CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
Clinical pathology abstracts editor: Deborah Sesok-Pizzini, MD, MBA, associate professor, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, and medical director, Blood Bank and Transfusion Medicine, Children’s Hospital of Philadelphia.
Prevalence of antimicrobial use in U.S. acute care hospitals
Inappropriate antimicrobial drug use is associated with adverse events in hospitalized patients as well as the emergence of resistant pathogens. Targeting effective interventions to improve antimicrobial use in the acute care setting may help guide safe and effective therapy while reducing the risks and complications of resistant and difficult-to-treat pathogens. Inappropriate antimicrobial use may be due to incorrect drug selection, dosing levels, or treatment duration. The authors performed a one-day antimicrobial drug use prevalence survey in acute care hospitals in 10 states between May and September 2011 to determine the most common antimicrobial drug types and their prevalence, as well as the reasons for their use. On the survey date, patients were randomly selected from each hospital’s morning census. The data collectors reviewed the medical records retrospectively to learn more about the antimicrobial drugs, as well as the reasons for treatment, infection sites, and if the infections began in community or health care settings. Results showed that the use of broad-spectrum antimicrobial drugs, such as piperacillin-tazobactam and vancomycin, for resistant pathogens was common. This was true for community-onset infections and among patients outside critical care units. Approximately 50 percent of patients were receiving two or more antimicrobial drugs for treatment of infection at the time of the survey. The authors concluded that although the data suggest the potential misuse of antimicrobial drugs for active infections in hospitalized patients, the use of drugs for surgical prophylaxis is largely consistent with current guidelines. Additional work is needed to understand the settings and indications for which reducing antimicrobial use is safe and efficacious.
Magill SS, Edwards JR, Beldavs ZG, et al. Prevalence of antimicrobial use in US acute care hospitals, May–September 2011. JAMA. 2014;312(14):1438–1446.
Correspondence: Dr. Shelley S. Magill at smagill@cdc.gov