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Antimicrobial Resistance

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Antimicrobial agents have been used since the 1940s to treat patients who have infectious diseases. However, over time and due to increasing use of these drugs in humans, animals, and agriculture, many bacteria, fungi, viruses, and parasites have adapted to them, making the drugs less effective. Some microorganisms may develop resistance to a single antimicrobial agent (or related class of agent), while others develop resistance to several antimicrobial agents or classes. These organisms are often referred to as multiple drug resistant organisms (MDRO). In some cases, the microorganisms have become so resistant that no available antibiotics are effective against them.

Infections with drug-resistant organisms are primarily a problem in hospitals and other healthcare settings, however they can also spread in the community at large. People infected with drug-resistant organisms are more likely to have longer and more expensive hospital stays, and may be more likely to die as a result of the infection. When the drug of choice for treating their infection doesn't work, they require treatment with second- or third-choice drugs that may be less effective, more toxic, and more expensive. This means that patients with an antimicrobial-resistant infection may suffer more and pay more for treatment.

  • Strategies for Preventing Antimicrobial Resistance
  • Core Elements of Antibiotic Stewardship Programs
  • Recorded Webinars
  • Helpful Resources

Patients can:

  • Ask if tests will be done to make sure the right antibiotic is prescribed.
  • Take antibiotics exactly as the doctor prescribes. Do not skip doses. Complete the prescribed course of treatment, even when you start feeling better.
  • Only take antibiotics prescribed for you; do not share or use leftover antibiotics. Antibiotics treat specific types of infections. Taking the wrong medicine may delay correct treatment and allow bacteria to multiply.
  • Do not save antibiotics for the next illness. Discard any leftover medication once the prescribed course of treatment is completed.
  • Do not ask for antibiotics when your doctor thinks you do not need them. Remember antibiotics have side effects.
  • Prevent infections by practicing good hand hygiene and getting recommended vaccines.

Healthcare providers can:

  • Prescribe antibiotics correctly – get cultures, start the right drug promptly at the right dose for the right duration. Reassess the prescription within 48 hours based on tests and patient exam.
  • Document the dose, duration and indication for every antibiotic prescription.
  • Stay aware of antibiotic resistance patterns in your facility.
  • Participate in and lead efforts within your hospital to improve prescribing practices.
  • Follow hand hygiene and other infection control measures with every patient.

Healthcare facility administrators and payers can:

  • Adopt an antibiotic stewardship program that includes the seven Core Elements of Antibiotic Stewardship Programs
  • Work with other healthcare facilities to prevent infections, transmission, and resistance.

Source: https://www.cdc.gov/Features/AntibioticResistance/index.html

  1. Leadership Commitment - Antibiotic stewardship is a team sport in which many hospital staff (including physicians, pharmacists, nurses, and administrators) play an important role.
  2. Accountability - Hospitals must appoint a single leader, such as a physician, who is responsible for program outcomes.
  3. Drug Expertise - Hospitals must designate a single pharmacist who can lead initiatives to improve antibiotic use among patients.
  4. Action - Hospitals must implement a systematic approach to evaluating patients’ needs for antibiotics.
  5. Tracking - Monitoring the impact of antibiotics on patients and patient outcomes is essential to ensuring that antibiotics are prescribed only in cases where they treat bacterial infections.
  6. Reporting - Doctors, nurses, and other key staff must regularly share information with all hospital stakeholders.
  7. Education - Education must be provided regularly to all hospital staff, as well as patients and their families.

Please refer to the full guide for more information: For hospitals - For nursing homes

Source: https://www.cdc.gov/getsmart/healthcare/pdfs/Antibiotic-Stewardship-Final-factsheet_-071216-508.pdf

Name and email registration are required to view recordings.

Florida Department of Health Antibiotic Stewardship - presented by Tammy Jernigan, ARNP, MSN, CIC – November 20, 2015

Objectives:

  • Provide an overview of antibiotic stewardship program components for hospitals
  • Discuss the use and misuse of antibiotics in the U.S.
  • Identify strategies to improve patient care through antibiotic stewardship programs
  • Summarize the National Action Plan for Combating Antibiotic-Resistant Bacteria

Recording

Slide Set

Multi-Drug Resistant Gram Negative Bacteria and Antimicrobial Stewardship - presented by Brian Meister, Pharm.D, BCPS – February 19, 2016

Objectives:

  • Definition and evolution of gram negative resistance
  • Epidemiology of gram negative resistance
  • Treatment of resistant organisms
  • Stewardship role of hospital pharmacist

No Recording Available

Slide Set

Clostridium difficile Infection (CDI) Diagnosis, Treatment, and Prevention – presented by Ed Septimus, MD.FACP, FIDSA, FSHEA – May 13, 2106

Objectives:

  • Epidemiology and transmission
  • Diagnostic options
  • Treatment
  • Prevention

Recording

Slide Set

An Introduction to Judicious Use of Antibiotics – presented by Ivan Guerrero, MD – September 30, 2016

Objectives:

  • Discuss untoward effects of antibiotic use
  • Define antibiotic stewardship
  • Describe 6 goals of antibiotic stewardship programs
  • Describe a rationale for antibiotic selection
  • Describe directed and empiric antibiotic therapy
  • Describe and give examples of 4 tenets of appropriate antibiotic use

Recording

Slide Set

Antibiotic Stewardship in Long-Term Care: Background and Implementation Strategies – presented by Joseph M. Mylotte, MD – November 28, 2016

Objectives:

  • To understand the importance of antibiotic stewardship in LTC by reviewing the use of antibiotics and their adverse effects in this setting
  • To review the CDC core elements of antibiotic stewardship for LTC
  • To provide methods to implement the CDC core elements in individual LTC facilities

Recording

Slide Set

Impact of Antimicrobial Stewardship Program – presented by Ripal Jariwala, Pharm.D, AAHIVP – February 2017

Objectives:

  • To understand the importance of antibiotic stewardship in LTC by reviewing the use of antibiotics and their adverse effects in this setting
  • To review the CDC core elements of antibiotic stewardship for LTC
  • To provide methods to implement the CDC core elements in individual LTC facilities

Recording

Slide Set

Building a Joint Commission Ready Antimicrobial Stewardship Program – presented by Florian Daragjati, Pharm.D, BCPS – June 6, 2017

Objectives:

  • Understand the 2020 goals, which are part of the national strategy for combating antimicrobial resistant organisms
  • Understand and be able to describe the elements of performance for Joint Commission Standard MM 09.01.01
  • Understand the importance of engaging stakeholders within the organization to improve antimicrobial prescribing
  • Discuss the role of testing stewardship as an important component of antimicrobial stewardship

Recording

Slide Set

Building a Strong Antimicrobial Stewardship Program in a Community Hospital with Limited Resources – presented by Sue Lau, Pharm.D – September 21, 2017

Objectives:

  • Evaluate the importance of an Antimicrobial Stewardship Program (ASP)
  • Apply the steps of building up an ASP from scratch with limited resources
  • Identify ways to sustain the ASP
  • Show the accomplishments from the ASP at Dr. P. Phillips Hospital

Recording

Slide Set