1. Antibiotic Stewardship is Vitally Important

2. Some Key Points
Antibiotic Stewardship is a way to improve the use of these medications.
Over 260 million outpatient antibiotic Rx each year
At least 30% of antibiotic prescriptions are unnecessary
Antibiotic use is the main risk factor for C. difficile infection
23,000 people die each year due to antibiotic-resistant bacterial infections
Fewer new antibiotics are being developed
A significant # of ED visits for medication problems are due to antibiotics

3. Risks & Benefits of Antibiotic Use
Antibiotics are life-saving drugs
Antibiotic misuse/overuse contributes to bacteria becoming resistant & more people having adverse drug events (ADEs)
Antibiotics have risks, side effects, and drug interactions
If you need the antibiotic, the risks are worth it
If you don’t really need them, why take the risk?

4. Why so many Rx for Abx? Comfort / familiarity
Antibiotic prescribing habits
Diagnostic uncertainty
Fear of infectious complications
Patient pressure
Clinicians commonly perceive that an antibiotic is the reason for the clinic visit
Patient satisfaction
Clinicians fear losing patients to other providers or getting bad reviews if antibiotics are not prescribed
Sanchez, EID. 2014; 20(12):2041-7
Fleming-Dutra, Am Fam Physician. 2016; Aug1;94(3):200-2.

5. What’s the big deal?
When antibiotics are used inappropriately, it can lead to:
More complications from antibiotics
Diarrhea, C. diff, heart problems, allergic reactions, yeast infections, tendonitis, tendon rupture, delirium, etc.
Prolonged hospital stays
More frequent readmissions to hospital
Poor outcomes, septic shock or death
More widespread antibiotic resistance (infections that are harder to treat)

6. This is a map of the United States showing how many antibiotics are prescribed in each state. Research has shown that at least 30% of antibiotics prescribed in doctors’ offices, emergency departments and hospital clinics are unnecessary. For some conditions the rate of inappropriate prescribing is over 50%!

10. CDC “Get Smart” Campaign
Information available about antibiotic use in the following settings:
Hospitals
Long-Term Care
Doctor’s Offices
On the Farm
In Fall 2017, the CDC will launch a new campaign for U.S. Antibiotic Awareness.
Nov , 2017 is U.S. Antibiotic Awareness Week

11. Let Patients Know that You Commit to Safe Antibiotic Use

12. Medication Interactions
Antibiotics may interact with other medications:
Diabetes medication
Increased risk of low blood sugar reaction
Anticoagulants (blood thinners)
Increased risk of bleeding
Proton pump inhibitors (PPIs)
Increased risk of C. difficile infection
Some people want to take an antibiotic “just in case” it will help their symptoms. However, if the antibiotic is not truly needed, they may be doing more harm than good.

13. Provider-to-Patient Communication
Are people aware of the risks of taking antibiotics?
Do people expect antibiotics for certain conditions when they may not be necessary?
Strategies for provider-to-patient communication:
Review physical exam findings
Deliver a clear diagnosis
Use a 2-part negative/positive treatment recommendation
Negative (what won’t work)
Positive (what you can do to manage symptoms)
Provide a contingency plan

14. Penicillin Allergy?
When a person is allergic to Penicillin they are often treated with antibiotics that are stronger than necessary, cost more, may not be as effective, and have increased risks of complications
Special testing can determine whether a person is allergic to Penicillin

15. “One Health”
Human health is connected to the health of animals and the environment.

18. Everyday Antibiotic Stewardship
Tell your provider that you only want antibiotics if really necessary
Take all medications as prescribed
Eat a healthy diet: plenty of water, fiber, and whole grains
Look for meat raised without antibiotics
Proper disposal of unused medications
Get recommended vaccinations
Prevent illness (or make it less severe)
Reduce antibiotic use
Help slow the development of drug-resistant organisms

19. Contact Information
QI Advisor
Kim Roberts
(662)
State Director
Trannie Murphy Atkinson
(601) , ext. 222