Poor prescribing practices for antibiotics put patients at risk

Poor antibiotic prescribing practices are putting patients at risk for allergic reactions, super-resistant infections, and deadly diarrhea cause by Clostridiumdifficile, according to new report from the Centers for Disease Control and Prevention (CDC).

The CDC report said the inconsistent prescribing practices are also driving antibiotic resistance and that antibiotic prescribing practices need to be changed immediately.

According to the report:

• Antibiotic prescriptions to treat urinary tract infections and prescriptions for the drug vancomycin included a potential error about one-third of the time. Some patients are given drugs without proper testing or evaluation, and others were given drugs for too long.
• In some hospitals, antibiotics were prescribed three times as much as in other hospitals, even though patients were receiving similar care.
• A 30% reduction in the antibiotics most likely to cause C. difficile infections can reduce these deadly infections by more than 25%.  

To help hospitals improve in the area of antibiotic prescribing, CDC developed a checklist of core safety elements that each facility should have in place. CDC said every hospital should have an antibiotic stewardship program. That program should include the following elements:

• Leadership commitment. Dedicate the necessary human, financial, and IT resources.

• Accountability. Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.

• Drug expertise. Appoint a single pharmacist leader to support improved prescribing.

• Action. Take at least 1 action to improve prescribing. For example, implement a universal reassessment within 48 hours to double-check drug choice, dose, and duration.

• Track. Monitor antibiotic prescribing and resistance patterns.

• Report. Regularly report to staff on antibiotic prescribing and resistance information and what can be done to improve.

• Educate. Offer education about antibiotic resistance and best prescribing practice.