Safety

SHEA: More Research Needed on Antibiotic Use

Hospital Safety Insider, October 31, 2019

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There is a lack of research available on the overuse of antibiotics in healthcare, according to a new Society for Healthcare Epidemiology of America (SHEA) white paper published in Infection Control & Hospital Epidemiology.

“Antibiotic stewardship is crucial to maintaining the effectiveness of life-saving treatments and preventing harm to patients and the wider community,” said SHEA President Hilary Babcock in a release. “We developed this research agenda to draw attention to serious gaps in our knowledge for future investigators and funders.”

Lead author Andrew Morris, MD, medical director of Sinai Health System-University Health Network Antimicrobial Stewardship Program, Toronto, said antibiotic stewardship research in still in the early stages.

“For most infections, we don’t know the optimal drug, dose, or treatment duration. For many, we don’t even know if they require antibiotic treatment,” Morris said.

Antibiotic stewardship programs have become powerful tools to address inappropriate antibiotic use, but they haven’t been used to their full potential yet, according to the paper’s authors.

To address these gaps, the white paper outlines four broad categories where gaps exist:
 

  • A scientifically rigorous evidence base to define optimal antibiotic prescribing practices, which adequately inform stewardship interventions across a variety of patient populations and settings
  • Effective stewardship approaches to recognize effective interventions, knowledge of how these interventions can be adapted for implementation both locally and across diverse settings, and an understanding of how interventions can be sustained once implemented
  • Standardized processes and outcome metrics
  • Advanced study designs with appropriate analytic methods, accompanied by infrastructure to support data collection and sharing

The authors detail areas where additional clinical evidence is needed to define optimal antibiotic use, including diagnosing and treating pneumonia, urinary tract infections, skin and soft tissue infections, diabetic foot infections, intra-abdominal infections, and prevention of bacterial infections.

This article originally ran on PSQH.com



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