In "Core Elements of Antibiotic Stewardship for Nursing Homes," the CDC pinpointed drug expertise, accountability, tracking, reporting, leadership commitment, action and education as the seven guidelines health institutions should follow to appropriately administer antibiotics.
CDC expert Dr. Nimalie Stone recently gave insight into the most egregious superbugs inside nursing homes.
"The urgent and serious antibiotic resistance (AR) threats in nursing homes are similar to those found in other health care settings," Stone told American Pharmacy via e-mail. "Among the major health care threats identified in the CDC’s 'AR Threat Report,' C. difficile and highly resistant gram-negative bacteria, such as Carbapenem-resistant Enterobacteriaceae, are major concerns in nursing homes."
The diarrheal infection caused by C. difficile (C. diff) is particularly bad for the elderly.
"Two out of every three health care-associated C. diff infection occurs in individuals aged 65 years or older as do more than 80 percent of the deaths associated with C. diff infection," Stone said. "More than 100,000 C. diff infections develop among residents of U.S. nursing homes each year, making C. diff infections among the most serious health care complications that affect the nursing home population."
Stone said the CDC created its guidelines in order to empower hospitals and nursing homes to provide optimal care to its patients.
"The guidance developed for nursing homes identified practical ways that the seven elements could be implemented in nursing homes based on input from nursing home provider organizations, clinicians who have supported efforts to improve antibiotic use in nursing homes and the examples of antibiotic stewardship in nursing homes described in the literature," Stone said. "These seven core elements represent the foundational pieces, which are key for the success in almost any quality improvement initiative, and hopefully will enable nursing homes to build upon their existing medication safety activities as they work to improve the way antibiotics are prescribed in these facilities."
The CDC isn't stopping its efforts at its report, however. Instead, it is also collaborating with additional departments across regions to present a consolidated defense against superbugs.
"In addition to promoting improved antibiotic use through the implementation of the Core Elements, the CDC is also supporting state and local health departments to engage nursing homes in regional efforts to reduce the spread of antibiotic resistant organisms," Stone said.
The CDC is stressing a coordinated approach among health care facilities as patients move from one setting to another.
"For example, several state health departments have convened prevention collaboratives, which bring hospitals and nursing homes together to talk about how to improve communication about antibiotic use and identify antibiotic resistance during care transitions," Stone said. "These coordinated efforts between health care providers have been shown to be more effective at preventing the spread of AR threats in communities compared with individual facilities working by themselves."