- Hospitals don’t seem to have gotten the message about the growing threat of antibiotic resistance considering that between 2006 and 2012 there was barely a reduction in antibiotic use overall, according to a new study in JAMA Internal Medicine.
- CDC researchers found a significant increase in the use of broad spectrum antibiotics — third- and fourth-generation cephalosporins, macrolides, glycopeptides, β-lactam/β-lactamase inhibitor combinations, carbapenems and tetracyclines. The mean change for these antibiotics increased by 95%.
- The researchers looked at antibiotic use data for 383 hospitals and found that 55.1% of patients received at least one dose of antibiotic during their stay.
“While the optimal level of antibiotic use or distribution of classes is not really known for every hospital, we know from other studies that inpatient prescribing of antibiotics for some infections is often inappropriate,” lead author James Baggs told Reuters Health. Baggs added reasons for overprescribing include lack of awareness of treatment guidelines and misdiagnosis, and in many cases hospitals begin treating patients with antibiotics before all of the lab work is completed.
In 2012, CDC launched a real-time monitoring option for antibiotic use in U.S. hospitals as part of the National Healthcare Safety Network. “As enrollment in the antibiotic use option grows, it will provide ongoing systematic assessment at the hospital, state, regional, and national levels,” the study authors wrote.
At least 2 million people acquire antibiotic-resistant infections each year and at least 23,000 die as a result, according to the CDC. Antibiotic resistance was recently found to have substantially increased some hospitalization costs among Medicare beneficiaries.
The threat of deadly pandrug-resistant “superbugs” has raised fears of a post-antibiotic world and led to antibiotic stewardship programs aimed at promoting more measured use of the drugs.
HHS announced a prize competition last week to develop rapid, point-of-care diagnostic tests capable of detecting and distinguishing antibiotic-resistant bacteria, as well as tests that can distinguish between viral and bacterial infections. The FDA has also pushed a common sense approach to the problem -- banning 19 chemicals used in antibacterial soaps.
Ronald Wyatt, medical director of healthcare improvement for The Joint Commission, told Healthcare Dive late last year that antibiotic stewardship doesn’t have to be complicated. It can rely on common sense steps like ensuring staff members wash their hands, the walls and floors and clean, and bedding is properly cleaned following the discharge of a patient with a virus.