Nexus: Arming ourselves in the battle against superbugs Last Updated: June 11, 2015
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Antibiotic-resistant bacteria is quickly becoming one of the nation’s most urgent threats to public health, infecting more than 2 million Americans and causing at least 23,000 deaths annually. The Centers for Disease Control and Prevention (CDC) estimates that antibiotic resistance results in direct healthcare costs of $20 billion annually. In fact, the threat has become so prominent that the White House in March released a National Strategy on Combating Antibiotic Resistant Bacteria and convened a White House Forum. Premier was one of the organizations invited to the White House forum to discuss the critical need for antibiotic stewardship on June 2. The House Energy and Commerce Committee has included provisions in its “21st Century Cures ” package. Having prioritized this work for years, the Premier healthcare alliance applauds this focus and attention and calls for additional steps to encourage providers’ efforts to strengthen antibiotic resistance surveillance and prevention.

Inappropriate use of antibiotics can increase risk to patient safety, reduce the efficacy of these drugs and drive up avoidable costs 

  • According to the CDC, up to half of patients treated in the U.S. receive unnecessary or inappropriate therapy, including multiple antibiotics when either one or neither would be the best approach. This builds resistance in patients.
  • In fact, the CDC and Premier published research on the widespread use of unnecessary and duplicative antibiotics in U.S. hospitals. The study identified three specific combinations of antibiotics accounting for 70 percent of inappropriate prescribing and unnecessary use, which could have led to an estimated $163 million in excess costs.
  • More importantly, inappropriate use of antibiotics can be harmful to patients and can accelerate the growth of antibiotic-resistant bacteria, especially among antibiotics that are frequently prescribed to treat a wide range of infections.

Focused efforts are needed to win the continuous battle against current and emerging antibiotic-resistant pathogens 

  • In March, the White House released a National Strategy on Combating Antibiotic Resistant Bacteria. The overarching federal initiative offers critical goals that as a nation we must achieve, including establishing antibiotic stewardship programs in all acute care hospitals by 2020. In addition, the plan calls for:
    • Establishing benchmarks to reduce antibiotic use by 50 percent in outpatient settings and 20 percent in inpatient settings by 2020;
    • Establishing antibiotic resistance prevention programs in all 50 states by 2020;
    • CDC working with partners to propose new healthcare facility antibiotic measures with the National Quality Forum in the inpatient setting; and
    • CDC initiating large scale demonstration projects to field-test antibiotic resistance interventions in the outpatient setting.
  • The federal government can continue to play a strong leadership role in improving antibiotic use by:
    • Using incentives, rather than penalties, to encourage and support healthcare providers to be judicious stewards of antibiotics;
    • Prior to enforcing antimicrobial stewardship policy, investing in research to learn which elements of such programs are most effective;
    • Working with the healthcare community to create consistency in the definition of antibiotic use and in prescribing guidelines; and
    • Incenting improvements in automated surveillance to enable automatic reporting into CDC’s National Healthcare Safety Network (NHSN).

The Premier healthcare alliance is committed to substantially reducing antibiotic resistance  

  • Provider collaboration helps target specific quality and safety improvement areas, accelerate changes and avoid preventable harm. Hospitals in Premier’s national QUEST® collaborative and Hospital Engagement Network participate in performance improvement initiatives and use safety surveillance systems to drive antibiotic stewardship techniques into patient safety practices.
  • QUEST hospitals have already prevented 21,700 instances of harm, such as hospital-acquired infections. Now, in partnership with the CDC, the QUEST collaborative is running a “sprint” focused on cultivating effective antimicrobial stewardship programs, with the goal of reducing the inappropriate use of redundant anaerobic antibiotic combinations by 20 percent.
  • More than 1,000 Premier hospitals and health systems use the alliance’s clinical surveillance analytics to monitor and protect patients from infections, harmful drug interactions and other adverse events.
  • Through Premier research and learnings from collaboratives, Premier plans to assist with the identification of the elements within antibiotic stewardship programs that are most effective, and identify opportunities for most impact to quality and cost with appropriate use, and continue to share learnings broadly.
  • Reflective of these efforts, Premier has pledged to support the President’s National Action Plan for Combating Antibiotic-Resistant Bacteria.
What’s being said?

“We are near a tipping point with antibiotic resistance. An increasing proportion of bacteria no longer respond to the drugs designed to kill them. We can either work to improve antibiotic use and prevent infections, or watch as the clock turns back to a world where simple infections kill people.”

–        Tom Frieden, director of the CDC, Wall Street Journal, Preserving the Blessing of Antibiotics

“In the hospitals across our country, and in cities across the world, this threat grows. Still our greatest threat isn’t adaptation, it’s actually our own inaction……The challenge is great, but so is our will to meet it.”

–       HHS Secretary Sylvia Burwell at the White House Forum