Steven Ross Johnson September
26, 2019 02:02 PM
The CMS on Wednesday finalized a rule requiring
all hospitals to have antibiotic stewardship programs, which experts say is a
big step forward in the fight against superbugs.
The rule was first proposed
in 2016 and requires all acute-care and critical access hospitals that
participate in Medicare or Medicaid to develop and implement an antibiotic
stewardship program as part of their infection control efforts.
Dr. David Hyun, senior officer for the Pew
Charitable Trusts' Antibiotic Resistance Project, said this is the first
federal policy mandating hospital antibiotic stewardship.
"It definitely creates a broader level of
involvement across different hospitals across the United States," Hyun
said.
Hyun said he was hopeful the rule would help
sustain momentum to improve antibiotic stewardship. In 2016, the CMS finalized
requirements for nursing facilities to have a stewardship program in response
to widespread misuse of antibiotics in such settings. Up to 70% of the
estimated 4 million patients receiving care in nursing homes received
antibiotics in 2017, according to the Centers for Disease Control and
Prevention, with up to 75% of those drugs prescribed incorrectly.
In 2017, the Joint Commission issued
standards for acute-care hospitals, critical access hospitals and nursing homes
to have an antibiotic stewardship program to maintain their accreditation. The
commission expanded its requirements in June to include ambulatory care centers.
A 2018 CDC survey of more than
4,900 acute-care hospitals found more than 76% reported adhering to all seven
of the agency's core elements of hospital antibiotic stewardship programs,
which include standards such as leadership commitment, tracking antibiotic
prescribing and resistance patterns, and educating clinicians on better
prescribing practices.
But there are more opportunities for additional
healthcare settings to adopt stewardship programs, Hyun said, including
outpatient sites.
He predicted the focus will begin to shift from
expanding the number of providers that have antibiotic stewardship programs to
improving the quality of those programs.
CDC estimates about 47 million, or 30%, of
antibiotic prescriptions written each year are given to treat for infections
that don't need antibiotics.
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