Multidrug-Resistant Infections: Implementing Programs for Antimicrobial Stewardship
Achieving antimicrobial stewardship programs’ primary goal of using antibiotics responsibly to optimize patient care and minimize development of resistant infections, requires education of and collaboration among multiple parties, including physicians, information technology (IT) specialists, hospital administrators, and patients, according to experts who participated in a Contagion® Peer Exchange panel.
Jason Pogue, PharmD, BCPS-AQID, said that implementation of a successful antimicrobial stewardship program requires support from hospital administrators and the developers and users of the stewardship policies. “If you’re going to have initiatives [and] optimize antibiotic use, you have to ultimately have support from the C-suite,” said Dr. Pogue.
Debra Goff, PharmD, said that she uses “the 5 Ds” to ensure the responsible use of antimicrobials to offset antibiotic resistance and decrease adverse events: making the correct diagnosis; selecting the correct drug, dose, and duration; and having the potential for de-escalation of therapy.
“If all you look at is antibiotic use, you’re missing the picture,” she said. “You have to have more than just the physician who might be labeled as ‘in charge of stewardship’. You need all physicians engaged.”
However, Dr. Goff pointed out that expecting all physicians to know the details of first-line therapy for various types of infections is impractical. “I don’t expect a surgeon to know what a [carbapenem-resistant Enterobacteriaceae] is,” she said. “I tell them, ‘That’s not your job. What I need you engaged with is to engage with us and follow the guidelines. We’ll give you the rationale. We’ll give you the guidance.’ We teach them how to use the drugs responsibly, [and] then when you get the call for an antibiotic on the protected list, all the newer agents, it’s a 2-second phone call.”
Source: Contagion LiveEffective Surveillance