We are entering exciting times in the world of antibiotics and the elderly. A team including nursing home staff, doctors, pharmacists, and lab partners are about to be more involved in helping to decrease bacterial resistance and increase the effectiveness of antibiotics. The Centers for Medicare and Medicaid Services issued a Final Rule on November 28, 2016 updating current regulations for nursing homes. One added rule states that an antibiotic stewardship must be established in every nursing home by November 28, 2016. Antibiotic stewardship is defined by the Infectious Disease Society of America as “coordinated use of antibiotic agents by promoting the selection of the optimal antibiotic drug regimen including dosing, duration of therapy, and route of administration". Well established benefits of antibiotic stewardship include decreased adverse events such as, clostridium difficile infections, improved patient outcomes, and decreased bacterial resistance to antibiotics.
To aid in creating an antibiotic stewardship program, Washington State Department of Health (DOH) has taken an active role in helping nursing homes develop their stewardship programs. The Education, Quality, and Infection Prevention for LTC (EQuIP) group was formed by DOH, specifically for this purpose. I highly recommend visiting their website below and attending the webinars provided by EQuIP. I also suggest visiting the CDC website link below, which provides an overview of the “Core Elements” included in an antibiotic stewardship.
Mercury Pharmacy Services (MPS) is dedicated to providing antibiotic stewardship guidance. I am currently on the EQuIP Steering Committee. MPS is always on the lookout for new and innovative ways to support our customers and improve resident health and their quality of life. This newsletter article is part one of four involving antibiotic stewardship implementation strategies, resistance concerns, and other stewardship information. In the coming months we look forward to working with our nursing homes in developing the antibiotic stewardship programs.
Let us all view this as an opportunity to better the lives of the elderly we serve.
Grant Walker, PharmD
CDC Core Elements of Antibiotic Stewardship in Nursing Homes:
Department of Health EQuIP resource page: