Stewardship / Resistance Scan for Nov 14, 2019

Hospital stewardship toolkit
Candida auris in NY hospitals
Antibiotic prescribing drop in Finland

AHRQ publishes stewardship toolkit for hospitals

The Agency for Healthcare Research and Quality (AHRQ) has released a new toolkit to improve antibiotic use in acute care hospitals.

The toolkit consists of presentations, slides, posters, and other documents that provide guidance on how to develop a culture of safety around antibiotic prescribing, how to develop and improve antibiotic stewardship programs, and how to learn and disseminate best practices for the diagnosis and treatment of common infectious disease syndromes. It also includes an explanation of the "Four Moments of Antibiotic Prescribing," a step-by-step approach that clinicians can use to achieve optimal antibiotic prescribing.

The toolkit is based on the experiences of more than 400 US hospitals that took part in AHRQ's Safety Program for Improving Antibiotic Use, a 5-year project to improve antibiotic prescribing practices across acute care, ambulatory care, and long-term care facilities in the United States.
Nov 13 AHRQ toolkit


New York names hospitals, nursing homes with Candida auris cases

New York has become the first state to release the names of medical facilities that have treated patients with Candida auris, according to a report yesterday in the New York Times.

The list published by the Times includes 64 hospitals and 103 nursing homes (mostly concentrated in Manhattan, Brooklyn, and Queens) that have cared for patients who were either infected or colonized with the multidrug-resistant fungus. New York health officials told the paper they decided to release the names of the facilities to provide transparency to consumers and help curtail C auris, which has spread rapidly in healthcare settings in New York and other states since first being detected in the United States in 2016.

Of the 836 confirmed and probable C auris infections reported to the Centers for Disease Control and Prevention (CDC), 392 have been in New York, with 231 reported in Illinois and 159 in New Jersey. Ten other states have reported cases. An additional 1,624 US patients have been found to be colonized with C auris.

In its updated report on the antibiotic resistance threats in the United States, the CDC added C auris to the list of drug-resistant pathogens it considers to be urgent threats. The fungus has shown resistance to all three classes of antifungal medication, and more than 1 in 3 patients with invasive C auris infections dies.
Nov 13 New York Times story
Oct 29 CDC case count


Study finds antibiotic prescriptions have fallen by nearly a third in Finland

Antibiotic prescriptions have fallen by 29% in Finland over the past decade, according to a study commissioned by pharmaceutical company Pfizer.

Using health insurance data from Kela, the Finnish government agency in charge of social benefits, Pfizer researchers found that nearly 1 million fewer antibiotic prescriptions were filled in Finland in 2018 compared with 2008. Antibiotic prescribing for children ages 0 to 4 fell by 60%, while the number of antibiotic courses prescribed for children ages 5 to 7 fell by 43%. The smallest decline in antibiotic prescribing, 17%, was in adults over 65.

Pekka Honkannen, Emeritus Professor of General Medicine at the University of Oulu, notes in a translated Pfizer press release that the decline in antibiotic prescribing in children is likely linked to the inclusion of a pneumococcal vaccine in the country's national vaccination program.

Recent data from the European Centre for Disease Prevention and Control show that Finland has the ninth lowest antibiotic prescribing rate in Europe.
Nov 13 Pfizer press release

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