FRITZ FRANCOIS, MD, CMO, Patient Safety Officer, Associate Professor of Medicine, NYU Langone Medical Center (New York City)
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“What we see right now as a major concern is the overuse of antibiotics. As a result, we have seen the incidence of multidrug-resistant organisms rising, and we’ve also lost tools traditionally used for these organisms. Our concern is that individuals might present with conditions associated with these resistant bacteria. We’re also thinking about the individuals who might harbor resistant organisms and have not yet shown any signs of disease.
We’re approaching it in several different ways under the umbrella of antibiotic stewardship — to better understand the pattern of use of antibiotics and educate our clinicians about what [medicine] would be most appropriate. We continue to study recommendations and guidelines about how long individuals should be exposed to antibiotics, and ask ourselves if it is possible that we could safely reduce that exposure.
On the hospital side, in our step-down unit, we are using molecular techniques to not only identify certain organisms but also the pattern of spread. We tie that with a specific processes to reduce the chance of transmission, and with that we have started to see some improvements.
On the outpatient side, we’re in the beginning phases of looking at the data to understand the use of antibiotics as well as the consequences [of using them] in various populations. We have done some very interesting research here at NYU Langone. We are interested in investigating the consequence of early antibiotic exposure on the lifecycle of an individual. We are asking questions around this issue knowing full well that we’ve seen a rise of a number of things, including allergies and obesity that may be associated with changes in the microbiome. The data might allow us to develop strategies to reduce the chance that these higher risk populations would develop significant health problems in the future.”
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