Overview and Evidence to Support Stewardship

• Antibiotics are a shared resource – and becoming a scarce resource.
• 30-50% of antibiotic use in hospitals is unnecessary or inappropriate.
• Antibiotic overuse contributes to the growing problems of Clostridium difficile infection and antibiotic resistance in healthcare facilities.
• Reducing unnecessary antibiotic use can decrease antibiotic resistance, Clostridium difficile infections, and healthcare costs, and improve patient outcomes.
• Interventions to improve antibiotic use can be implemented in any healthcare setting—from the smallest to the largest.
• Improving antibiotic use is a medication-safety and patient-safety issue.

Training Slide Sets
Antimicrobial Resistance Across the Continuum of Care

Antimicrobial Resistance Across the Continuum of Care: Winning the War One Battle at a Time (Note: CME has expired)

Antimicrobial Stewardship for the Community Hospital: Practical Tools & Techniques for Implementation

This educational initiative was designed to overcome and address the barriers to facilitate practical implementation of Antimicrobial Stewardship Programs in the community hospital setting led by the hospital pharmacist and infectious disease specialist in conjunction with other collaborating physician specialties. These sessions were recorded during a scientific roundtable meeting that was presented by the Centers for Disease Control and Prevention and titled “Antimicrobial Stewardship for the Community Hospital: Practical Tools & Techniques for Implementation,” which took place on August 24, 2010, in Atlanta, Georgia. Cooperating organizations for this initiative include the American Medical Association, the Association for Professionals in Infection Control and Epidemiology, the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the Society of Hospital Medicine, and the Society of Infectious Diseases Pharmacists.

• Addressing the Rising Tide of Antimicrobial Resistance: Why Something Must Be Done
  John G. Bartlett, MD (29:15)
• The Proven Benefits of Antimicrobial Stewardship

  Christopher A. Ohl, MD (41:12)

• Assessing the Current Status of Antimicrobial Stewardship in Your Hospital

  Edward J. Septimus, MD, FIDSA, FACP, FSHEA (38:44)

• Management of Asymptomatic Bacteriuria in Hospitalized Patients: Room for Improvement
  Sara E. Cosgrove, MD, MS, FSHEA (36:31)
• The CMS Core (Performance) Measures for Community-Acquired Pneumonia (CAP): Relating to Antimicrobial Stewardship
  Thomas M. File Jr, MD, MSc, MACP, FIDSA, FCCP (41:11)
• Antimicrobial Prophylaxis in the Surgical Setting: Practical Application in Smaller Hospitals
  Joseph S. Solomkin, MD, FACS, FIDSA (25:25)
• The Face of Stewardship in Community Hospitals Today

  Elizabeth Dodds Ashley, PharmD, MHS, BCPS (29:00)

• Implementing an Antimicrobial Stewardship Program: The Pivotal Role of the Hospital Pharmacist
  Robert C. Owens Jr, PharmD (36:39)
• Appropriate Antibiotic Usage and Public Health: The Perspective From the CDC
  Arjun Srinivasan, MD, FSHEA (19:11)

Disclosure Information:

The faculty reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
John G. Bartlett, MD: Advisory Board: Tibotec, Salient, Optimer; Honoraria: Abbott, Merck
Sara Cosgrove, MD, MS, FSHEA: Advisory Board: Forest, Rib-X; Consultant: Merck; Grant Recipient: Cubist, Astellas, Advan-Dx
Elizabeth S. Dodds Ashley, PharmD, MHS, BCPS: Consultant: Pfizer; Speakers Bureau: Merck
Thomas M. File Jr., MD, MSc, MACP, FIDSA, FCCP: Advisory Board: GlaxoSmithKline, Pfizer, Merck, Novartis, Cerexa, Forest, Protez, Nabriva, Tetraphase; Research Grant Recipient: Cerexa, Forest, Pfizer, Boehringer Ingelheim, Gilead, Tibotec
Christopher A. Ohl, MD: Advisory Board: Johnson & Johnson; Consultant: Johnson & Johnson; Speakers Bureau: Pfizer, Cubist
Robert C. Owens Jr., PharmD: Consultant: TheraDoc, Premiere
Edward J. Septimus, MD, FIDSA, FACP, FSHEA: Grant Recipient: AHRQ/CDC; Speakers Bureau: Cubicin, Merck, Sage
Joseph S. Solomkin, MD, FACS, FIDSA: Advisory Board: Johnson & Johnson, Merck, Optimer; Consultant: Cubist; Grant Recipient: Pfizer
CDR Arjun Srinivasan, MD, FSHEA: Nothing to Disclose

Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
Otto Ratz, MD; Josh Paul; Bradley Pine; Blair St. Amand; Jay Katz; Kay Weigand; Paula Larson; Nothing to Disclose

There is a plethora of evidence to support the case for antibiotic stewardship interventions. Here are a few that highlight impact on costs, reduction of Clostridium difficile infections, use, and more.

• Antimicrobial Resistance
• Clostridium difficile (C. diff) infections
• Costs
• Multiple End Points
• Use

Vital Signs: Improving Antibiotic Use Among Hospitalized Patients
PDF version [PDF – 357 KB]

Vital Signs Technical Appendix:
Estimating the Potential Reductions in Clostridium difficile Infection (CDI) among Patients when Antibiotic Use is Improved.