Taking antibiotic action

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Emily Mongan
Emily Mongan

Antipsychotics may soon lose their title as the most maligned medications in healthcare if startling headlines, clinical findings and expert opinions are any evidence.

That was the message shared during a session titled “Move Over Psychotropics … Here Come the Antibiotics!” presented last week during the National Association of Directors of Nursing Administration in Long Term Care annual conference in Austin.

To presenters William Vaughan, BSN, RN, and Jennifer Hardesty, PharmD, FASCP, both of Remedi SeniorCare, recently released data on antibiotic overuse in nursing homes means one thing: Change is coming, and it's coming fast.

“Your practice is about to change again. You will be using antibiotics differently than you do today,” Vaughan said. “If we don't change how we use antibiotics, my son's kids are not going to have very effective antibiotics and neither will yours.”

To stay afloat in the ever-changing world of antibiotics, Vaughan and Hardesty recommend providers take a rational approach to care based on evidence, thoughtful risk/benefit analysis, resident/family involvement, and plenty of documentation in high-risk situations.

Thoughtful care is especially important as conditions such as urinary tract infections and Clostridium difficile are placed in the crosshairs of antibiotic regulations — and as a growing number of people each year become infected with drug-resistant bacteria.

“We go back to that conversation with had with the medical director who wanted to put everyone on antibiotics,” Hardesty said, emphasizing that 14,000 patients with C. diff that die each year. “We see these C. diff stats and we wonder — ‘Am I actually putting my patients at risk?'”

The good news? Much of the research on antibiotics and how to use them prudently is already done and ready for providers to use. (“You guys don't have to do all the heavy lifting,” Hardesty said.)

The Centers for Disease Control and Prevention's top recommendation for halting the spread of infections and antibiotic resistance is one that may soon be law for providers: antibiotic stewardship programs, which may be made mandatory under the massive regulatory overhaul for nursing homes that's currently slated to be finalized in September.

Stewardship programs offer benefits not only for residents but for providers as well, making them a “win-win” for all involved parties, Hardesty said. By ensuring that residents get the right antibiotic at the right dose, at the right time and for the right duration, providers can help decrease antibiotic resistance, C. diff infections and care costs, all while increasing positive patient outcomes.

Such programs require plenty of expertise and leadership commitment, but resources are available for those looking to take the plunge. Policies aiming to curtail antibiotic use are sure to come sooner than later, but being ahead of the curve is worth it for your facilities — and your families.

Follow Emily Mongan @emmongan.


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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.