The antibiotic stewardship program at Blount Memorial Hospital is in its twelfth year and was the first formal program of its kind in this area. Antibiotic stewardship ensures a patient receives the best antibiotic possible, in the appropriate dose, at the appropriate time. This program is a combination of education, rapid diagnostic testing and advanced technology to get each patient the best antibiotic with the lowest risk of side effects, ultimately reducing time spent in the hospital and reducing cost to the patient.
“We noticed in 2010 that organisms were becoming more resistant, and we were looking into how to change that,” said pharmacist Brad Crane, who specializes in infectious disease and is the director of Blount Memorial’s antibiotic stewardship program. “The trend we are seeing now is that organisms are less resistant. We are reversing that trend and that is due to this antibiotic stewardship program,” Crane added.
One example is Clostridiodes difficile, or C. diff, which is a serious, life-threatening type of diarrhea. “We hardly see C. diff anymore because we stopped using a key antibiotic class that increased the risk of it, involved our infection control team and brought new technology into the microbiology department,” Crane said. One aspect of this is rapid diagnostic testing, or RDT. “RDT gives key information needed to put people on the right antibiotics, if any antibiotics are even needed,” Crane added. Before RDT, it often took a couple of days to figure out which organisms were causing the problem or infection. Now, it can take as little as 20 seconds – or even less. The prescribers and pharmacy staff then can quickly determine which antibiotic is best to use to attack that organism specifically.
Advanced technology in the pharmacy has continued to evolve, as well. “In the last two years, we’ve added real-time notification,” Crane said. “As soon as microbiology puts information gathered from testing and labs into the system, the pharmacy is notified. We immediately start to match the right antibiotic to the right condition or infection. The pharmacy then notifies the treating physician,” Crane added.
Blount Memorial chief medical officer Dr. Jane Souther notes how this program has been a benefit to both physicians and patients. “The antibiotic stewardship program has been an invaluable asset for our medical staff. Our collaboration with Brad Crane and other pharmacy staff in rapid identification of organisms, appropriate choice of antibiotics and as a resource for consultation when needed has significantly strengthened our ability to provide excellent care for our patients. As a result of the work of the antibiotic stewardship team, we are treating infections more effectively, leading to fewer complications and shorter hospital stays,” Souther said.
While all of this takes place within the hospital, there is a focus on the outpatient setting, as well, with pharmacists dedicated to continuing to advance antibiotic stewardship outside the hospital. “The transition of this team into the outpatient arena is so important as we work to prevent hospitalizations through early recognition and treatment of various infections. Providing quality care to our community is of utmost importance, and the efforts of the antibiotic stewardship program are an integral piece of that care,” Souther added.