Issue link: https://beckershealthcare.uberflip.com/i/1028549
33 ANTIBIOTIC RESISTANCE & STEWARDSHIP Only 'most intensive' stewardship programs effectively lower total antibiotic use By Anuja Vaidya A study published in Clinical Infectious Diseases assessed the effectiveness of implementing antibiotic stewardship programs in Salt Lake City-based Intermoun- tain Healthcare's 15 small hospitals. Researchers divided the hospitals into three groups. ey implemented antibiotic stew- ardship programs of escalating intensity at each group of hospitals. • Group 1 received basic antibiotic stew- ardship education and tools as well as access to an infectious disease hotline and antibiotic utilization data • Group 2 hospitals received those interven- tions in addition to advanced education, audit and feedback for select antibiotics and locally controlled antibiotic restrictions • Group 3 hospitals received all the inter- ventions for group 2 as well as audit and feedback on the majority of antibiotics; additionally, an infectious diseases-trained clinician approved restricted antibiotics and reviewed microbiology results e study shows hospitals in group 3 expe- rienced reductions in total and broad-spec- trum antibiotic use during the intervention period as compared to the baseline period. Hospitals in groups 1 and 2 did not experi- ence a reduction in antibiotic use. "Only the most intensive ASP interven- tion was associated with reduction in total and broad-spectrum antibiotic use when compared with baseline," the study authors wrote. n Bacteria growing more resistant to hospital disinfectants By Megan Knowles A lthough alcohol-based disinfectants are a crit- ical component of hospital infection control, a multidrug-resistant bacterium is becoming more tolerant to alcohols in hospital disinfectants, a study published in Science Translational Medicine found. The researchers tested alcohol tolerance of 139 hospi- tal isolates of Enterococcus faecium obtained between 1997 and 2015. They found E. faecium isolates after 2010 were 10 times more tolerant to killing by alcohol than the older isolates they tested. E. faecium that developed resistance to alcohol sanitiz- ers were better able to resist isopropanol surface disin- fection and colonize the guts of mice researchers used in the study, the study found. "These findings may help explain the recent increase in this pathogen in hospital settings," the researchers wrote. "A global response to E. faecium will need to include consideration of its adaptive responses not only to antibiotics but also to alcohols and the other active agents in disinfectant solutions that have become so critical for effective infection control." n 3-pronged intervention improves intraoperative antibiotic redosing compliance By Anuja Vaidya A study published in American Journal of Infection Control examined the efficacy of a quality im- provement project aimed at improving compli- ance with national guidelines that recommend intraoper- ative redosing of prophylactic antibiotics. The QI project included: • Education • Progress reports • Automated redosing reminders in the anesthesia EHR Researchers implemented the project at a large hospi- tal and conducted a retrospective, observational study spanning the pre-and post-project period using the intraoperative antibiotic redosing criteria for all surgeries lasting more than four hours. Researchers studied 13,695 surgical procedures. They found that the project was associated with significant compliance rate improvement, with no significant change in underlying improvement trend. "Implementation of a multifaceted intervention improved rates of guideline-concordant redosing of intraoperative prophylactic antibiotics," the study authors concluded. n