Antibiotic resistance… two words that strike fear into the hearts of healthcare providers all over the world. Antibiotic resistance isn’t a “new” problem, it began with the first introduction of antibiotics. When Penicillin was introduced in 1942, the first case of Penicillin resistance was noted in the late 1940’s. Fast forward to 2003 and the introduction of Daptomycin then the speed in which bacteria formed a resistance increased dramatically with the first case of resistance within just 1 year. Antibiotic resistance is a “hot topic” in today’s culture. Whispers can be heard everywhere, not just in healthcare facilities; but the daycare down the street or our sweet little elderly neighbor two doors down. This widespread problem isn’t just spoken of in quiet corners of the doctor’s lounges in big metropolitan hospitals or discussed in hushed tones among the top infectious disease doctors in Atlanta any more. No, these days, it is front page news.
In November of 2017, the President of the United States addressed it in a Presidential message in which he states, “My Administration is, therefore, committed to implementing the National Action Plan for Combating Antibiotic-Resistant Bacteria. This plan provides a roadmap to identify instances of antibiotic resistance, stop the spread of resistance, and improve the prescribing and use of antibiotics”. (Presidential, 2017) The Centers for Disease Control and Prevention (CDC) has addressed the growing problem by developing multiple tools that were laid out in prior Leading Age Newsletters, including a January, 2014 article introducing the CDC’s (then new) LTC Infection Control website (Munley, 2015) and an October, 2015 article about the CDC releasing the Core Elements of Antibiotic Stewardship for Nursing Homes (New, 2014).
What can we do about this urgent issue?
The most common answer is antibiotic stewardship, but what is antibiotic stewardship? The CDC defines antibiotic stewardship as, “a set of commitments and actions designed to optimize the treatment of infections while reducing the adverse events associated with antibiotic use.”(The Core, 2017). This is a very general definition and often results in healthcare providers acknowledging that something must happen, but scratching their heads as to how, or how it applies to them. The executive summary of the above mentioned National Action Plan sums it perfectly by stating, “All of us who depend on antibiotics must join in a common effort to detect, stop, and prevent the emergence and spread of resistant bacteria.” (National, 2015).
We all remember the “recycling” presentation in grade school where a presenter came in and we all circled around sitting “criss cross applesauce” and listened as they told us the dangers of producing trash and litter. They told us about how we can “be the change” and start recycling all the trash we possibly could. They pumped us full of sugar and sent us home to tell our moms and dads (and anyone else who would listen) about the dangers of trash and the glorious benefits of recycling. We all became “recycling warriors” for about a day then, as most children do, was distracted by the next thing that came along and it fell to the wayside. But look at us now with our recycling bins in front of our houses on recycling day and being good, productive members of society. It’s time for us (a little older and, hopefully, a little smarter) to become “Antibiotic Stewardship Warriors”.
What does an “Antibiotic Stewardship Warrior” look like?
An Antibiotic Stewardship Warrior understands that not all illness requires an antibiotic to get better. They understand that a healthy body (plenty of rest, good food, staying hydrated, and having a healthy lifestyle) is important to our immune health. They learn to listen to their body and their physician, and the importance of a good trusting relationship with their physician to stay healthy and avoid illness. They know to stay home when they’re sick and avoid other people who may be sick and, of course, to wash their hands.
As a healthcare community, we must become an army of “Antibiotic Stewardship Warriors”, so how does the healthcare community really affect change through antibiotic stewardship? This is THE question, but it has many answers. The greatest and most useful tool that we can all use is education. Educate our patients, residents, clients, family members, and visitors as well as our own family and friends. We can also, “know our role”. All roles, from being a patient to a prescriber, have a responsibility to being good stewards of antibiotics and to only use them when necessary. The CDC gives guidance through their LTC Core Elements of Antibiotic Stewardship for Nursing Homes that includes: Leadership Commitment, Accountability, Drug Expertise, Action, Tracking, Reporting, and Education. Antibiotic stewardship gives each one of us, from leadership to patient, a responsibility and role. Of course, the best way to affect change is to have an infectious disease expert that specializes in antibiotic stewardship to review each antibiotic ordered, give expert advice on prescribing and help change prescribing habits. This would have been an expensive and unrealistic option for many facilities, until technology stepped in to provide another option.
SmartSteward is a software solution to the challenges of effecting change through antibiotic stewardship. It is an infection control and prevention and antibiotic stewardship software solution that uses technology to provide recommendations and feedback for expert level antibiotic stewardship. SmartSteward offers a HIPPA-compliant, time management friendly solution to nurses and doctors to communicate and easily share patient information, along with other tools including a proprietary expert-level antibiotic recommendation engine to positively impact the rampant overuse and misuse of antibiotics. The future of healthcare is looking to technology to bring safer, better, and more timely solutions to the bedside for every patient. Through advancements in machine learning and artificial intelligence to communication and prescribing solutions; healthcare is turning to technology to help solve some of its more pressing concerns. SmartSteward is an example of how technology is aiding the healthcare team to combat the rising concern of antibiotic resistance bacteria.
- Centers for Disease Control and Prevention. (2017). The Core Elements of Antibiotic Stewardship for Nursing Homes. Retrieved on August 29th, 2019.
- Munley, Evvie. Leading Age. (2015, October 1). CDC Releases Core Elements of Antibiotic Stewardship for Nursing Homes. Retrieved August 29th, 2019.
- Leading Age. (2014, January 31) New CDC LTC Infection Control Website. Retrieved August 29th, 2019.
- The White House. (2017). Presidential Message on Antibiotic Awareness Week, 2017. Retrieved August 29th, 2019.
- The White House. (March 2015). National Action Plan for Combating Antibiotic Resistant Bacteria. Retrieved on August 29th, 2019.