Antimicrobial Stewardship

Antibiotic use in health care facilities and the community is common and often unnecessary.  Overuse of antibiotics has attributed to increasing antibiotic resistance, which has been identified as a major public health threat by the World Health Organization.  One way to combat antibiotic resistance is through antimicrobial stewardship.

There are four main goals of antimicrobial stewardship

  1. Improve patient outcomes
  2. Improve patient safety
  3. Reduce resistance
  4. Reduce healthcare costs

Antimicrobial stewardship programs have been proven to cut costs, reduce Clostridium difficile infections, and decrease the use of unnecessary antibiotics.

In hospitals, an estimated 50% of antibiotic use is inappropriate or unnecessary. It is recommended all hospitals have an antimicrobial stewardship program and support their efforts.

The CDC has summarized core elements of successful hospital Antibiotic Stewardship Programs.  They also provide general information and resources for implementing a stewardship program

Antibiotic Stewardship Basics for Multi-Disciplinary Healthcare Professionals: On-demand education modules to introduce nurses, pharmacists, and practitioners to the basics of an appropriate Antibiotic Stewardship Program. Continuing education credits available upon successful completion of a module and post-test.

The CDC provides guidance on practical strategies to implement antibiotic stewardship programs in small and critical access hospitals.

Presentation on Antimicrobial Stewardship in Small and Critical Access Hospitals was given on December 11, 2018 by the Antimicrobial Resistance Coordinator at VDH.

Presentation Objectives:

  1. Report NHSN survey results related to antimicrobial stewardship for small and critical access hospitals
  2. Define the CDC Core Elements for small and critical access hospitals
  3. Compare evidence-based stewardship strategies to increase optimal antimicrobial use
  4. List antimicrobial stewardship resources available from state agencies and partners

In long-term care facilities, up to 70% of residents receive one or more courses of antibiotics in a year. Antimicrobial stewardship efforts are important in this setting to ensure optimal antibiotic use.  It is recommended all long-term care facilities have an antimicrobial stewardship program and support their efforts.

The CDC has summarized core elements for long-term care facilities that provide general information and resources for starting or improving a stewardship program

At least 30% of antibiotic use in the outpatient setting is unnecessary. Antimicrobial stewardship efforts are important in this setting to ensure optimal antibiotic use.

The CDC has summarized core elements for outpatient facilities to help improve prescribing practices.

VDH Report on Antibiotic Treatment for Acute Upper Respiratory Infection

The Virginia All-Payer Claims Database was used to assess the proportion of antibiotic prescription claims for upper respiratory infections in outpatients. CDC does not recommend antibiotic therapy for uncomplicated upper respiratory infections.In 2016, 21.5% of outpatient claims for acute upper respiratory infection led to an antibiotic prescription claim in Virginia. For more information on the methods and results please see the PDF below.

Report on Antibiotic Treatment for Acute Upper Respiratory Infection 

Providers can print out this poster to hang in waiting rooms showing patients their commitment to safe antibiotic practices.

The Virginia Healthcare-Associated Infections group has developed treatment algorithms for upper respiratory infections located here.