategies from each element over time. Any action taken to improve antibiotic use is expected to reduce adverse events, prevent emergence of resistance, and lead to better outcomes for residents in this setting.
Growth Promotion – The use of some antibiotics can destroy certain bacteria in the gut and help livestock and poultry convert feed to muscle more quickly causing more rapid growth. This class of use has been the subject of controversy and scrutiny, and in 2012, the FDA asked livestock and poultry producers to phase out the use of antibiotics for growth purposes.
Animals can carry harmful bacteria in their intestines. When antibiotics are given to animals, antibiotics kill most bacteria. But resistant bacteria survive and multiply.
State of Delaware, Delaware Health and Social Services, Division of Public Health.
The SHEA Antimicrobial Stewardship Toolkit is comprised of three sections: Hospital and health resources, clinician resources, and patient resources.
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