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Combat Antibiotic Resistance with Antimicrobial Stewardship

Monday, June 18, 2018   (0 Comments)
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Mari Archibeque and Russell Stenquist are Account Managers for Henry Schein. Henry Schein is a featured vendor through our partnership with Community Health Ventures' Value in Purchasing Program.



The right medicine. The right dosage. The right time. 

Sounds simple. Yet one of the world's most urgent health problems is the rise of antibiotic-resistant infections within the outpatient setting. More than 23,000 Americans die from infections caused by antibiotic resistant germs, according to the CDC.

As the CDC notes in its report Antibiotic Resistance Threats in the United States, 2013, the frequency of clinicians in outpatient settings (including community health centers) prescribing antibiotics when they are not needed-or prescribing the wrong antibiotic entirely-is, alarmingly, "common."

Reasons for this can include:

* Doctors not ordering laboratory tests to confirm that the infection is being caused by

  bacteria, leading to the prescription of an unnecessary bacteria

* Patients demanding treatment for conditions that can't be treated by antibiotics, such as a


* Healthcare providers too willing to satisfy a patient's expectation for an antibiotic     


This means that the antibiotic you're prescribing might do more harm than good-and in some cases, it might do no good at all.

"Unusual" Resistance Becomes a "Nightmare"
There are different kinds of antibiotic-resistant germs, and the CDC recently identified the development and spread of "unusual resistance" germs, which are resistant to all or most antibiotics tested and are uncommon or carry special resistance genes.

In 2017 alone, lab tests uncovered unusual resistance more than 200 times in what the CDC calls "nightmare bacteria." In 11% of screening tests in people with no symptoms, a hard-to-treat germ that spreads easily was found.

The CDC endorses early and aggressive action to prevent germs with unusual resistance from spreading in health care facilities and causing hard-to-treat or even untreatable infections. This includes a containment strategy to identify and respond to unusual antibiotic resistance.

Just as important are the steps you can take to prevent or reduce the risk of antibiotic resistance at the very start in your facility, and that begins with an antimicrobial stewardship program.

The Risk of Antibiotic Resistance in the Outpatient Setting
Antibiotic development has declined in recent decades, limiting the options for treating increasingly resistant infections and compounding the problem of antibiotic resistance.
The inappropriate prescription of antimicrobials-including incorrect dosage or duration of an appropriate antimicrobial-contributes to antibiotic resistance.

Patients are at risk for antibiotic-resistant infection regardless of their demographics or where they are treated, but the pediatric population is particularly at risk because of:

* Different antimicrobial needs and uses
* Unique dosing considerations
* Vulnerability for resistance due to a lifetime of antibiotic exposure
* An increased risk of adverse events

Antibiotics are the most common cause of emergency department visits for adverse drug events in children.

Optimize Microbial Use with Antimicrobial Stewardship
Antimicrobial stewardship programs (ASPs)
-coordinated interventions designed to improve and measure the appropriate use of antimicrobials by promoting the selection of the optimal antimicrobial drug regimen, dose, duration of therapy, and route of administration-are already in place at hospitals nationwide, and have been recommended and endorsed by the CDC and other leading healthcare associations including:
* The Infectious Diseases Society of America (IDSA)
* The Association for Professionals in Infection Control and Epidemiology (APIC)
* The Society for Healthcare Epidemiology of America (SHEA)
* The Joint Commission

The Mission and Benefits of an ASP
The main goal of an ASP is to ensure each patient receives the most appropriate antimicrobial with the correct dose and duration. Proper ASPs can lead to:
* Optimal clinical outcomes related to antimicrobial use
* A reduction in adverse events
* Reduced costs of health care for infections
* Limiting the selection for antimicrobial resistant strains

Prevent, Diagnose, Treat: The Tenets of Antimicrobial Stewardship
We've identified three principles that should be at the heart of every ASP:
* First, PREVENT the development and spread of infections, including antimicrobial-

  resistant bacteria. Prudent infection prevention programs include hand hygiene products,

  injection equipment, and personal protective equipment-such as gloves, gowns, and face

  and eye protection.
* Next, DIAGNOSE quickly and accurately to identify the source of the infection. An

  inaccurate, incomplete, or late diagnosis could lead to the prescription of unnecessary

  antibiotics, accelerating the rate at which bacteria become resistant and putting patients at

  risk for allergic reactions or Clostridium difficile. Rapid lab testing-especially at the

  molecular level-ensures confident results.
* Finally, TREAT the condition with a plan that avoids inappropriate and unnecessary

  antibiotics. Antimicrobial stewardship interventions-delivering the right antibiotic, at the

  right dose, at the right time, and for the right duration improve individual patient outcomes,

  reduce the overall burden of antibiotic resistance, and save healthcare dollars.

Resources for More Information on Antimicrobial Stewardship
Learn more about the benefits of an ASP:
* The CDC offers a list of recommendations for outpatient healthcare professionals

  regarding appropriate antibiotic prescribing as part of its Get Smart: Know When

  Antibiotics Work program. Be sure to download the CDC report Antibiotic Resistant

  Threats in the United States, 2013, for more information about the threat.
* The APIC offers resources, including toolkits and position papers that promote the appropriate use of antimicrobials.
* SHEA has an extensive section dedicated to antimicrobial stewardship that includes research, guidelines and strategies.

Launch an Antimicrobial Stewardship at Your Community Health Center
Henry Schein offers the expert guidance and resources to help you develop an ASP that can reduce the risk of antibiotic resistance. Visit Henry Schein's ASP Resource Center at www.henryschein.com/asp. Henry Schein's Infection Prevention and Control Resource Center is located at www.henryschein.com/incontrol.



For more information, please contact: 

Mari Archibeque
Regional Account Manager
Henry Schein Dental
(480) 262-5707 mari.archibeque@henryschein.com
 Russell Stenquist
Strategic Account Manager
Henry Schein Medical
(208) 497-1059





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