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Reducing prescriptions of high-risk antibiotics in hospitals by 30% could lead to 26% fewer cases of deadly diarrhea infections, according to new advice from the Centers for Disease Control and Prevention (CDC).
A new report from the CDC shows that clinicians in some hospitals prescribe three times as many antibiotics than clinicians in other hospitals, even though patients were receiving care in similar areas of each hospital. In addition, about one-third of the time, prescribing practices to treat urinary tract infections and prescriptions for the critical and common drug vancomycin included a potential error: given without proper testing or evaluation, or given for too long.
The report also found that, in hospitals, a 30% reduction in use of the antibiotics that most often cause deadly diarrheal infections with Clostridium difficile can reduce these infections by more than 25%. The same antibiotics also prime patients for future super-resistant infections, the report says. The CDC suggests hospitals include these components in an antibiotic reduction program:
• Leadership commitment: Dedicate the necessary human, financial, and IT resources.
• Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
• Drug expertise: Appoint a single pharmacist leader to support improved prescribing.
• Act: Take at least one prescribing improvement action, such as requiring reassessment of prescriptions within 48 hours to check drug choice, dose, and duration.
• Track: Monitor prescribing and antibiotic resistance patterns.
• Report: Regularly report prescribing and resistance information to clinicians.
• Educate: Offer education about antibiotic resistance and improving prescribing practices.
More than half of all hospitalized patients will get an antibiotic at some point during their hospital stay, the CDC reports. The most common types of infections for which hospital clinicians write prescriptions are urinary tract infections, lung infections, and suspected infections caused by drug-resistant Staphylococcus bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA). The full CDC report is available online at http://tinyurl.com/mn65var.