Dr. Steven Solomon - Public Health Impact of Antimicrobial Resistance

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Public Health Impact of Antimicrobial Resistance - Dr. Steven Solomon, Centers for Disease Control & Prevention, from the 2013 NIAA Symposium Bridging the Gap Between Animal Health and Human Health, November 12-14, 2013, Kansas City, MO, USA.

More presentations at http://www.trufflemedia.com/agmedia/conference/2013-niaa-antibiotics-bridging-the-gap-animal-health-human-health

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Dr. Steven Solomon - Public Health Impact of Antimicrobial Resistance

  1. 1. Public Health Impact of Antibiotic Resistance Steven L. Solomon, MD Director, Office of Antimicrobial Resistance Centers for Disease Control and Prevention Symposium: Bridging the Gap Between Animal Health and Human Health November 12, 2013 Kansas City, Missouri
  2. 2. Fighting back against antibiotic resistance
  3. 3. Antibiotic use and misuse • Up to 50% of antimicrobial use in hospitals is unnecessary or inappropriate • Up to 20% in a recent pediatric survey
  4. 4. Mock-up of Hospital Antimicrobial Use Monitoring: Benchmarking of Antimicrobial Use To Guide Stewardship Antimicrobial Usage Rates and Standardized Utilization Ratios (SURs) Antibiotic Days (Total) Observed Predicted SUR Interpretation MICU 4000 1000 4.0 Excessive SICU 2000 2000 1.0 Consistent Medical Ward 3000 4000 0.75 Lower Use Surgical Ward 1000 3000 0.33 Much Lower 170,250 171,000 0.99 Consistent Hospital SUR is a ratio of the actual usage compared to predicted
  5. 5. Antibiotic best practices 1. Ensure all orders have dose, duration, and indications 2. Get cultures before starting antibiotics 3. Take an “antibiotic timeout,” reassessing antibiotics after 4872 hours
  6. 6. Improving antimicrobial use • Prescriber- and facility-based strategies – – – – Formulary restriction Prior approval “Time-out” programs Education, benchmarking • Consider improved use measures as part of: – State licensure for healthcare facilities – Hospital accreditation – Reimbursement from third party payers
  7. 7. Summary • All antibiotic use contributes to the development of resistance • Antibiotic use in all settings can be improved • Both reducing antibiotic use and using antibiotics with greater care in all settings will improve human health • www.cdc.gov/drugresistance • www.cdc.gov/drugresistance/threat-report-2013

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