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November 17, 2010

by Arjun Srinivasan 

We all know that antibiotic resistance adversely impacts the health of millions of hospitalized patients every year. Did you know that the major driver of this resistance is likely inappropriate antibiotic use? Let s look at the facts. Numerous studies have documented that inappropriate antibiotic use in hospitals and nursing homes results in increased resistance, worse patient outcomes, and increased healthcare costs, and helps drive the current national epidemic of Clostridium difficile infections. These are clearly serious problems that are impacting our patients every day leading to morbidity and mortality.

The question becomes, how much use is too much? Studies have shown that as much as half of all antibiotic use in hospitals is either unnecessary or inappropriate. It is estimated that one in every three patients will receive two or more antibiotics in the course of their hospital stay. Of the patients receiving antibiotics, three out of every four will receive unnecessary or redundant therapy, resulting in excessive use of antibiotics.
However, there is good news. We can improve the health of our patients while saving money by simply improving the ways we use antibiotics. Studies have also shown, repeatedly, that improving antibiotic use can decrease resistance, decrease C. difficile infections and improve infection cure rates, all while saving healthcare dollars. Inappropriate antibiotic use is a medication error and we must begin tackling it now.
Antibiotics are a shared resource and, for some infections, are becoming a scarce resource. Antibiotic resistance is not just a problem for the person with the infection. Some resistant bacteria have the potential to jump to others spreading antibiotic-resistant infections in the population.
New antibiotics are not going to solve our problems. They will take time to develop and even when they arrive, they can’t address all of the resistance challenges we currently face. But most importantly, if we don’t act now to improve the way we use antibiotics, we’ll lose new drugs just like we are losing the ones we currently have. The time is now for all of us- clinicians, patients, administrators and legislators- to take action to optimize the use of antibiotics in all settings.

Arjun Srinivasan, M.D., is Medical Director for the Center for Disease Control and Prevention’s Get Smart for Healthcare program and Associate Director for Healthcare-associated Infection Prevention Programs for CDC’s Division of Healthcare Quality Promotion.

 

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