RANDOLPH – The work by the Antibiotic Stewardship Committee at Gifford Medical Center in Randolph to address antibiotic resistance, a continuing global public health threat, has resulted in a greater than 50 percent reduction in the use of the drugs with Gifford patients.
Overuse of antibiotics contributes to antibiotic resistance, the ability of bacteria to resist the effects of the medications that were once successful in treating them.
“More than 2.8 million antibiotic-resistant infections occur in the U.S. each year, and more than 35,000 people die as a result,” stated Center for Disease Control in a recent report.
Gifford’s multidisciplinary Antibiotic Stewardship Committee includes physicians, pharmacists and infection prevention specialists.
Over the last year and a half, the committee has developed protocols that have been implemented across the medical center’s inpatient units to reduce the number of antibiotics prescribed.
“We are attacking the issue of antibiotic resistance from various angles, and have cut the number of antibiotics we’re using with our patients by more than half,” said Gifford Chief Medical Officer Dr. Joshua White.
Dr. White shared data indicating Gifford inpatient days of antibiotics therapy from September 2017 through April 2019, and for example, compared April 2018 with April 2019 per 1,000 patient days, showing an antibiotics usage drop from 496 days of antibiotics therapy to 213 days.
The Antibiotic Stewardship Committee’s initiatives include a 72-hour antibiotic timeout, in which antibiotics are stopped during inpatient rounds to review whether they are still needed and whether the medication is the appropriate antibiotic, Gifford-specific adult and pediatric quick reference guides for clinic and Emergency Department providers, and increased provider education, including review of stewardship efforts and reports at medical division meetings.
In addition, Gifford has implemented a procalcitonin (PCT) testing strategy to evaluate the use of antibiotics in lower-respiratory infections.
The test can be helpful in determining whether antibiotics should be used, as high levels of PCT indicate a bacterial infection while low levels indicate a viral infection or other cause.
“For the second year in a row, we have seen an increase in quinolone sensitivity of E. coli in our urine studies, the exact opposite of what is happening on the national stage,” said White while referring to the sensitivity to a class of antibiotics that is bucking national trends.