ANTIBIOTIC STEWARDSHIP PROGRAM CORNELIA AKUHN
Objectives • What is the problem • Why the programme is necessary • Key elements of the programme • Hospital leadership role
30% rule • Antimicrobial prescribing facts • 30% of all hospitalized patients • 30% prescribed inappropriately • 30% of all prophylaxis is inappropriate • 30% of hospital pharmacy cost is due to antimicrobial • 10-30% cost can be saved by antimicrobial stewardship programs.
Reasons for inappropriate antimicrobial use • Knowledge deficit • Inappropriate prophylaxis • Use of multiple agents • Pressure from patients • Time constraints • Cost and availability of radiological and lab studies • Fear of litigation • Pressure from companies • Poverty
The problem • Antibiotic manufacture ,use and resistance trend is something that is of worry • Why • There no antibiotics that are being manufactured of late so what we have is all we have • There increasing super bugs in our health setups which are developing resistance to available drugs at a fast rate • There is increasing over the counter drug use including antibiotics being given for even viral infections • Prolonged use of antibiotics results to side effects like clostridium difficile, kidney or liver damage, hearing loss and other such complications.
Antibiotic misuse includes: • Unnecessary prescription • Delayed administration especially to critical care patients • Use of broad spectrum antibiotics too generously while narrow spectrum are used incorrectly • Inappropriate dosage • Inappropriate duration • Prescription not matching microbial culture results
Antimicrobial stewardship program • These are processes designed to optimize the appropriate use of antimicrobials by ensuring that every patient receives an antibiotic only when one is needed with the right agent, right dose, right route, right duration in order to improve patient care and optimize health care outcomes while minimizing unintended consequences
Why antibiotic stewardship program ? • Reduce the development and spread of resistant bacteria • Promote better outcomes • Ensures optimal antibiotic use • help hospitals reach the goal of providing patients requiring antibiotic treatment with the right antibiotics, at the right time, at the right dose, and for the right duration
Key elements of the programme • Tracking patterns of antibiotic prescribing and resistance; • Informing staff on antibiotic use and resistance on a regular basis; • Continuous antibiotic education on optimal antibiotic use.
Role of hospital leadership Commitment to providing support that includes • Staffing, • Financial, • Evidence based resources, • Information technology to ensure an effective stewardship program.
Key members of the programme • Infection prevention and control professionals, • Physicians, • Nurses, • Pharmacists(clinical) • Patients, families
Summary. • Antimicrobial stewardship program is key in hospital system and it’s the way to control the super bugs.