The Centers for Disease Control and Prevention (CDC) has designated Nov. 18-24 as Get Smart About Antibiotics week. The goal of the week is to provide information to the public on the proper use of antibiotics and to reduce the overuse of antibiotics.
To find out more about the proper use of antibiotics, we've asked St. Luke's pharmacist Brian McCullough, who serves as the antimicrobial stewardship coordinator for St. Luke’s Treasure Valley, to tell us more about the antimicrobial stewardship program (ASP) at St. Luke's. Brian joined St. Luke's in 2012. He received his Pharm.D. from the University of Florida and is residency trained in pharmacy practice and infectious diseases.
What better time to talk about the antimicrobial stewardship program (ASP) here at St. Luke’s! I’d like to take a moment to explain antimicrobial stewardship; share strategies we are employing at St. Luke’s to help patients get appropriate care while meeting St. Luke’s Triple Aim of better health, better care, at lower cost; and list ways you can help cut down on antibiotic use.
Antimicrobial stewardship is the practice of utilizing antibiotics more rationally. Up to 50 percent of antibiotics are prescribed inappropriately! Clearly, something must be done. According to guidelines published by the Infectious Diseases Society of America, “The primary goal of antimicrobial stewardship is to optimize clinical outcomes while minimizing unintended consequences of antimicrobial use, including toxicity, the selection of pathogenic organisms (such as Clostridium difficile), and the emergence of resistance.”
In July 2012, St Luke’s hired its first antimicrobial stewardship coordinator to begin the task of improving antimicrobial use. Since the inception of the program, St Luke’s has saved approximately $240,000 in antibiotic drug cost while providing optimum patient care. A true win-win!
As part of the program, patients are reviewed daily by pharmacists to determine whether patients may be candidates for streamlining antibiotics. Opportunities investigated include prescribing fewer antibiotics, more targeted or narrow-spectrum antibiotics, shortening antibiotic duration when possible, and prescribing less costly (yet equally effective) antibiotics.
Orderset revisions have also been a major part of the ASP. To date, we’ve improved antibiotic choices for community-acquired pneumonia, sepsis, Clostridium difficile, and enhanced our IV to PO automatic interchange policy to help patients receive effective, cost effective medications.
The best thing all people can do is avoid antibiotics for viral infections. Typically, most mild infections are viral in nature and resolve within a week. A watch and wait approach may help spare antibiotics! Also, make sure you and your family stay current with vaccines (including the flu shot)! Vaccines are a great way to avoid infections for yourself and others. Finally, take antibiotic courses as prescribed. Stopping too soon may lead to a recurrence of infection that could be resistant to certain antibiotics.
I just want to send a personal thank you for making antimicrobial stewardship a success here at St. Luke’s. It has been a wonderful first year! Let’s continue to work together for the good of the patients by Getting Smart About Antibiotics.
Ken Dey served as Public Relations Coordinator at St. Luke's from 2008-2014.