May 02, 2017
An antimicrobial stewardship program that did without preauthorizations and other restrictive strategies decreased antimicrobial use by nearly 11% at Children’s Hospital Colorado, reported a study in The Pediatric Infectious Disease Journal (doi:10.1097/INF.0000000000001245).
“The risks associated with antibiotics require that we find an effective way to limit their use,” said Sarah Parker, MD, pediatric infectious diseases physician and medical director of the antimicrobial stewardship program at Children's Colorado, in a Eurekalert article.
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“Not only do 30% of children who take antibiotics experience a side effect such as diarrhea, but antibiotics can also kill good bacteria in the body, which can lead to more serious illnesses down the line. And perhaps most compelling, according to the Centers for Disease Control and Prevention, more than 23,000 deaths and $20 billion in indirect health care costs are attributed to resistant bacteria in the United States each year.”
Dubbed “handshake stewardship,” the program relinquishes restriction and preauthorization commonly found in antimicrobial stewardship programs and replaces them with personal contact and trust. To seal the deal of hospitalwide antimicrobial stewardship, a pharmacist-physician team rounds daily to give in-person advice to every inpatient unit that uses antibiotics. Every inpatient antibiotic prescription, including dosages, type of medication, and infection type, is also reviewed by the pharmacist-physician team daily.
To gauge the effectiveness of the program, researchers looked at all antibiotics prescribed to inpatients before, during, and after implementation of handshake stewardship. The program, they found, decreased antibacterial use 10.3%, antifungal use 12.1%, and antiviral use 16.4%.
Overall, antimicrobial use dropped 10.9% across hospital units after handshake stewardship was implemented.
“This type of stewardship also helps ensure the appropriate use of antibiotics — that is, that they are only used when needed, and that they are given at the right dosage for the right duration of time,” said Dr Parker. “Ultimately, this leads to better patient outcomes.”