FROM CLINICAL INFECTIOUS DISEASES
There is more room for improving U.S. acute care hospitals’ antibiotic stewardship programs (ASPs) and implementing the seven core elements, according to findings from the 2014 National Healthcare Safety Network ( NHSN ) Annual Hospital Survey.
In univariate analyses, Dr. Lori A. Pollack , of the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention, and her associates looked at 4,184 acute care hospitals. Of those acute care hospitals, 1,642 (39%) reported implementing all seven CDC-defined core elements – leadership commitment, a single program leader responsible for outcomes, a pharmacy leader, specific interventions to improve prescribing, tracking antibiotic use and resistance, reporting data back to provider, and education – for hospital ASPs. In the hospitals with more than 200 beds, 775 (56%) were more likely to report all seven core elements, compared with 672 (39%) hospitals with 51-200 beds, and 328 (22%) of hospitals with 50 or fewer beds.
The hospitals with 50 or fewer beds were less likely to report leadership support (40%) or antibiotic stewardship education (46%), compared with facilities with greater than 50 beds (69% leadership, 69% education). Also, the major teaching hospitals were more likely to report all seven core elements (54%) than were hospitals that had only undergraduate education or no teaching affiliation (34%).
The study also conducted a final multivariate model and found that the strongest predictor for meeting all seven core elements was support from the facility administration (adjusted relative risk, 7.2; P less than .0001).
“Our findings suggest that many hospitals need to add infrastructure and measurement support to their current actions to improve antibiotic use,” the researchers concluded. “CDC is committed to on-going work with partners to help all hospitals implement effective antibiotic stewardship programs, and future years of this survey will help monitor progress toward that goal.”
Read the full study in Clinical Infectious Diseases ( doi: 10.1093/cid/ciw323 ).
