Issue link: https://beckershealthcare.uberflip.com/i/1075308
23 ANTIBIOTIC RESISTANCE & STEWARDSHIP Northwestern, USC, Teladoc to study antibiotic stewardship in telehealth By Jessica Kim Cohen N orthwestern University in Evanston, Ill., and the University of Southern California's Leonard D. Schaeffer Center for Health Policy & Economics in Los Angeles partnered with Teladoc Health to study how physicians practicing remote care are prescribing antibiotics. Four things to know about the research project: 1. An estimated one-third of all outpatient antibi- otics — across all delivery sites, including primary care and urgent care settings — are unnecessarily prescribed, according to data cited by Teladoc. is is a problem for the healthcare industry, since unnecessary antibiotic use is associated with the rise of antibiotic-resistant "superbugs." 2. e five-year study led by Northwestern, USC and Teladoc will comprise a large-scale randomized quality improvement trial to assess various factors that may influence antibiotic pre- scribing in the virtual care setting. e project will both identify existing prescribing behaviors and develop new processes to determine how behavioral science interventions can encourage safe antibiotic use. 3. e researchers hope their work will contrib- ute to emerging clinical quality standards for telehealth-delivered patient care. "Telemedicine is the future of care, and so it's vital that stewardship strategies are systematical- ly studied in this rapidly growing setting," said principal investigator Daniella Meeker, PhD, an assistant professor of preventive medicine at the Keck School of Medicine at USC and the USC Schaeffer Center. 4. e project is funded through a grant from HHS' Agency for Healthcare Research and Quality and is part of the White House's National Action Plan for Combating Antibiotic-Resistant Bacteria. n Bedside flu diagnosis in pediatric ED reduced antibiotic treatment by 70% By Anuja Vaidya A study published in Clinical Microbiology and Infection shows that the bedside use of a rapid influenza digital immunoassay among children in an emergency ward may help reduce costs and enhance antimicrobial stewardship strategy. Researchers conducted the study at a pediatric emergency department in France between January and March 2016. They tested nasopharyn- geal aspirates samples from 514 children with flu-like symptoms using a rapid influenza digital immunoassay as well as immunofluorescence and/or molecular routine assays. The study showed the use of the digital immunoassay at bedside de- creased the prescription of: • Blood puncture by 47.9 percent • Chest X-rays by 69 percent • Lumbar puncture by 77.8 percent • Urine culture by 79.2 percent Additionally, bedside use of the digital immunoassay reduced antibiot- ic treatments by 70.1 percent and hospital stays by 25 percent. It also reduced medical costs by an estimated $78,308-plus in a season. n Many hospitals do not follow CDC's antibiotic recommendations for newborns, study shows By Anuja Vaidya S ignificant gaps exist between CDC recommendations for improv- ing antibiotic use practices and antibiotic stewardship programs for newborns, according to a study published in Pediatrics. Researchers collected data using a cross-sectional audit of Vermont Oxford Network members in February 2016. They assessed centers using patient-level measures, as well as unit measures derived from the seven domains of the CDC's Core Elements of Hospital ASPs: leadership commitment, accountability, drug expertise, action, track- ing, reporting and education. In all, 143 centers completed structured self-assessments. No center addressed all seven core elements, and only accountability (55 per- cent) and drug expertise (62 percent) had compliance greater than 50 percent. Additionally, of the 412 patients who received antibiotics for more than 48 hours, only 26 percent had positive culture results. n