CDC Vital Signs: Antibiotic Prescribing in Hospitals

CDC’s March VitalSigns highlighted the effect poor prescribing habits can have on the ability to protect patients from unnecessary risk and preserve the power of antibiotics. The report found that approximately one-third of the time, prescribing practices to treat urinary tract infections and prescriptions for vancomycin included a potential error – given without proper testing or evaluation, or given for too long. In addition to the potential errors, prescribing practices vary widely between hospitals and doctors within a hospital. According to CDC, doctors in some hospitals prescribed 3 times as many antibiotics as doctors in other hospitals.

CDC estimates that reducing the use of high-risk antibiotics by 30% can lower C. difficile infections by 26%. CDC recommends that hospitals have an antibiotic stewardship program in place to reduce instances of inappropriate antibiotic prescribing.

The release of the March Vital Signs coincides with CDC’s announcement of a new antibiotic resistance initiative, that will focus on the four core actions called for in CDC’s Antibiotic Resistance Threat Report: detection of antibiotic resistance; response to outbreaks; prevention of infections; discovery of new antibiotics and diagnostic tests for resistance. The initiative aims to reduce the threats of seven antibiotic resistant organisms, including carbapenem-resistant Enterobacteriaceae (CRE), by improving detection through regional laboratories and strengthening antibiotic prescribing practices.

CDC recommends that hospitals institute an antibiotic stewardship program that includes:

•Leadership commitment

•Accountability

•Drug expertise

•Taking at least one prescribing improvement action

•Tracking prescribing and antibiotic resistance patterns

•Regularly reporting to staff prescribing and antibiotic resistance patterns

•Education