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Mission Critical: Preventing Antibiotic Resistance

Antibiotic resistance occurs when germs outsmart drugs. In today's healthcare and community settings, we're already seeing germs that are stronger than any antibiotics we have to treat them. This is an extremely scary situation for patients and healthcare workers alike.

So, what is fueling antibiotic resistance, you may ask? We're finding that the widespread overuse—as well as inappropriate use—of antibiotics is fueling antibiotic resistance. Additionally, the overuse of antibiotics is causing even more problems faced by patients. Drug side effects, allergic reactions, and serious diarrheal infections caused by Clostridium difficile* are all popping up as a result of inappropriate antibiotic use. These complications of antibiotic therapy can have serious outcomes, even death.

According to new data released by the National Healthcare Safety Network a growing number of healthcare-associated infections are caused by bacteria that are resistant to multiple antibiotics. These include: MRSA, vancomycin-resistant Enterococcus, extended-spectrum cephalosporin-resistant K. pneumonia (and K. oxytoca), E. coli and Enterobacter spp., carbapenem-resistant P. aeruginosa, carbapenem-resistant K. pneumonia (and K. oxytoca), E. coli, and Enterobacter spp.

So, what can we do to prevent antibiotic resistance?

Patients, healthcare providers, hospital administrators, and policy makers must work together to employ effective strategies for improving antibiotic use—ultimately improving medical care and saving lives.

Patients can:

  • Take antibiotics exactly as the doctor prescribes. Do not skip doses. Complete the prescribed course of treatment, even when you start feeling better.
  • Only take antibiotics prescribed for you; do not share or use leftover antibiotics. Antibiotics treat specific types of infections. Taking the wrong medicine may delay correct treatment and allow bacteria to multiply.
  • Do not save antibiotics for the next illness. Discard any leftover medication once the prescribed course of treatment is completed.
  • Do not ask for antibiotics when your doctor thinks you do not need them. Remember antibiotics have side effects. When your doctor says you don't need an antibiotic, taking one might do more harm than good.
  • Prevent infections by practicing good hand hygiene and getting recommended vaccines.

Healthcare providers can:

Prescribe correctly

  • Do not treat viral infections with antibiotics, even when patients ask for them.
  • Prescribe antibiotics only when they are absolutely necessary – giving them at the right dose and only for as long as they are needed.
  • Avoid unnecessary overlaps in antibiotics. It is not usually necessary to give two antibiotics to treat the same bacteria.
  • Become familiar with resistance trends in your region.

Collaborate with each other and with patients

  • Talk to your patients about appropriate use of antibiotics.
  • Include microbiology cultures when placing antibiotic orders.
  • Work with pharmacists to counsel patients on appropriate antibiotic use, antibiotic resistance, and adverse effects.
  • Utilize patient and provider resources offered by CDC and other professional organizations.

Stop and assess

  • Before prescribing antibiotics, take a moment to ask, "Are these really necessary?" and think through the possible consequences of your actions.
  • When you prescribe an antibiotic, take an "antibiotic timeout" after 24 to 48 hours. This is the time to stop and assess the patient's treatment and use of antibiotics. Are the culture results available? How has the patient responded? Are antibiotics still needed and is this the right drug?

Embrace antibiotic stewardship

  • Utilize the new IHI Driver Diagram to help improve antibiotic use in hospitals. This can help reduce resistance and complications related to antibiotic use such as Clostridium difficile diarrhea.
  • Improve antibiotic use in all facilities—regardless of size and setting—through stewardship interventions and programs, which will improve individual patient outcomes, reduce the overall burden of antibiotic resistance, and save healthcare dollars.
  • Rethink how antibiotics are being used to treat the elderly. Seventy percent of long-term care facilities' residents receive an antibiotic every year, and 27,000 nursing home residents are fighting antibiotic-resistant infections.

Take steps to prevent transmission of resistant germs to patients or being spread in their healthcare facilities

Healthcare Facility Administrators and Payers Can:

  • Make appropriate antibiotic use a quality improvement and patient safety priority.
  • Focus on reducing unnecessary antibiotic use, which can reduce antibiotic-resistant infections, reduce deadly Clostridium difficile infections, and reduce costs, while improving patient outcomes.
  • Emphasize and implement antibiotic stewardship programs and interventions for every facility – regardless of facility setting and size.
  • Monitor Healthcare Effectiveness Data and Information Set (HEDIS®) performance measures on pharyngitis, upper respiratory infections, acute bronchitis, and antibiotic utilization.

In recognition of the 2012 Get Smart About Antibiotics Week (November 12-18), CDC and the Center for Disease Dynamics, Economics and Policy have joined forces with numerous national health organizations and will present a unified policy statement focused on the critical issue of antibiotic resistance. As representatives from a range of fields concerned with human health, these organizations recognize the collective responsibility to protect the effectiveness of all antibiotics – those that we have today and those yet to be developed.

CDC Commentaries for Clinicians on Antibiotic Resistance

Photo: Antibiotics video

Arjun Srinivasan, MD

 

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  • Page last reviewed: November 7, 2012
  • Page last updated: November 7, 2012
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