Antibiotic Resistance

Taking a Closer Look at Antibiotic Resistance

Jane Kirk


By Jane Kirk MSN RN CIC

Former Clinical Director Healthcare, GOJO Industries

Right now, antibiotic resistance is a topic that is top of mind for many. From industry presentations to news reports, to even the White House, more and more people are asking questions and focusing their discussions on antibiotic resistance – what it is and how a person can fight it.

What is Antibiotic Resistance?
The use of antibiotics is a common practice. Since the 1940s, antibiotics have been used to treat numerous infectious diseases. When prescribed and taken correctly, these drugs have been proven effective. But, with decades of wide spread use and sometimes misuse, the very organisms these antibiotics were made to kill have actually adapted to them, making the drugs less effective. In fact, according to Association for Professionals in Infection Control and Epidemiology (APIC), antibiotic resistance is responsible for more than 23,000 deaths each year in the United States1. This, in turn, has raised an issue of increasing concern about the potential widespread impact of this issue, as well as having healthcare leaders tasked at looking at new ways to treat certain infectious diseases.

Antibiotic Stewardship
Antibiotic stewardship, which according to APIC, is a coordinated program that promotes the appropriate use of antibiotics, improves patient outcomes, reduces microbial resistance and decreases the spread of infections caused by multi-drug resistant organisms, is a strong first step in fighting antibiotic resistance.

Implementation of an antimicrobial stewardship program in a healthcare facility – regardless of inpatient setting – will help ensure that hospitalized patients receive the right antibiotic, at the right dose, at the right time, and for the right duration. As a result, there is reduced mortality, reduced risks of Clostridium difficile-associated diarrhea, shorter hospital stays, reduced overall antimicrobial resistance within the facility, and cost savings. Despite all of these benefits, antimicrobial stewardship programs and interventions are far from the norm in U.S. hospitals today2.

APIC has developed the ABC’s of Antibiotics to educate both patients and healthcare professionals about this issue and these types of programs, which can be beneficial to both parties. These ABC’s stand for:

Ask – Don’t be afraid to question if these antibiotics are necessary. As healthcare professionals, if antibiotics were provisionally prescribed, be sure to follow-up with the culture results to determine if the antibiotic is appropriate.

Bacteria – Antibiotics work against bacteria, not viruses. Asking for antibiotics for the common cold is not appropriate.

Complete the course – finish the prescription even when you feel better. As a patient at home, never “save” some of the antibiotics for the next time or self-prescribe them.

A Global Issue

Antibiotic resistance is a global concern that needs addressed at the national level. Recently Dr. Beth Bell of the Centers for Disease Control and Prevention (CDC) wrote a blog in the Global Health Technologies Coalition,3 which identified four things countries need to do to address this problem:
1.    Lab detection of antimicrobial resistance
2.    National antibiotic resistance tracking programs
3.    Antibiotic stewardship programs
4.    Infection control programs

Hand Hygiene and Alcohol-Based Hand Sanitizers
According to the CDC, clean hands are the single most important factor in preventing the spread of pathogens and antibiotic resistance in healthcare settings4.  Knowing when to use either soap or sanitizer is important. If hands are visibly soiled or you have been in contact with spores (such as C. difficle) then soap is the appropriate product. For all other situations of routine decontamination, alcohol-based hand rub is preferable.

Antibiotic resistance is a growing issue but by using antibiotics correctly (when and as prescribed) and practicing good hand hygiene, including handwashing and the use of an alcohol-based hand hub, we can win the fight against antibiotic resistance.     

1 Association for Professionals in Infection Control and Epidemiology. APIC Teaches the ABCs of antibiotic resistance. Retrieved Oct. 15, 2014, from http://www.apic.org/For-Media/News-Releases/Article?id=0f3dda23-08fc-4a41-8943-da5fbce4ac1a
 2 The Center for Disease Control and Prevention. Why Inpatient Stewardship? Retrieved March 19, 2015 , from http://www.cdc.gov/getsmart/healthcare/inpatient-stewardship.html
 3 Global Health Technologies Coalition.  Fighting for the future: Why we must come together to fight antibiotic resistance around the globe. Retrieved March 19, 2015 from http://blog.ghtcoalition.org/2015/03/17/fighting-for-the-future-why-we-must-come-together-to-fight-antibiotic-resistance-around-the-globe/
 4 The Center for Disease Control and Prevention. Hand hygiene in healthcare settings. Retrieved March 19, 2015  from http://www.cdc.gov/handhygiene/download/hand_hygiene_core.pdf

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