Less is more
CDC tracking system takes aim at antibiotic use
When it comes to antibiotics, the Centers for Disease Control and Prevention is urging providers to take a less-ismore approach. The CDC has launched two new antibiotics-related initiatives aimed at helping hospitals understand how they’re using the drugs antibiotics are prescribed unnecessarily, and misuse and overuse are fueling the growth of drug-resistant bacteria. And with few new antibiotics coming down the pipeline, the situation is becoming increasingly dire, said Dr. Arjun Srinivasan, head of the CDC’S Get Smart About Healthcare program. “The threat of untreatable infections is real,” Srinivasan said in a news release about the tracking system. “Although previously unthinkable, the day when antibiotics don’t work in all situations is upon us.”
The agency says it is working with vendors of electronic medication administration records and bar coding systems to ensure they build NHSN compatibility into their products, Srinivasan said in an interview. Once those capabilities are in place, Nhsn-participating hospitals—now numbering more than 4,800—will be able to use their electronic pharmacy systems to access the antibiotic tracking module.
“Many hospitals don’t have those EMAR or bar coding systems yet, but it is the direction that the field is moving in,” Srinivasan said, adding that the tracking tool will become “more and more useful over time.”
The goal of the CDC’S pilot project with IHI is to test theories about antimicrobial stewardship on a small scale and then use the results to carry out larger-scale pilot projects in the future, according to Diane Jacobsen, an IHI director. “Clinical theory and expertise is one piece, but that doesn’t tell us how feasible and practical these steps are in the real world, and what we may be missing,” Jacobsen said.
Eight hospitals, representing a range of care settings, were chosen to participate in the eight-month pilot. Each hospital chose one or two target areas, such as timely antibiotic maintenance and de-escalation.
“The delivery and use of antibiotics in hospitals is very complex,” Srinivasan said. “The only way to make it easier is to break it down into discrete steps and show practical interventions for each one. That’s what this project does.”
Community Hospital, Tallassee, Ala., was one of the hospitals selected for the pilot. Officials at the 69-bed hospital had worked with IHI in the past and jumped at the chance to take part, said Heather Johnson, clinical quality officer and infection preventionist at the hospital.
“We are a small, independent community hospital, so it really helps us to be able to partner with larger hospitals that have more resources,” Johnson said. “For us, it was a great opportunity.”
Other participating hospitals include 307bed Rogue Valley Medical Center, Medford, Ore., and 456-bed Ronald Reagan UCLA Medical Center, Los Angeles.
Both initiatives were announced in conjunction with the CDC’S fourth annual Get Smart About Antibiotics Week, which ran Nov. 14-20. While past campaigns have mainly targeted primary-care physicians and inpatient hospitals, this year the CDC also reached out to nursing homes and other long-term-care settings, Srinivasan said.
As many as 70% of long-term-care facility residents receive antibiotics at least once a