Antibiotic stewardship could cut readmissions for infection

Antibiotic stewardship programs guiding individual patient prescriptions could significantly cut readmission rates due to infection, according to research presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy, Medscape reports.

Researchers, led by Fredrik Resman, M.D., of Skåne University Hospital in Malmö, Sweden, analyzed a stewardship program for six months in 2013 in four geriatric wards, comparing the results to a control group in the previous year. During the program, an infectious disease expert visited the wards twice a week, spending about eight hours a week making treatment recommendations, according to the article.

Of the patients in the stewardship program, 781 received antibiotics, compared with 886 in the control group. Resman and his team found hospitals were less likely to readmit patients in the stewardship group for infections (4.5 percent versus 7.5 percent), according to the article. Researchers also found a 27 percent reduction in overall antibiotic use in the stewardship patients, particularly among broad-spectrum antibiotics.

"While geriatric patients are very vulnerable to severe infections, they often lack distinct clinical features of such infections, yet this study showed they were overusing antibiotics," Resman told Medscape. He added that the point of antibiotic stewardship programs is not simply antibiotic reduction, but about "improving antibiotic use for the patient. In some patients, we actually widened the treatment, but not in many."

He added that although stewardship programs reduce antibiotic use, their cost is too high to save providers money in the long-term, but acknowledged that providers in the U.S. may wish to prioritize their effect on readmission rates, he told Medscape.

A recent study from the Centers for Disease Control and Prevention found that nearly 80 percent of hospitals prescribe unnecessary or inappropriate antibiotics, threatening patient safety and running up more than $160 million in avoidable costs, FierceHealthcare previously reported.

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