AUG 14, 2017 | JESSICA ROBINSON, PHARMD, BCPS; JAMIE WAGNER, PHARMD, BCPS; NICOLE BRANDT, PHARMD, MBA, BCPP, CGP, FASCP; AND ALAN GROSS, PHARMD, BCPS-AQ-ID
Antimicrobial resistance is a worldwide threat, resulting in more than 2 million infections and almost 25,000 deaths each year in the United States.1
Patients in long-term-care (LTC) facilities are considered to be at an increased risk of infection with multidrug-resistant bacteria due to several factors. First, these patients generally have multiple comorbidities, making them more susceptible to infection. Second, patients in LTC facilities are also more likely to be exposed to an antimicrobial agent.2
Studies have shown that up to 70% of residents receive at least one course of systemic antibiotics per year, with 40% to 75% of those courses being unnecessary or inappropriate.2,3
This increases not only the risk of colonization or infection because of a multidrug-resistant organism, but also the risk of antibiotic-associated adverse events, including Clostridium difficile
Antimicrobial stewardship is now widely recognized as a key strategy to ensuring optimal patient outcomes while reducing the risk of antimicrobial resistance. In 2016, the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America published new antimicrobial stewardship guidelines, endorsed by the Society of Infectious Diseases Pharmacists (SIDP) and others.3
These updated guidelines recommend employing antimicrobial stewardship strategies to decrease antimicrobial use throughout LTC facilities. Soon after these recommendations were released, the Centers for Medicare & Medicaid Services (CMS) published a final rule requiring LTC facilities to establish an antibiotic stewardship program by November 28, 2017. The rule states that the program should consist of antibiotic use protocols as well as a system to monitor antimicrobial use.