Antimicrobial Stewardship Program helping to streamline antibiotic use in critically ill patients
Toronto, October 27, 2014
By Heather Brown
Dr. Linda Taggart, physician lead for the Antimicrobial Stewardship Program, reviews patient cases with clinicians from the Trauma and Neurosurgery Intensive Care Unit, to assist with optimizing their antibiotic therapy. (Photo by Katie Cooper)
Each weekday Dr. Linda Taggart, an infectious diseases physician, and Beth Leung, an antimicrobial stewardship pharmacist, meet with the physicians and pharmacists from the Trauma Neurosurgery and Medical Surgical Intensive Care Units to discuss each patient’s antibiotic treatment plan to determine whether it should be adjusted. Suggestions could include a dose increase or decrease, a change to a different antibiotic, or removal of an antibiotic altogether.
Dr. Taggart, the physician co-lead along with Beth Leung as the pharmacist co-lead for St. Michael’s Antimicrobial Stewardship Program, said studies have shown that up to 50 per cent of antibiotic use is inappropriate in some way. This may be because the prescribed antibiotic covers a wide variety of different bacteria instead of just the bacteria that needs to be treated, is given for a longer duration than needed or is not needed at all.
The program was created to optimize antibiotic use among patients in the Medical Surgical and Trauma Neurosurgery Intensive Care Units and help to reduce antibiotic resistance, which is becoming a growing issue across the globe. Another goal of the program is to help lower the hospital’s C. difficile infection rate, since antibiotic use is associated with increased rates of this type of infection.
“There is a time and place when antibiotic use is necessary,” said Dr. Taggart. “But we must ensure the antibiotic is being prescribed for the right reason, in the right dose, and for the right period of time.”
Antimicrobial stewardship programs are an important quality improvement and patient safety initiative, as well as required organization practice for Accreditation. Infections caused by antibiotic-resistant bacteria create challenges in the ability to appropriately treat infections, which can put a patient’s health further at risk and prolong their stay in the hospital.
“Studies have shown that up to 50 per cent of antibiotic use is inappropriate in some way. This may be because the prescribed antibiotic covers a wide variety of different bacteria instead of just the bacteria that needs to be treated, is given for a longer duration than needed or is not needed at all.”
The two intensive care units were chosen for this program first because many of their patients require multiple courses of antibiotics. These units were two of many academic ICUs across the province to begin this initiative with support from the Council of Academic Hospitals of Ontario. The Cardiovascular Intensive Care Unit will be the next area to be brought into the program later this year.
About St. Michael's Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.