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Get Smart About Antibiotics Week Ends Nov. 20

In an effort to reduce adverse antibiotic events and promote effective use, the Centers for Disease Control and Prevention (CDC) is sponsoring Get Smart About Antibiotics Week, which runs through Sunday, Nov. 20.

Every year, more than 2 million illnesses and 23,000 deaths are related to antibiotic resistance, according to the CDC.

In support of the national campaign, the Cedars-Sinai Antimicrobial Stewardship team has implemented year-round initiatives to encourage the precise use of antibiotics, which involves prescribing the right antibiotic with the right dose, at the right time and for the right duration.

In December 2015, the team implemented clinical decision support in CS-Link™ on several pilot units to initiate a three-day antibiotic timeout. During that period, prescribers were asked to reassess the need for certain antibiotics and evaluate if further treatment was required. New guidelines were also recently introduced that promote evidence-based guidance for duration of antibiotic treatment.

The Antimicrobial Stewardship team found that as a result of its interventions, more than 80 percent of antibiotic recommendations — to discontinue, narrow or target therapy — were accepted. These and other efforts resulted in a reduction in antibiotic days of therapy. Two antibiotics — vancomycin and levofloxacin — drove the reduction. The team is working to expand the clinical decision support tools.

Other efforts have included the expanded use of rapid diagnostic testing on positive blood cultures. This approach uses sophisticated molecular tests to rapidly identify organisms with antibiotic resistance markers in patients with bacteria in their blood.

Thanks to these tests, staff from Microbiology and Pharmacy Services are able to help clinicians select the best antibiotic treatment quickly or change treatment when needed. Compared to traditional testing methods, this approach has shortened time from blood culture collection to appropriate therapy by more than 24 hours.

The Antimicrobial Stewardship team's latest work for fiscal year 2017 also includes efforts to improve criteria for urine and C. difficile testing to reduce false positive tests that may lead to unnecessary antibiotic use. Rates of C. difficile, or Clostridium difficile, a bacterium that causes inflammation of the colon, are the lowest since 2014. This reduction is a direct result of both infection prevention and antimicrobial stewardship efforts.

"Our work to reduce the overuse of antibiotics and antibiotic resistance have been successful, but we must remain vigilant in this effort," said Rita Shane, PharmD, chief pharmacy officer. "De-escalation of antibiotics using rapid diagnostic testing and proper use of urine studies are focus areas that will help us continue to provide for the safety of patients and ensure they receive the proper treatment."

To learn more information on how to help promote the safe use of antibiotics, visit the CDC's website.