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Public Health Impact of Antimicrobial Resistance - Dr. Steven Solomon, Centers for Disease Control & Prevention, from the 2013 NIAA Symposium Bridging the Gap Between Animal Health and Human Health, November 12-14, 2013, Kansas City, MO, USA. More presentations at http://www.trufflemedia.com/agmedia/conference/2013-niaa-antibiotics-bridging-the-gap-animal-health-human-health
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Public Health Impact of
Antibiotic Resistance
Steven L. Solomon, MDDirector, Office of Antimicrobial Resistance
Centers for Disease Control and Prevention
Symposium: Bridging the Gap Between
Animal Health and Human Health
November 12, 2013Kansas City, Missouri
Fighting back against antibiotic resistance
Antibiotic use and misuse
• Up to 50% of antimicrobial use in hospitals
is unnecessary or inappropriate
• Up to 20% in a recent pediatric survey
Antimicrobial Usage Rates and Standardized Utilization Ratios (SURs)
Antibiotic Days (Total)
InterpretationObserved Predicted SUR
MICU 4000 1000 4.0 Excessive
SICU 2000 2000 1.0 Consistent
Medical Ward 3000 4000 0.75 Lower Use
Surgical Ward 1000 3000 0.33 Much Lower
Hospital 170,250 171,000 0.99 Consistent
Mock-up of Hospital Antimicrobial Use Monitoring:Benchmarking of Antimicrobial Use To Guide Stewardship
SUR is a ratio of the actual usage compared to predicted
Antibiotic best practices
1. Ensure all orders have dose, duration, and indications
2. Get cultures before starting antibiotics
3. Take an “antibiotic timeout,” reassessing antibiotics after 48-72 hours
Improving antimicrobial use
• Prescriber- and facility-based strategies– Formulary restriction– Prior approval– “Time-out” programs– Education, benchmarking
• Consider improved use measures as part of: – State licensure for healthcare facilities– Hospital accreditation– Reimbursement from third party payers
Summary• All antibiotic use contributes to the
development of resistance
• Antibiotic use in all settings can be
improved
• Both reducing antibiotic use and using
antibiotics with greater care in all settings
will improve human health
• www.cdc.gov/drugresistance
• www.cdc.gov/drugresistance/threat-report-
2013