'Last resort' antibiotics use on the rise, study shows

Apr 03, 2011

A large, multi-year study of antibiotic use in Veterans Health Administration's acute care facilities demonstrates dramatically increased use of carbapenems, a powerful class of antibiotics, over the last five years. These drugs are often considered the last treatment option for severe infections with multi-drug resistant pathogens. The increased carbapenem use, which has also been described in non-VA facilities in the US, is alarming because carbapenem-resistant bacteria are becoming more common. Overuse of these drugs could weaken their efficacy, threatening their effectiveness against these and other emerging infections. The study was presented today at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA).

Using barcode medication administration (BCMA) data for antibiotics administered in 110 VA acute care health facilities from 2005-2009, Makoto Jones, MD, and colleagues identified an increasing trend in the use of broad spectrum antibiotics. In the study's five year period, researchers noted a gradual increase in overall antibiotic use, but striking increases in the use of carbapenems (102 percent increase), intravenous vancomycin (79 percent increase), and combinations of penicillin with beta-lactamase-inhibitors (41 percent increase). Fluoroquinolones were the most frequently used drugs across facilities, accounting for 20 percent of all antibiotic use.

"Use of these antibiotics helps the patient receiving the treatment, but has future consequences for innocent bystanders," said Jones. "The more these drugs are used, the more resistance we see." Additionally, the researchers noted that the quantity of antibiotics reported from VA facilities seems to be similar to reported data from non-VA hospitals in the US.

The use of BCMA to collect data of antibiotic use across VA facilities allowed researchers to analyze which antibiotics are given to any patient on any given day. Jones noted that patient-level data permit powerful studies of antibiotic effects that have not been possible to date. Overall, researchers noted that more than half of all patients received at least one dose of any antibiotic during their hospital stay, regardless of presenting condition.

"In this era of multi-drug resistant organisms, clinicians are placed in a difficult situation. As treatment outcomes of many bacterial infections are influenced by the timing of appropriate therapy, the increasing presence of resistant organisms triggers broader use of these powerful antibiotics for proven or suspected infections when treating patients in the hospital" said Steven Gordon, MD, president of SHEA. "Clinicians must always put the patient first in treatment decisions but we must empower effective antibiotic stewardship programs, infection prevention and control efforts, the development of new diagnostic testing to facilitate better treatment decisions as well as support development of new "

Among other measures antimicrobial stewardship ensures effective and appropriate use of the medications we have, with a focus on improving patient safety and treatment outcomes while slowing the growth of resistance. Use of individual level data can be used to inform both the basic science and the implementation of antimicrobial stewardship programs.

" studies in the U.S. are critical to understanding the basic science of how and why resistance is on the rise," said Gordon. "Dr. Jones' study is a clarion call for a need for better diagnostic tools to identify pathogens and resistance as implementation of effective antimicrobial stewardship."

Explore further: New treatment approved for rare form of hemophilia

Provided by Society for Healthcare Epidemiology of America

3 /5 (2 votes)
add to favorites email to friend print save as pdf

Related Stories

Antibiotic use increases at academic medical centers

Nov 10, 2008

Antibacterial drug use appears to have increased at academic medical centers between 2002 and 2006, driven primarily by greater use of broad-spectrum agents and the antibiotic vancomycin, according to a report in the Nov. ...

Antibiotics have long-term impacts on gut flora

Nov 01, 2010

Short courses of antibiotics can leave normal gut bacteria harbouring antibiotic resistance genes for up to two years after treatment, say scientists writing in the latest issue of Microbiology, published on 3 November.

Recommended for you

WHO: Millions of Ebola vaccine doses ready in 2015

14 hours ago

The World Health Organization says millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines will start being tested in March.

Added benefit of vedolizumab is not proven

Oct 23, 2014

Vedolizumab (trade name Entyvio) has been approved since May 2014 for patients with moderately to severely active Crohn disease or ulcerative colitis. In an early benefit assessment pursuant to the Act on the Reform of the ...

Seaweed menace may yield new medicines

Oct 22, 2014

An invasive seaweed clogging up British coasts could be a blessing in disguise. University of Greenwich scientists have won a cash award to turn it into valuable compounds which can lead to new, life-saving drugs.

User comments : 0