1 / 12

Downstate Illinois Partnership Against Antibiotic Resistance

Downstate Illinois Partnership Against Antibiotic Resistance. Wayne Mathews, MS, PA-C Justin Parker, MD SIU Department of Family and Community Medicine The presenters have no disclosures to make. Focus: Regional Outpatient Antimicrobial Stewardship Initiative.

albertwalker
Download Presentation

Downstate Illinois Partnership Against Antibiotic Resistance

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Downstate Illinois Partnership Against Antibiotic Resistance Wayne Mathews, MS, PA-C Justin Parker, MD SIU Department of Family and Community Medicine The presenters have no disclosures to make.

  2. Focus: Regional Outpatient Antimicrobial Stewardship Initiative • Web- based, online November 2014: www.siumed.edu/antibioticresistance • Medical Education impacts training future primary care physicians: based in five downstate Family Medicine residencies. • Purpose: analyze regional outpatient resistance patterns, educate providers on improving prescribing and patients on understanding scope of problem.

  3. Scope and Partners State and National -- Illinois Department of Public Health Carbondale, IL -- Memorial Hospital of Carbondale -- SIU Family and Community Residency Decatur, IL -- Decatur Memorial Hospital -- SIU Family and Community Residency -- St. Mary's Hospital Quincy, IL -- Blessing Hospital -- SIU Family and Community Residency Springfield, IL -- Memorial Medical Center -- SIU Family and Community Residency -- St. Mary's Hospital Urbana, IL -- Carle Family Medicine Residency -- Carle Foundation Hospital -- Presence Hospital

  4. Hospital: High Tech Tools, Surveillance, Infection Control Measures The Problem: Hospital vs. Ambulatory Environment

  5. Ambulatory: Lax monitoring, prescribing often by patient choice. The Problem: Hospital vs. Ambulatory Environment

  6. Estimated 50% current antibiotic prescriptions unnecessary- CDC MMWR 2011 833 antibiotic Rx per 1000 persons in US in 2010- NEJM, April 2013 Azithromycin most frequently prescribed antibiotic- highest in age < 10 and >65 High Regional variation Current State of Ambulatory Antibiotic Prescribing

  7. Regional Resistances • Analyzed local hospital antibiograms for past 4 years for presence and trend of resistances. • Criteria for analysis: 1. Bacteria which would likely be treated in the out-patient setting, where most antibiotic prescriptions occur. Example is Strep Pneumonia to Macrolides (Zithromax is the most frequently prescribed antibiotic in the US). 2. Bacteria which could be influenced by prescribing in the outpatient setting and test as resistant in the hospital. Example is Strep. Pneumonia to Ceftriaxone (Ceftriaxone is one of the first line antibiotics used to treat community acquired pneumonia), or Methicillin-resistant Staph Aureus. 3. Bacteria that evidence a trend of increasing resistance. Example is E. coli to Sulfas. 4. Bacteria with resistances mentioned by guidelines from the Infectious Disease Society of America, which should be used to guide empiric treatment. Example is caution using Sulfa in UTI: ‘avoid if resistance prevalence is known to exceed 20 %, or if used for UTI in previous 3 months’.

  8. Regional Resistances of Concern 2014 West Central: East Central:

  9. Regional Resistances of Concern West: East: South:

  10. Projects Underway • Partner with IDPH on Precious Drugs and Scary bugs Campaign using method of Meeker at al: nudging guideline concordant antibiotic prescribing. JAMA Internal Medicine 2014. • Survey on Antibiotic Stewardship to US Family Medicine Program Directors. • Educate ED providers on AS issues. • Study Effects of LTC prescribing for Asymptomatic Bacteruria on UTI resistance patterns. • News Releases, participated in Get Smart with Antibiotics Week.

  11. Family Medicine Program Directors Survey • Survey to 288 FM PD’s • 98% identified Antibiotic Stewardship as Important to Extremely Important. • 67% stated program involvement of Infectious disease faculty physician. • 73% stated program had no plans to change curriculum for AS in next year. • Only 14% had an AS quality improvement metric in place.

More Related