Antibiotics are powerful treatments for bacterial infections, but they aren’t always the answer. Sometimes, bacteria develop antibiotic resistance — the ability to defeat medication.
At least 2 million people in the United States are infected with antibiotic-resistant bacteria each year, and at least 23,000 people die as a result. Other types of microbes also can become resistant, including parasites, viruses, and fungi.
To promote the fight against resistance, the Centers for Disease Control and Prevention (CDC) launched the Antimicrobial Resistance (AMR) Challenge at the United Nations General Assembly in September. This yearlong challenge invites organizations around the world to make commitments to reduce antibiotic resistance by:
- refining tracking and data;
- launching infection prevention and control initiatives;
- reducing antibiotic use;
- improving sanitation; and
- investing in development of and access to vaccines, therapeutics, and diagnostics.
Essential hospitals across the country are among the more than 100 organizations that have committed to improving antimicrobial stewardship.
Atrium Health, in Charlotte, N.C., made a multipronged commitment to the AMR challenge.
First, the health system plans to use CDC’s Targeted Assessment for Prevention strategy to reduce its standardized infection ratio by at least 10 percent by 2020. Atrium seeks to improve antibiotic use data tracking, with a goal of 50 percent of acute inpatient facilities submitting data to the National Healthcare Safety Network by 2021. A systemwide Outpatient Antimicrobial Stewardship Program will expand to include all providers in Atrium Health’s medical group and emergency departments by 2019. Its goal is to reduce inappropriate antibiotic prescribing by 20 percent by 2020.
Atrium Health will extend these efforts to two partner hospitals in Guatemala. “Our goal is to assist these facilities in developing recommendations, educational plans, and facility-specific policies aimed at reducing antimicrobial resistance and improving infection prevention and stewardship in resource-limited pediatric settings,” said Lisa Davidson, MD, medical director of Atrium Health’s Antimicrobial Support Network.
Henry Ford Health System
In 2014, Detroit’s Henry Ford Health System launched an antimicrobial stewardship program, which spurred pilot programs to reduce unnecessary urine cultures and antimicrobial therapy. This fall, the health system is growing that initiative with a “shorter is better” pilot program to decrease the duration of antibiotic therapy for select bacterial infections. Henry Ford also pledged to improve patient education by creating wellness packets for people who visit urgent care for an upper respiratory illness.
University of Illinois at Chicago; University of Utah
With support from a CDC grant, researchers at the agency’s Epicenters for Prevention of Healthcare Associated Infections, including association members University of Illinois at Chicago (UIC) and the University of Utah, in Salt Lake City, will study the use of negative pressure wound therapy to reduce surgical site infections in patients who are obese or who have diabetes.
“Obese patients are more prone to develop surgical site infections because incisions tend to be larger and need to be deeper to allow surgeons to access the areas they need to work,” said Susan Bleasdale, MD, associate professor of clinical medicine in the UIC College of Medicine.
Negative pressure wound therapy uses a vacuum dressing to increase blood flow to the area, keep wounds dry, and promote healing. This technique often is used to treat chronic, open wounds such as diabetic ulcers. To help surgeons decide whether to use these preventive measures, the epicenters also will test a machine learning model that determines whether patients are at risk for surgical site infections.
University of Illinois College of Medicine, Chicago
In addition to housing a Prevention Epicenter, UIC’s College of Medicine will conduct a multisite, cross-sectional study of antibiotic use and resistance in teaching hospitals, pharmaceutical dispensaries, and outpatient laboratories in the Dominican Republic. Researchers also will study providers’ and consumers’ perceptions of antibiotic use.
Corporate affiliate member Premier Inc., in Charlotte, N.C., pledged to aid its more than 500 Hospital Improvement Innovation Network members in implementing CDC’s seven Core Elements of Antibiotic Stewardship Programs. The health care improvement company seeks to reduce the rate of health care–associated Clostridium difficile by 20 percent by March 2019, conduct and publish research on antimicrobial use in hospitals, and improve sharing and analysis of antibiotic use data.
Make a Commitment
Is your organization interested in taking the pledge for antibiotic stewardship? Use this template to craft your own commitment, which will be featured on CDC’s website and social media channels. Organizations can make commitments until September 2019. The CDC also has released an antibiotics awareness toolkit with social media messages and educational resources for health care providers to share,
Contact ARX@cdc.gov with questions.