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Meet My Mom: The Peggy Lillis Story
March 16, 2018
2018 KHA Annual Quality Conference
The Stakes…
9,967
13,712
23,000
29,000
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
US Deaths 2014
Drunk Driving
HIV/AIDS
AROs
C. diff
Who Was Peggy?
Peggy’s C. diff Story
Broad spectrum antibiotic
following root canal
Symptoms begin 5 days
into course
Suspected stomach virus
Admitted to hospital 5
days after diarrhea onset
Died 36 hours later
Lessons from Peggy’s Story
Antibiotic Overuse (Prophylaxis)
Lack of C. diff Awareness
Persistence of C. diff Myths
No warning from prescriber
Danger of Prescribing Imodium
Learning from Patient Stories
Stories help engage patients by:
Illustrating the benefits and risks of
antibiotic usage
Humanizing statistics
Breaking through mythology
Highlighting opportunities for shared
decision-making
Why Antibiotic Stewardship
Trends in Antibiotic Resistance→ In 2013, CDC identified 3 Urgent Threats
→ 2 million infections and 23,000 deaths
Overuse and mis-use→ 266 million prescriptions in 2014
→ 30% of oral antibiotics are unnecessary
The C. diff epidemic→ 500,000 infections and 29,000 deaths
Fluoroquinolone Toxicity
Microbiome Disruption
The Disconnect
Cycle of Blame
Patients don’t see downside
Doctors fear missing a
dangerous infection
Antibiotic-related harm
is hidden from public
Antibiotic Resistance =
Climate Change
Changing The Conversation
Doctors must treat antibiotics like any
other prescription drug
→ Chemotherapy or Opioids
→ Imperfect analogies
Informed consent: Share benefits AND
risks with patients and caregivers
Offer methods for symptom relief
Be Proactive
Proactive Strategies
Integrate Patient Stories about Adverse Events from
Antibiotic Usage
Facility-wide US Antibiotic Awareness Week Events
Include Stewardship messages in Patient Safety Week
Activities
Have Patients/Caregivers Serve on AS Committees
Share Your Practice’s Orientation Toward Antibiotics with
New Patients
Include information on antibiotics in patient materials
Provider Resources*
CDC’s Get Smart About Antibiotics Campaign
→ US Antibiotic Awareness Week*
→ March 2014 Vital Signs*
Joint Commission New Antibiotic Standard
APIC Antibiotic Stewardship
National Quality Partners Playbook: Antibiotic
Stewardship in Acute Care
IDSA Faces Of Antimicrobial Resistance
PLF Advocates Council Videos*
Pew Antibiotic Resistance Project
→ Why Doctors Prescribe Antibiotics—Even When
They Shouldn’t
→ What Drives Inappropriate Antibiotic Use in
Outpatient Care?
→ Unnecessary Antibiotic Use and Patient Safety
Choosing Wisely
Patient Resources
PLF Patient Brochure in English and
Spanish
PLF C. diff Stories
CDC – The Other Side of Antibiotics
video
Choosing Wisely→ Antibiotic Treatment in the Hospital
→ Antibiotics for people with catheters
→ Antibiotics: Will They Help You or Hurt You?
→ Colds, flu, and other respiratory illnesses in adults:
When you need antibiotics—and when you don’t
→ 7 others based on illness
Official Estimates = Tip of the Iceberg
29,000 deaths
according to CDC
108,000 deaths
2008 prevalence
study
Nursing Home Deaths
(Unreported)
Community Deaths
(Unreported)
Unreported Deaths
No C. diff!
Making C. diff Count
Require C. diff and other HAIs to be recorded on death certificates
Modernize Nationally Reportable Disease Laws
Expand and Update State Public Reporting Laws
Increase Funding at Federal and State Level
Other Areas for Collaboration
Research for prevention (CDC, vaccines) and treatment
(Ebiotics, FMT, etc.)
Raising awareness of underutilized treatments (FMT and
Fidaxomicin)
Advocating for increased public and private funding
Patient education (particularly around antibiotic overuse
and HAI risk factors and symptoms)
“All you have in this world is each other.”
- Peggy Lillis
Peggy’s Vision
A World Where C. diff is Rare, Treatable &
Survivable.