• Article
  • November 17, 2016

Addressing the Threat of Antibiotic Resistance

Get Smart About Antibiotics Week highlights the importance of antibiotic resistance and proper prescribing and use.

Preeti Jaggi, M.D., is several years into her mission of making sure antibiotics are used only when indicated. As an infectious diseases physician at Nationwide Children's Hospital in Columbus, Ohio, Jaggi currently leads the hospital's Antibiotic Stewardship Program (ASP), which started in 2013—a program focused on driving improvements in antibiotic use in surgical areas and across all the hospital's services. The ASP develops guidelines to help providers determine what antibiotics should be prescribed and when they should be discontinued. Basically, guidelines to help providers get smarter about antibiotic use.

"Get Smart" About Antibiotics Week

This week, November 14-20, is the Center for Disease Control and Prevention's (CDC) 9th annual Get Smart About Antibiotics Week, a campaign designed to raise awareness of the threat of antibiotic resistance and the importance of appropriate antibiotic prescribing and use.

The CDC says antibiotic use, which has greatly reduced illness for decades, is also the single most important factor leading to antibiotic resistance around the world. Put simply, the more antibiotics are used, the more harmful microbes are able to adapt and spread. Also according to the CDC, antimicrobial-resistant germs lead to more than 2 million illnesses and 23,000 deaths in the United States a year.

Getting even smarter about antibiotics

In 2014, Nationwide Children's began using data from the Children's Hospital Association's Pediatric Health Information System (PHIS), a comparative pediatric database that helps hospitals drive decision-making and education about antibiotic use. And it didn't take long to produce a measurable result.

"We, overall, are on the lower end of using antibiotics, but we have used PHIS to document that we were using some specific drugs more than others," Jaggi says. "We have used this to show our doctors we have used linezolid and aminoglycosides more than other peer hospitals."

In addition to leveraging the PHIS data for physician education, the organization also used the data to guide its goals around decreasing use of specific agents.

Data to drive improvements

The PHIS database includes clinical and resource utilization data for inpatient, ambulatory surgery, emergency department and observation unit patient encounters shared by nearly 50 children's hospitals. Member hospitals share data across a wide range of categories, including clinical effectiveness, resource utilization, care guideline development, readmission analysis, antimicrobial stewardship, physician profiling and more.

Hospitals can leverage the database to improve clinical care, enhance financial outcomes, improve clinical documentation and perform research. Nationwide Children's is among the top four hospitals in the PHIS database that carefully monitor antibiotic use to ensure prophylaxis is given only when indicated.

Data and collaboration at Nationwide

Nationwide is also a member of the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) program, a collaboration of about two dozen children's hospitals focusing on using prescribing data to establish best practices for the use of antibiotics among hospitalized children. Jaggi believes the ability to share practices and discuss comparative data, like PHIS, have been very helpful to the ongoing stewardship work at Nationwide Children's as the team pushes to become smarter on antibiotic use.

Send questions or comments to magazine@childrenshospitals.org.