Preventing Antibiotic Overuse In Long-Term Care Settings Keeps Patients Safe
By: Neil Gaffin, M.D., Ridgewood Infectious Disease Associates, PA
Antibiotics are counted as one of the greatest discoveries in the last century. Considered miracle drugs when first discovered, they are responsible in large part for much of what modern medicine and the population take for granted. From routine joint replacement surgery to the treatment of cancer, antibiotics have enabled us to prevent and treat infections that may arise as a result of these and many other procedures.
Unlike almost every other class of drug, antibiotics have a limited life span because bacteria are able to develop resistance to them and thus evade their killing activity. This ability to develop resistance is markedly accelerated when antibiotics are overused and it is because of our overuse of antibiotics, that we now have multidrug resistant bacteria, aka “superbugs”, and Clostridium difficile (known as C. diff), a tenacious and hard to kill bacteria that can cause severe diarrhea and death.
Also unlike every other class of drug, antibiotic use affects everyone, not just the individual receiving the drug. This is important to consider because inappropriate use adversely affects all of us.
Antibiotic stewardship is the process that helps to ensure that only those patients truly requiring antibiotics receive the right drug, at the right dose, for the right duration. In nursing facilities in particular, its true value is as a tool to minimize patient harm from C. diff infection. Ideally, an infectious disease specialist who possesses the requisite knowledge and experience oversees the program. The CDC recently released guidelines for stewardship programs in nursing facilities and it is expected that these will be mandatory in the near future. CareOne is ahead of the curve in this area and over the past year, has partnered with Ridgewood Infectious Disease Associates, PA to develop and manage antibiotic stewardship programs at several of its locations. Our experience in antibiotic stewardship has given us a unique perspective about the direct relationship between antibiotic overuse and the incidence of C. diff infection; minimizing unnecessary antibiotics is clearly associated with reductions in C. diff. infection.
Since the program’s inception at the CareOne at Ridgewood Avenue location, there has been a significant decline not only in antibiotic utilization, but also in the rate of C. diff infection. As a mechanism to ensure patient safety, antibiotic stewardship programs are a welcome addition to the care that patients in nursing and long-term care facilities receive. We commend CareOne for proactively protecting their patients through our partnership and ensuring the highest quality of care.
About Ridgewood Infectious Disease Associates:
Board Certified Infectious Disease specialists located in Ridgewood, New Jersey, these physicians have over one hundred years of collective experience in the diagnosis and management of complex infectious diseases and in the appropriate utilization of the wide array of antibiotics that exists today. In addition to Dr. Gaffin, members of the group include Gary Knackmuhs, M.D., Carol O’Hagan Sotsky, M.D., and Simon Tsiouris, M.D., M.P.H.. Their interest in antibiotic stewardship stems from witnessing the devastating effects of C. difficile infection and a passion for minimizing antibiotic misuse. As a result, they helped to deter the administration of thousands of unnecessary doses of broad spectrum antibiotics over the past several years.