Alarm over drug-resistant bacteria is building, not only within the health care community, but also among the general public. And so is the pressure to do something about it.
Last week, the spotlight was turned directly on hospitals. The Centers for Disease Control and Prevention urged every hospital to develop an antimicrobial stewardship program, noting that physicians in some hospitals prescribe three times the antibiotics as those in others who treat similar patients. By cutting antibiotic use 30 percent, U.S. hospitals could reduce resistant organisms, including Clostridium difficile. The CDC estimates C. difficile infections would fall by an estimated 25 percent.
In its Vital Signs report, the CDC outlined seven major steps for creating the stewardship program, the most crucial of which may be to designate a single physician leader to be held accountable for the program's success. Without a specified antibiotics czar, so to speak, the program is unlikely to gain traction and be sustained over time.
The CDC report is the latest in a series of efforts by a variety of health care stakeholders to draw attention to the frightening issue of antibiotic-resistance. In previous blogs, I've noted that pharmaceutical manufacturers cannot develop new drugs quickly enough to replace those that lose effectiveness. Moreover, antibiotics are overprescribed and incorrectly prescribed at a shockingly high rate. If drug-resistance isn't brought under control, experts warn that the nation — indeed, the world — will find itself in the same vulnerable situation we were in before antibiotics emerged in the 1920s.
On Friday, the CDC issued another report noting that the majority of pediatric C. difficile infections occur among children who recently took antibiotics prescribed in a doctor's office for other conditions.
A white paper produced by the American Hospital Association before the Vital Signs report, titled Appropriate Use of Medical Resources, likewise recommends that hospitals maintain an antibiotic stewardship program.
And the Society for Healthcare Epidemiology of America has developed a new website, Stewardship-Education.org to assist clinicians.
On another front, the Food and Drug Administration in December took aim at the overuse of antibiotics in the food we eat when it issued a policy asking drug companies to change drug labels. The new labels would eliminate any indication that the antibiotics can be used to promote growth in livestock. The overuse of antibiotics in American agriculture and in food consumption is a leading contributor to drug-resistance in people.