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29 ANTIBIOTIC RESISTANCE & STEWARDSHIP One-fifth of VA patients prescribed antibiotics at hospital discharge By Anuja Vaidya N early 20 percent of veterans received an oral antibiotic at hospital discharge from VA facilities, according to a study published in Clinical Microbiology and Infection. Researchers examined national administrative data to identify all acute-care admissions from 2014 to 2016 within the Veterans Health Administration. They as- sessed days of antibiotic therapy while in the hospital as well as oral antibiotics dispensed at discharge. Of 1.68 million acute-care admissions at 122 VA hos- pitals, 335,369 (or 19.9 percent) were prescribed an oral antibiotic at discharge. Fluoroquinolones were most commonly prescribed, accounting for 38.3 percent of all antibiotics prescribed. Thirty-nine percent of the duration of antibiotic exposure occurred after discharge. n 52% of nurses not familiar with term 'antimicrobial stewardship' By Anuja Vaidya M ore than half of registered nurses are not familiar with efforts to curb antibiotic overuse, according to a study published in the American Journal of Infection Control. Researchers from Brigham Young University College of Nursing in Provo, Utah; LDS Hospital in Salt Lake City; and Intermoun- tain Medical Center in Murray, Utah, conducted an online sur- vey that included questions assessing knowledge of antimicro- bial stewardship. The survey includes responses from 316 staff nurses at three hospitals. Two findings: • Fifty-two percent of nurses were not familiar with the term "antimicrobial stewardship". • About 39 percent of nurses indicated that an antimicro- bial stewardship program was moderately or extremely important in their healthcare setting. Researchers concluded that while there was a gap in antimicro- bial stewardship knowledge among nurses, they believed those efforts were important and wanted to be involved. n Use of early-onset sepsis calculator results in fewer antibiotics for newborns By Anuja Vaidya U sing an early-onset sepsis calculator can substantially reduce antibiotic therapy for newborns, according to a study published in JAMA Pediatrics. Researchers conducted searches in Medline, Embase, Web of Science and Google Scholar from 2011 through Jan. 31 to find studies with original data that compared antibiotic management guided by the early-onset sepsis calculator with conven- tional strategies to manage antibiotic therapy for newborns suspected of having early-onset sepsis. They examined 13 relevant studies analyzing a total of 175,752 newborns. All the studies showed a substantially lower relative risk of antibiotic therapy when using the calculator. Although evidence on safety was limited, research- ers found that the proportion of missed early-onset sepsis cases was similar when using the calculator and when using conventional strategies. n CMS requires hospitals to deploy antibiotic stewardship programs By Mackenzie Bean C MS is requiring hospitals to implement antibiotic stewardship and infection control programs under its Omnibus Burden Reduction final rule released Sept. 26, reported CIDRAP News. The programs must be hospitalwide and adhere to nationally recognized guidelines on the surveillance and prevention of healthcare-associated infections, along with the optimization of antibiotic use. Hospitals will have six months to implement a program after the final rule is published in the Federal Register. "The changes are aimed at effectively reducing the devel- opment and transmission of HAIs and antibiotic-resistant organisms that ultimately will greatly improve the care and safety of patients while adding cost benefits for hospitals," CMS said in a fact sheet. n