Healthcare News & Insights

Hospitals still prescribing too many antibiotics: How to stop

176825529With all the news that’s come out about the dangers of overusing antibiotics, have hospitals cut back on prescribing them? According to a new study, they haven’t.

In fact, the majority of hospitals reviewed in the study – 78% – routinely gave patients antibiotics that either weren’t appropriate for their conditions or weren’t necessary at all.

The study, conducted by the Centers for Disease Control & Prevention (CDC), looked at inpatient admissions in over 500 hospitals over a three-year period. Specifically, researchers wanted to see whether patients were given redundant antimicrobial therapy, defined as dosages of overlapping antibiotics, for two or more consecutive days.

Occasionally, patients who have been diagnosed with clostridium difficile (C. diff) are treated with two similar antibiotics, so researchers excluded those patients from the analysis. Even without those patients, however, researchers still found that many hospitals were giving patients numerous unnecessary antibiotics for other illnesses.

Negative effects

Besides the heightened risks of adverse events caused by drug interactions, many of these antibiotics were administered through an IV, and that increases the likelihood of bloodstream infections.

And the dangers of redundant antibiotic therapy don’t end there. Past research has shown that overuse of antibiotics has led to the development of germ-resistant “superbug” infections, which can cause severe harm to patients.

Not only was the overuse of antibiotics dangerous, it was expensive. Researchers estimated the cost of giving patients redundant antibiotics was close to $13 million in the hospitals studied. If all hospitals in the country used antibiotics similarly during that time period, the price tag would have exceeded $163 million.

Researchers said that costs could soar higher when considering the costs of non-drug-related supplies and labor – as well as the costs to treat any complications arising in patients as a result of receiving the drugs.

Better antibiotic prescribing

Given these factors, it’s important for hospitals to do what they can to avoid the overuse of antibiotics.

The CDC recommends that all hospitals have an antibiotic stewardship program in place. This type of program promotes using antibiotics conservatively and following established best practices to avoid adverse outcomes.

An effective program contains several elements, including:

  • Leadership commitment. One of the most important elements to any successful antibiotic stewardship program is support from hospital execs. Top brass can show their support by creating formal policies supporting efforts to improve antibiotic use, and making education and training a priority in the facility.
  • Accountability. Antibiotic stewardship programs work best if a single person is in charge of the program. Doctors are some of the best choices for leaders, according to the CDC, because they already have formal training about infectious diseases.
  • Drug expertise. Besides having a general program leader, there should be another person who acts as a pharmacy leader. The pharmacist should work closely with the program leader to promote safe and appropriate antibiotic use.
  • Action. When it comes to improving your hospital’s use of antibiotics, actions speak louder than words. Taking immediate action on the policies you’ve put in place is necessary to change your hospital’s attitude toward antibiotic use. One policy your hospital can try is to use mandatory antibiotic “time outs” 48 hours after a patient is first started on the drugs. Here, clinicians take time to evaluate whether antibiotics are still necessary, and if so, whether the current dosage is still appropriate.
  • Tracking. Your hospital should put the structure in place to monitor its antibiotic prescribing to see if the program is working effectively. Along with tracking prescriptions, your facility should also have the tools in place to track any resistance patterns (e.g., emerging superbugs in your hospital or in surrounding healthcare facilities). This will help you make any necessary adjustments to your program early on.
  • Reporting. Any data your hospital is tracking should be passed along to doctors, nurses and any other relevant clinical staff. That way, they’ll be in the loop about what’s going on, and they can take steps within the scope of their jobs to help the hospital reach antibiotic prescribing goals.
  • Education. Hospitals should provide continuing education to clinical staff about the dangers of overprescribing antibiotics. They should also keep staff informed about current trends that may affect optimal prescribing practices.

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