Charlotte Hungerford Hospital (CHH) has recently formed an Antibiotic Stewardship program to create awareness and offer information on appropriate antibiotic use for patients and providers that are inside and outside of the hospital. The growing use of antibiotics and its increasing resistance is an ongoing issue in many communities worldwide. The misuse and overuse of antibiotics has been a major public health concern for healthcare providers and is a topic that is critical to providing quality patient care.
The Antibiotic Stewardship Program (ASP) was started at CHH in January 2017 when the hospital’s infectious disease, pharmacy, and infection control and prevention departments began conducting surveillance of all patients on antibiotics. This was initiated to assure that patients are being placed on the optimal antibiotic, for a specific amount of time. Antibiotics that have completed their treatment are discontinued, in order to prevent the potential for adverse reactions. Antibiotic use is customized based on the whole patient with concern for the future. Bacteria that cause infections adapt easily by passing resistance to each other, which is why it is crucial to monitor these type of medications used for treatment. The program also looks into antibiotics that could be given by mouth which has shown to decrease length of stay in the hospital.
At CHH, we don’t want our drugs to lose effectiveness in the quality of care and treatment provided to our patients. Government agencies that oversee Connecticut Hospitals have encouraged us to address the antibiotic issue, and this stewardship program is one of the many approaches CHH is taking to battle infections.
According to the Centers of Disease Control and Prevention (CDC), as much as 50% antibiotic use is considered inappropriate or not prescribed properly leading to at least 2,049,442 illnesses and 23,000 deaths. The overprescribing of antibiotics on a regular basis causes people to become resistant to the antibiotic treatment. In addition, the growth of these organisms spread resistant strains which could potentially be transmitted via contact from person to person, or from non-human sources, such as natural resources in the environment. Poor prescribing of these antibiotics may put a patient a higher risk of having a life-threatening event in addition to contributing to antibiotic resistance.
The goal of the hospital’s ASP program is to minimize unintentional side-effects of antimicrobial use which encompasses multi-drug resistant organisms (MDROS) such as clostridium difficile, (c-dif), extended spectrum beta-lactamase (ESBL) gram negative, MRSA, and other emerging infectious organisms. All outcomes and results of this program will be presented to members of specific committees for study and analysis throughout the CHH health system.
In addition, as a high reliability organization, the CHH ASP will help improve patient outcomes, reduce resistance to antibiotics, as well as decreasing the incidence/prevalence of infections caused by MDRO’s. Some of these performance improvement initiatives that are in place at CHH include monitoring prescribing and antibiotic resistance patterns, reporting regularly to staff, and offering educational activities, such as grand rounds, improving prescribing practices, and working with other healthcare facilities to prevent infections, transmission, and resistance.
The CDC has a variety of resources that support the development of Antibiotic Stewardship Programs. Feel free to ask any health care worker at CHH for more information about Antibiotic Use & Resistance and check out the Get Smart Campaign online at cdc.gov.