As part of South County Health's Centennial programs, an academic discussion entitled “Antibiotics: Past, Present and Future” was held at the University of Rhode Island College of Pharmacy. While antibiotics have greatly improved the treatment of potentially lethal infections, they can have serious side effects when unnecessarily or inappropriately prescribed. The colloquium, held on March 14, was sponsored by the University of Rhode Island.
The event featured several of the state’s leading experts on antibiotics and infectious diseases, including remarks by Barry Wepman, MD, and Fredric Silverblatt, MD, Infectious Disease Specialist, from South County Health.
The topics and speakers at the colloquium were:
• “What a difference a century makes… or does it?” presented by John R. Lonks, MD (Director, Inpatient Infectious Diseases Consult Service, Hospital Epidemiologist, The Miriam Hospital; Associate Professor of Medicine, Brown University Alpert School of Medicine)
• “Antimicrobial Stewardship: Primum Non Nocere” presented by Cheston B. Cunha, MD (Medical Director, Antimicrobial Stewardship Program, Rhode Island Hospital and The Miriam Hospital; Assistant Professor of Medicine, Brown University Alpert School of Medicine)
• “Resistance Roundup: How to lasso the little buggers!” presented by Jerome M. Larkin, MD (Director, Inpatient Infectious Diseases Consultation Service, Rhode Island Hospital; Assistant Professor of Medicine, Brown University Alpert School of Medicine)
Antibiotic use has become a topic of discussion among healthcare providers. Many hospitals have formed Antibiotic Stewardship Programs to bring together multiple medical disciplines to improve how and when antibiotics are used. Dr. Silverblatt leads the Antibiotic Stewardship Program at South County Health.
“For all hospitals, improved use of antibiotics is an important patient safety initiative,” Dr. Silverblatt said.
At South County Hospital, there are numerous ongoing initiatives underway as part of the stewardship program. Along with Dr. Silverblatt, the South County Health Antibiotic Stewardship efforts involve Joshua Guerin (Director of Pharmacy), Jacqueline Costantino (Pharmacy Team Leader), Andrew Ross (Antimicrobial Stewardship Pharmacist), Christine Duffy (Pharmacist), Dave Krok (Pharmacy Resident), Kerry Baeder (Pharmacy Resident), Melissa Fleck (Microbiology Lab), Stephanie Parente (Infection Prevention), Christine Davis (Infection Prevention), and Lee Ann Quinn (Infection Prevention/Professional Development).
South County is one of only two hospitals in Rhode Island which voluntarily reports all its antimicrobial use to the Centers for Disease Control on a monthly basis.
The data, which is used for performance improvement, suggests South County is performing well compared to similar hospitals in terms of size and acuity.
Among the initiatives underway at South County Hospital are:
• An automatic, pharmacy-driven conversion program where medications that work equally well given orally as intravenously can automatically be switched to the oral route where appropriate.
• A policy which lists “restricted” antibiotics, which must be approved by the Infectious Diseases Department or the pharmacy. Providers must indicate the type of infection they are treating as part of the ordering process for these drugs.
• A collaborative effort led by the pharmacy team to de-escalate and discontinue therapies when they are no longer indicated or as microbiology results return. This allows the team to narrow the spectrum of drug we use.
• Ongoing staff education including a recent presentation by Dr. Silverblatt on the role of nursing in antimicrobial stewardship, a presentation to our orthopedic team on antimicrobial stewardship considerations on the management of post-operative infections, and an upcoming presentation to Express Care providers.
• An antimicrobial stewardship elective which gives interested pharmacy residents the opportunity to work directly with Dr. Silverblatt and the pharmacy team to learn the key administrative components of stewardship programs and important clinical considerations for the treatment of individual patients.