Académique Documents
Professionnel Documents
Culture Documents
Disclosures
Served on scientific Advisory Boards for Pfizer and Cubist Currently serve on the speakers bureau for Astellas Pharma and Forest Labs
Objectives
Describe the origins of Antimicrobial Stewardship Discuss the core and supplemental strategies for an effective Antimicrobial Stewardship Program Recall the California Antimicrobial Stewardship Program Initiative Discuss how the California Initiative can affect healthcare nationwide
It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the bodythere is the danger that the ignorant man may easily under-dose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.
-Alexander Fleming, Nobel prize lecture, 1945
Bad Bad Bugs, Bugs, No No Drugs. Drugs. IDSA. IDSA. July July 2004 2004
Meanwhile, in California
California Senate Bill 739 (Health & Safety Code 1288.5 to 1288.9 [2006])
What is SB 739?
By 1/1/2008, California Department of Public Health (CDPH) required that all general acute care hospitals
evaluate their antibiotic use create an oversight committee to monitor responsibilities for this issue
CDPH responsible for implementing a program for the statewide surveillance and prevention of HAI in acute care
California Senate Bill 739 (Health & Safety Code 1288.5 to 1288.9 [2006])
US Department of Commerce
Presented on 6/9/10 by Brad Spelberg, MD, FIDSA to the House Committee on Energy and Commerce Subcommittee on Health
www.idsociety.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=16656
Participating institutions
Community Hospital, Tallassee, AL Centerpoint Medical Center, Independence, MO Rogue Valley Medical Center, Medford, OR St. Francis Medical Center, Peoria, IL Seton Medical Center, Austin, TX The Reading Hospital and Medical Center, West Reading, PA Ronald Reagan UCLA Medical Center, Los Angeles, CA WellStar Cobb Hospital, Austell, GA.
CDC Get Smart for Healthcare. www.cdc.gov/getsmart/healthcare/learn-from-others/resources/index.html
Addressed possibility of mandating ASP for participation in CMS reimbursement Considered a good idea
Summary
Multi-drug resistant pathogens are becoming more common everywhere New antibiotics with novel mechanisms of action are not being produced by Big Pharma Antibiotic stewardship is meant to optimize the use of antibiotics, not to police them California SB 739, CASPI can help kick-start national legislation of ASP as a requirement for participation in CMS reimbursement We all need to do our part in the responsible prescribing of antibiotics; it effects all of us
"The last decade has seen the inexorable proliferation of a host of antibiotic resistant bacteria, or bad bugs, not just MRSA, but other insidious players as well. ...For these bacteria, the pipeline of new antibiotics is verging on empty. 'What do you do when you're faced with an infection, with a very sick patient, and you get a lab report back and every single drug is listed as resistant?' asked Dr. Fred Tenover of the Centers for Disease Control and Prevention (CDC). 'This is a major blooming public health crisis.'
Science magazine; July 18, 2008
Questions?