Dental antibiotic stewardship program shows promising results
A team of dentists, pharmacists, and physicians at the University of Illinois reported today in Open Forum Infectious Diseases that implementation of a comprehensive antibiotic stewardship intervention in a dental practice was associated with a significant improvement in antibiotic prescribing.
After conducting a baseline needs assessment and literature evaluation to identify opportunities to improve antibiotic prescribing, faculty from the University of Illinois at Chicago (UIC) College of Dentistry, UIC College of Pharmacy, and the University of Illinois Hospital and Health Sciences System devised and implemented a multimodal intervention that focused on antibiotic use for acute oral infections, a common condition in the UIC dental clinic.
The intervention, which is consistent with the Centers for Disease Control and Prevention's Core Elements of Outpatient Antibiotic Stewardship, included patient and provider education, clinical guideline development, and an assessment of the antibiotic prescribing rate per urgent care visit before and after the educational intervention.
The results of the assessment showed that, among all providers in the practice, the antibiotic prescribing rate per urgent care visit decreased by 72.9% before and after the multimodal intervention (pre-intervention urgent care prescribing rate [September 2017], 8.5% [24/283]; post-intervention [May 2018], 2.3% [8/352], P < 0.001). Clinical providers also reported that they had become more conscious of appropriate prescribing since implementation of the educational guidelines.
The authors of the study say the results suggest that simple educational interventions may decrease antibiotic prescribing in the dental setting, which accounts for 10% of all outpatient prescribing, and may be adapted to other dental practices.
Feb 13 Open Forum Infect Dis abstract
Study weighs value of antibiotics for resistant Staph in pandemic settings
An effective antibiotic that can treat secondary Staphylococcus aureus infections in a pandemic flu outbreak is worth more than $3 billion, according to a new study by researchers from the Center for Disease Dynamics, Economics, and Policy (CDDEP) and their colleagues in Scotland and the Netherlands.
Writing in Health Economics, the authors said though antibiotic reserves are part of pandemic preparedness plans, experts haven't explores the value of stockpiling or conserving the effectiveness of antibiotics, despite the high morbidity of secondary bacterial infections and the growing ineffectiveness of antibiotics because of emerging antibiotic-resistant organisms.
Using a mathematical framework based on UK preparedness plan assumptions the scientists estimated the value of investing in developing and conserving an antibiotic to lessen the burden of bacterial infections from resistant S aureus during a pandemic flu outbreak.
The team found that the value of withholding an effective new oral antibiotic can be positive and significant unless the pandemic is mild, with few secondary illnesses involving the resistant strain or if most patients can be treated intravenously.
Ramanan Laxminarayan, PhD, MPH, CDDEP director and the study's senior author, said in a CDDEP press release that secondary bacterial infections are a major cause of death and disability with flu, and antibiotic resistance is a major barrier to treating those infections. "This study shows that the value of an effective antibiotic against Staph infections, as an insurance policy against future pandemics, is between $3 [billion] and 4 billion at baseline," he said.
Feb 11 Health Econ abstract
Feb 12 CDDEP press release