Antibiotic Use For Clinicians

The Infectious Diseases Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), and the Pediatric Infectious Diseases Society (PIDS) define Antibiotic Stewardship as “coordinated interventions designed to improve and measure the appropriate use of antibiotic agents by promoting the selection of the optimal antibiotic drug regimen including dosing, duration of therapy, and route of administration.”¹

• IDSA/SHEA Antibiotic Stewardship Guidelines

The Centers for Disease Control and Prevention (CDC) has designed Core Elements documents of Antibiotic Stewardship to assist hospitals (including critical access and small and rural hospitals), long term and post-acute care facilities, and outpatient practices in designing and implementing processes to improve antibiotic use.  These can be found on the following links:

• Core Elements of Hospital Antibiotic Stewardship Programs
• Core Elements of Antibiotic Stewardship for Nursing Homes
• Core Elements of Outpatient Antibiotic Stewardship
• Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals

Additionally, the National Quality Partners Playbook: Antibiotic Stewardship in Acute Care offers intervention options, practical guidance on implementing each core element, common barriers, and how to overcome them.

The Tennessee Department of Health tracks stewardship progress, in the form of core element achievement, through the National Healthcare Safety Network’s Annual Facility Survey.  Stewardship progress results from this survey can be found here:

• Antibiotic Stewardship Progress Dashboard (SITE UNDER CONSTRUCTION)

Tennessee has one of the highest rates of outpatient antibiotic prescribing across the nation, with 1,169 antibiotic prescriptions filled for 1,000 persons in 2016.  The state ranked as the sixth highest in the nation.

Source: https://www.cdc.gov/antibiotic-use/community/images/programs-measurement/Community-antibiotic-map-2016.jpg.  Accessed May 16, 2019.

Additional outpatient antibiotic use data can be accessed at the CDC’s Patient Safety Atlas here: CDC Patient Safety Atlas on Outpatient Antibiotic Use.

Clinical Treatment Recommendations and Guidelines

• CDC Adult Treatment Recommendations
• CDC Pediatric Treatment Recommendations
• CDC Preventing and Treating Bronchitis Document
• American Academy of Family Physicians (AAFP) Clinical Treatment Guidelines Landing Page
• Infectious Diseases Society of America (IDSA) Practice Guidelines Landing Page
• CDC Materials and References to Use with Your Patients

Other Educational Resources:

• CDC Training on Antibiotic Stewardship
• Stanford Antimicrobial Stewardship Online CME Courses
• CDC Resources on Appropriate Antibiotic Use for Inpatient and Outpatient Professionals
• Society of Infectious Diseases Pharmacists (SIDP) Antimicrobial Stewardship Certificate Programs
• Making a Difference in Infectious Diseases (MAD-ID) Antimicrobial Stewardship Programs

¹ Fishman N. Infect Control Hosp Epidemiol 2012; 33: 322–7.