Study: Antibiotic Stewardship Can Reduce Multidrug-Resistant Organism Transmission

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A new study reveals the potential power of antibiotic stewardship programs in helping reduce infections.

The research, published in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America, looked at reducing antibiotic use in intensive care units and its effect on transmission of multidrug-resistant organisms (MDROs).

Researchers developed models that indicated reductions in antibiotics by 10 percent and 25 percent corresponded to reductions in the spread of the deadly bacteria of 11.2 percent and 28.3 percent, respectively.

"Antibiotic exposure is the most significant driver of resistance," said Sean Barnes, PhD, assistant professor of operations management in the Robert H. Smith School of Business at the University of Maryland, and the study's lead author. "In the hospital setting, nearly 50 percent of all patients receive an antibiotic, including up to 75 percent of all critically ill patients. But what is really troubling is that nearly half of all antibiotics prescribed may be inappropriate. Even moderate reductions in antibiotic use can reduce transmission of MDROs."

Efforts are underway across the country to reduce unnecessary antibiotic use through antimicrobial stewardship programs and other interventions. Research had demonstrated the benefits of these measures on patient care and costs. Now there is research supporting the positive the impact on MDRO rate.

"Antibiotics have been one of the most useful and critical drugs in modern medicine, but our overuse of these drugs has hurt us by supporting the development of MDROs", said Kerri Thom, MD, MS, associate professor at the University of Maryland School of Medicine and a study co-author. "Our model suggests that substantial reductions in infection rates are possible if stewardship programs aggressively pursue opportunities to reduce unnecessary usage of antibiotics."

Antimicrobial Stewardship in the Spotlight
The data from this study, titled "The Impact of Reducing Antibiotics on the Transmission of Multidrug-Resistant Organisms," will likely bring even more attention to the importance of antibiotic stewardship. As a report from The Joint Commission noted, "The global problem of antibiotic resistance results in 2 million illnesses and 23,000 deaths annually."

This was a motivating factor in The Joint Commission's development of antimicrobial stewardship standard MM.09.01.01, which went into effect January 1 for hospitals, critical access hospital and nursing care centers. The Joint Commission has indicated an antimicrobial stewardship standard for accredited ambulatory care organizations and office-based surgery practices is in development.

On March 8, the Centers for Disease Control and Prevention's acting director, Anne Schuchat, MD, presented at the U.S. Capitol about the need for continued action and investment to contain and address the urgent threat of antibiotic resistance to protect Americans.

The issues of antibiotic stewardship and development of antimicrobial stewardship programs, in settings including outpatient care facilities and ambulatory surgery centers, are of great interest to Infection Control Consulting Services (ICCS) President Phenelle Segal, RN, CIC, and the ICCS team. To learn more about these issues, read Phenelle's Becker's Infection Control & Clinical Quality column on ASC antibiotic stewardship program implementation and ICCS blog on ambulatory antimicrobial stewardship.

For assistance with development and implementation of an antimicrobial stewardship program, contact ICCS.

Phenelle Segal, RN, CIC, FAPIC

Phenelle Segal, RN, CIC, FAPIC, is the founder and president of Infection Control Consulting Services LLC (ICCS). Phenelle has more than 30 years' experience providing customized comprehensive infection control and prevention services to healthcare facilities nationwide. Her services focus on assisting hospitals, ambulatory surgery centers, dental office and oral surgery practices, doctor's offices, nursing homes and other organizations with implementing and maintaining an infection control program that: complies with The Joint Commission, AAAHC, Centers for Medicaid and Medicare Services (CMS) and other regulatory agencies; respond to situations of noncompliance; and improve the processes for reducing risk.