MedicalResearch.com Interview with:
James Baggs, PhD
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We used medical claims data to estimate the amount of antibiotics used in US hospitals from 2006 – 2012. Data came from the Truven Health MarketScan Hospital Drug Database, which included about 300 hospitals and more than 34 million discharges. Antibiotic use in hospitals was very common with more than half of patients receiving at least one antibiotic during their hospital stay. Overall rates of antibiotic use in U.S. hospitals did not change over time; however, there were significant changes in the types of antibiotics prescribed.
Importantly, the types of antibiotics with the largest increases in use were the types of antibiotics often considered to be the most powerful. Of particular concern, there was a 37% rise in the use of carbapenems, commonly referred to as “last resort” antibiotics.
MedicalResearch.com: What should readers take away from your report?
Response: Antibiotic use remains common and use of the most powerful antibiotics is rising. Many studies have shown that there are important opportunities to improve antibiotic use in hospitals. The CDC has called on all hospitals to improve the use of antibiotics through antibiotic stewardship. In 2014, CDC developed the Core Elements of Hospital Antibiotic Stewardship Programs and an accompanying checklist to help hospitals develop antibiotic prescribing improvement programs. The Core Elements of Hospital Antibiotic Stewardship Programs include:
• Leadership Commitment: Dedicating necessary human, financial and information technology resources.
• Accountability: Appointing a single leader responsible for program outcomes. Experience with successful programs show that a physician leader is effective.
• Drug Expertise: Appointing a single pharmacist leader responsible for working to improve antibiotic use.
• Action: Implementing at least one recommended action, such as systemic evaluation of ongoing treatment need after a set period of initial treatment (i.e. “antibiotic time out” after 48 hours).
• Tracking: Monitoring antibiotic prescribing and resistance patterns.
• Reporting: Regular reporting information on antibiotic use and resistance to doctors, nurses and relevant staff.
• Education: Educating clinicians about resistance and optimal prescribing.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Because inappropriate antibiotic use increases the risk of antibiotic resistance and other side effects, continued monitoring of antibiotic use is critical to future improvements in patient safety.
MedicalResearch.com: Is there anything else you would like to add?
Response: Our findings can help inform national efforts to improve antibiotic use by suggesting key targets for improvement.
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Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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