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

1. Public Health Impact of
Antibiotic Resistance
Steven L. Solomon, MD
Director, Office of Antimicrobial Resistance
Centers for Disease Control and Prevention
Symposium:
Bridging the Gap Between
Animal Health and Human Health
November 12, 2013
Kansas City, Missouri

5. Fighting back against antibiotic resistance

8. Antibiotic use and misuse
•
Up to 50% of antimicrobial use in hospitals is
unnecessary or inappropriate
•
Up to 20% in a recent pediatric survey

9. Mock-up of Hospital Antimicrobial Use Monitoring:
Benchmarking of Antimicrobial Use To Guide Stewardship
Antimicrobial Usage Rates and
Standardized Utilization Ratios (SURs)
Antibiotic Days (Total)
Observed
Predicted
SUR
Interpretation
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
170,250
171,000
0.99
Consistent
Hospital
SUR is a ratio of the actual usage compared to predicted

10. 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 4872 hours

11. 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

12. 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