Hospital fights antibiotic resistance with 'handshake stewardship'

Children's Hospital Colorado implements program that led to a 10.9 percent reduction in inpatient use of antibiotics form 2010 to 2014.

By Amy Wallace

April 17 (UPI) -- An antimicrobial stewardship program at Children's Hospital Colorado was shown to be effective at fighting antibiotic resistance.

The program is called handshake stewardship based on the personal contact, trust and sealing deals that society associates with handshakes. The handshake stewardship is different than other programs in that it lacks the restriction and pre-authorization found in other antimicrobial stewardship programs.


It also includes a daily pharmacist-physician review of every inpatient antibiotic prescription, including dosage, type of medication and type of infection. The handshake stewardship program involves daily rounding on inpatient floors by a pharmacist-physician team to monitor antibiotic usage and includes in-person advice to every unit using antibiotics.

"Very few hospitals have a medical doctor involved in the day-to-day running of this kind of program," Dr. Sarah Parker, a pediatric infectious disease physician and medical director of the Antimicrobial Stewardship Program at Children's Colorado, said in a press release.

"And very few programs review every single antibiotic prescription. However, the risks associated with antibiotics require that we find an effective way to limit their use. Not only do 30 percent of children who take antibiotics experience a side effect such as diarrhea, but antibiotics can also kill good bacteria in the body, which can lead to more serious illnesses down the line. And perhaps most compelling according to the CDC, more than 23,000 deaths and $20 billion in indirect health care costs are attributed to resistant bacteria in the United States each year."


Researchers measured antibiotic use hospitalwide and per unit before, during and after implementation of the handshake stewardship program between October 2010 and September 2014 and found that the handshake stewardship program led to a 10.3 percent decrease in antibacterial use hospitalwide.

There was also a 12.1 percent decrease in antifungal use and a 16.4 percent decrease in antiviral use hospitalwide.

"This type of stewardship also helps ensure the appropriate use of antibiotics -- that is, that they are only used when needed, and that they are given at the right dosage for the right duration of time," Parker said. "Ultimately, this leads to better patient outcomes."

The study was published in The Pediatric Infectious Disease Journal.

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