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New Tracking System Streamlines Inpatient Antibiotic Monitoring

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Hospitals Can Lead the Way


Dr. Chad Whelan

Tracking antibiotic use within and across hospitals is important for several reasons. For example, understanding the changing resistance patterns regionally helps to inform local prescribing patterns. Because resistance patterns may be closely tied to antibiotic use, similar information about antibiotics use within regions can help improve our understanding of factors that drive changing resistance patterns. Ultimately, improved antibiotic stewardship and monitoring may help to reduce the effects of highly resistant organisms.

Unlike outpatient practices, many hospitals have had antibiotic stewardship programs in place for years, so they are an accepted part of the culture. Thus, implementation of the tracking system does not represent a major culture change. Hospital epidemiologists and infection-control programs are structurally set up to affect antibiotic usage. I think the tracking system will likely be used by some medical centers relatively quickly, and if those early adopters find it useful, others will likely follow.

Dr. Chad Whelan is associate chief medical officer for performance improvement and innovation and an associate professor of medicine at the University of Chicago Medical Center. He said he had no relevant conflicts of interest.


 

FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION

A new tracking system for monitoring antibiotic use in hospitals will enable the identification of antibiotic prescribing patterns within and between institutions with an eye toward reducing unnecessary or inappropriate use and, ultimately, minimizing the emergence of antimicrobial resistant pathogens and Clostridium difficile.

The electronic system is part of the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN), a secure, Internet-based surveillance system that monitors infections in more than 4,800 healthcare facilities nationwide, according to a statement released by the agency. The CDC has funded four health departments and their academic partners to implement the system in 70 hospitals, and all hospitals that participate in the NHSN can use the electronic monitoring tool by working with their pharmacy software vendors. The vendors can transmit prescription data electronically from drug administration or barcoding records, obviating the need for manual data entry, according to the statement.

Dr. Arjun Srinivasan

The CDC announced the tool as part of the 2011 observance of "Get Smart About Antibiotics Week," an international collaboration designed to educate consumers and health care providers about inappropriate use of antibiotics. Concurrent with its Get Smart About Antibiotics Week program, the CDC also announced its partnership with the Institute for Healthcare Improvement to pilot test a tool designed to help hospitals implement strategies to improve antibiotic use as part of a joint initiative called the CDC IHI Driver Diagram and Change Package for Antibiotic Stewardship.

Antimicrobial stewardship – prescribing the right dose of the right antibiotic for the right duration – improves patient outcomes and saves health care dollars, according to Dr. Arjun Srinivasan, director of the CDC’s "Get Smart for Healthcare program."

"Although previously unthinkable, the day when antibiotics don’t work in all situations is upon us. We are already seeing germs that are stronger than any antibiotics we have to treat them, including some infections in health care settings," he stated in the CDC press release.

As leaders of multidisciplinary teams providing inpatient care, hospitalists, in particular, have an important role to play with respect to optimizing antimicrobial use, Dr. Srinivasan said in a recent report. Through the timely and appropriate initiation of antibiotics, as well as the management of administration and de-escalation according to established guidelines, hospitalists are well positioned to advance antimicrobial stewardship, he wrote (J. Hosp. Med. 2011 6[Suppl 1]:S31-3).

Dr. Srinivasan said he had no relevant conflicts of interest.

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