Antimicrobial resistance is a global concern as the number of resistant strains continues to rise. How important is the establishment of an Antimicrobial Stewardship Program (ASP) for today's healthcare provider? Let's examine this fast-growing area of the healthcare landscape.
Antimicrobial stewardship programs (ASPs) are critical to addressing antimicrobial resistance. Establishing an ASP has been proven to lower resistance, reduce adverse events, improve clinical outcomes, and lower costs. Best practices suggest that a collaborative approach that relies on all stakeholders (providers, payers and patients) can effectively combat growing antimicrobial resistance.
Recently, the federal government has supported collaboration to fight antibiotic resistance. In September, President Obama issued an executive order that requested for engagement from a variety of areas - academia, industry, healthcare, government, agriculture and the general public - to collaborate on strategies to reduce this growing threat to national health.
A collaborative approach helps ensure proper resource allocation for an ASP committee. Made up of physicians, pharmacy, laboratory personnel, quality control, and infection preventionists, the committee prioritizes focus areas for the greatest impact, return on investment, and patient outcomes. Pharmacy should have a lead role in the ASP development, and the committee should include a physician champion to help drive the effort. Once the ASP is implemented, the committee is responsible for establishing formalized policies and procedures and keeping effective governance and accountability measures.
Another component of the executive order includes proposed regulations that would require inpatient healthcare facilities to have a robust ASP in place (and is also strongly encouraged for ambulatory healthcare facilities).
Section 5A states the following:
“Sec. 5. Improved Antibiotic Stewardship. (a) By the end of calendar year 2016, the Department of Health and Human Services (HHS) shall review existing regulations and propose new regulations or other actions, as appropriate, that require hospitals and other inpatient healthcare delivery facilities to implement robust antibiotic stewardship programs that adhere to best practices, such as those identified by the Centers for Disease Control and Prevention (CDC). HHS shall also take steps to encourage other healthcare facilities, such as ambulatory surgery centers and dialysis facilities, to adopt antibiotic stewardship programs.”
Resources that can aid providers in building their ASP include Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship, developed by the Infectious Diseases Society of America (IDSA) to help acute care hospitals develop their programs.
Healthcare organizations, if not already in process, would be wise to begin working toward implementing an ASP in their facility. This stepping stone will not only improve the local resistance landscape, but will contribute to these proposed national efforts.