Minnesota Department of Health MN Antibiotic Stewardship Collaborative Update Bulletin

Stewardship quiz? You betcha! (scroll down for answer)

In both health care and veterinary medicine, the decision to prescribe antibiotics is complex and involves more than just medical consideration. A recent Pew Charitable Trusts report suggests that efforts to improve outpatient antibiotic stewardship must take into account multiple factors that influence prescribing decisions. 

What factors are key in influencing prescribing in outpatient settings?

a. Patient/client pressure
b. Time constraints
c. Diagnostic uncertainty
d. Desire for patient/client satisfaction
e. All of the above

Update from Your Minnesota Stewardship Collaborative

Engage with the Minnesota Antibiotic Stewardship Collaborative at the 2017 Minnesota State Fair!

Members of the Minnesota One Health Antibiotic Stewardship Collaborative will be at the 2017 State Fair to discuss the problem of antibiotic resistance, how antibiotic stewardship can make an impact, and how you play a role in addressing this important issue.

Thanks to our hosts, Minnesota Pollution Control Agency, you can find us in the Eco Experience Building!

Visit the Minnesota State Fair website to see a fairgrounds map and plan a trip to the Fair!

Minnesota Antibiotic Stewardship Honor Roll for Hospitals Open for Applications!

Submit an application by August 31 to be included in the first group of honor roll hospitals. Minnesota Hospital Association, Stratis Health, APIC Minnesota, the Minnesota Collaborative Healthcare-Associated Infection Network, and the Antibiotic Stewardship Collaborative all support the Minnesota Antibiotic Stewardship Honor Roll for Hospitals! This honor roll initiative strives to encourage hospital commitment to antibiotic stewardship, share stewardship activities happening across the state, provide incentive for program improvement, and publicize the importance of antibiotic responsibility.

Visit the Minnesota Antibiotic Stewardship Honor Roll website for more information and to apply for this three-tiered recognition program.  

Lights, Camera, Action for Antibiotics Video Contest

The Minnesota Department of Health invites Minnesota high schools and youth programs to help increase antibiotic awareness through the Lights, Camera, Action for Antibiotics Video Contest. Students will produce a 30-second video to spread the word about antibiotic resistance and good antibiotic use in human health care. Individual students, teachers, or schools can sign up to participate today!

Visit the video contest website for more details.

News to Note

World Organization for Animal Health (OIE) Releases Annual Report on the Use of Antimicrobial Agents in Animals.

• On September 21, 2016, the United Nations General Assembly adopted a political declaration aimed at combating antimicrobial resistance (AMR) and confirmed the One Health approach.

• OIE, supported by the Food and Agriculture Organization and World Health Organization, has built a global database on the use of antimicrobial agents in animals.

• 89/130 (68%) OIE Member Countries submitted quantities on the use of antimicrobial agents.

• 96/130 (74%) do not authorize antimicrobial agents for animal growth promotion.

• Though data quality, sources, and formats vary by country, the effort is an important step for global awareness of antibiotic use in animals and in international collaboration on the problem of AMR.

• Read the full OIE report.

Gonorrhea: Resistance is on the Rise and a New Class of Antibiotic Might Be on the Horizon.

• A WHO co-authored article in PLOS Medicine describes the severity of AMR among Neisseria gonorrhea bacteria.
• Coauthors of this article call for enhanced international surveillance and collaboration as well as rapid diagnostic testing and new therapeutic drugs.
• A publication released this week in Antimicrobial Agents and Chemotherapy describes the early in vitro activity of the antibiotic closthioamide against N. gonorrhea.

Pseudomonas aeruginosa Resistance to Carbapenem Antibiotics Decreased after Implementation of Antibiotic Restrictions in a Saudi ICU.

• Overall prevalence of carbapenem resistance of P. aeruginosa decreased significantly after implementation of restrictions on meropenem (74.1% to 30%, p=0.012) and imipenem (76% to 38.5%, p=0.019).
• Use of these carbapenems was approved only when indicated by laboratory-based culture results, used as empiric therapy after other antibiotics found clinically ineffective, and when prescribed by an infectious disease physician.
• Carbapenem use decreased by 16.8 DDD/1,000 patient days.
• Read the Clinical Infectious Diseases abstract.

CDC Announces First Fungal Disease Awareness Week, August 14-18. 

• Read about why fungal diseases are a problem in this CDC factsheet.
• Read the CDC factsheet on Candida auris: A Drug-resistant Germ That Spreads in Healthcare Facilities

Upcoming Events

CHAIN 2017 Fall Conference

• The Minnesota Collaborative Healthcare-Associated Infection Network (CHAIN) 2017 Fall Conference will be held on Wednesday, September 27, from 1:00-4:30PM at the Earle Brown Heritage Center in Brooklyn Center. 
• Learn about the latest evidence-based approaches for reducing and preventing healthcare-associated infections (HAIs) in Minnesota.
• Winners of the CHAIN Award for Excellence will be recognized at the conference. Nominations for this award are now being accepted. Find more information on the Award for Excellence on the CHAIN website.

APIC Minnesota 2017 Fall Conference

• September 28-29, 2017 at the Earle Brown Heritage Center in Brooklyn Center.
• Minnesota Association for Professionals in Infection Control and Epidemiology (APIC) Fall Conference website

Quiz Answer!

Correct Answer: e. All of the above

A new Pew Charitable Trusts report describes how behavioral science strategies can help improve antibiotic prescribing habits. The report suggests that professionals looking to move the needle on outpatient antibiotic stewardship must consider multiple factors that influence the decision to prescribe.

When considering an antibiotic prescription in outpatient practice, patient satisfaction and relationships, time constraints, diagnostic uncertainty, and the organizational challenges of the outpatient setting all are influential in the decision. In addition, there is a sense with prescribers that the problem lies somewhere else (e.g., in a different specialty/field or with other individual prescribers).

The report also includes some potential strategies to incorporate these known behavioral hurdles. Pew emphasizes that not one of these strategies is are likely to work on its own, but each should be part of a comprehensive approach. Strategies include public and professional educational initiatives, communications training for prescribers and staff, use of audit and feedback programs, clinical decision support systems (electronic or paper-based), and the incorporation of delayed prescriptions (i.e., "watchful waiting") where clinically appropriate. 

Read the full Pew report.

 

 

Handy Links

Minnesota One Health Antibiotic Stewardship Collaborative

CDC: Antimicrobial Resistance

CDDEP: Antibiotic Resistance

CIDRAP: Antimicrobial Stewardship

CDC: Antibiotic Stewardship

MPCA: Chemicals in Our Water

FDA: Antimicrobial Resistance

USDA: Antimicrobial Resistance

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