Over the next few years, acronyms like ASP, CDC, AUR, NHSN and DOT will become increasingly utilized throughout the healthcare vocabulary; particularly in hospitals and health systems. Why, might you ask? What do these acronyms mean? Who do they impact?
In September of 2014, the President’s Council of Advisors on Science and Technology (PCAST) released a report on Combating Antibiotic Resistance. The PCAST report provided recommendations and strategies on promoting appropriate antimicrobial use. Immediately following this report President Obama issued an executive order and the White House released a report entitled The National Strategy for Combating Antibiotic Resistant Bacteria. In addition, in March 2015, the National Action Plan for Combating Antibiotic-Resistant Bacteria was released and it outlines actions to be taken at the national, regional, and local levels to combat antibiotic resistance. The first two goals of the National Action Plan focus on improving current antibiotic use and surveillance efforts to combat resistance across all health care settings. These goals highlight the importance of adopting an Antimicrobial Stewardship Program (ASP) as well as enhancing and creating improved antibiotic usage and resistance pathogen surveillance.
The Centers for Disease Control and Prevention (CDC) has promoted antimicrobial stewardship activities for several years and also developed the National Healthcare Safety Network (NHSN) Antimicrobial Use and Resistance (AUR) Module. The NHSN is managed by the CDC’s Division of Healthcare Quality Promotion (DHQP). The goal of the NHSN AUR Module is to allow facilities to report and analyze use of and/or resistance to antimicrobials. The module helps to serve local and regional efforts by providing facility-specific measures to reduce resistant infections. Reporting mechanisms will help benchmark antimicrobial usage and evaluate trends of this use over time.
The AUR module is broken down into two options that involve different sets of data: Antimicrobial Use (AU) and Antimicrobial Resistance (AR). Some hospitals are already measuring antibiotic usage either using Defined Daily Dose (DDD) or Days of Therapy (DOT) metrics. The AU data in the AUR module specifically uses DOT as the numerator in the equation. Once a healthcare organization has calculated their DOT for specified antibiotics, they will then need to submit that data electronically to NHSN. While there is no exact timetable for when healthcare organizations will be required to submit AU data to the NHSN, some organizations have already started the process. This data will then be used in the future for benchmarking purposes at a local level, regionally, and nationally.
Infection preventionists have traditionally reported Healthcare-Associated Infection (HAI) data to the NHSN. For antibiotic usage data, pharmacy will likely be the driver behind the submission to the NHSN.
Clearly the national focus on infection treatment and antimicrobial stewardship is really heating up. This is a good time to consider how your organization is managing these patients and your therapeutic resources. Are you prepared for the future? Is your facility currently tracking antibiotic usage data? If so, what usage metric are you using; DDD or DOT? Improving your awareness around the National Action Plan and the CDC AUR module would likely be a wise investment of your time.
- Center for Disease Control and Prevention. (2015). Antimicrobial Use and Resistant (AUR) Module. Atlanta, GA: Center for Disease Control and Prevention. Retrieved from http://www.cdc.gov/nhsn/PDFs/pscManual/11pscAURcurrent.pdf
- The White House. (2015). National Action Plan for Combating Antibiotic-Resistant Bacteria. Washington, DC: The White House. Retrieved from https://www.whitehouse.gov/sites/default/files/docs/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf
- President’s Council of Advisors on Science and Technology. (2014). Report to the President on Combating Antibiotic Resistance. Washington, DC: Presidential Executive Office of the President. Retrieved from http://www.whitehouse.gov/sites/default/files/microsites/ostp/PCAST/pcast_carb_report_sept2014.pdf