Community hospital antibiotic use on a par with larger hospitals despite less complex patients

Rates of antibiotic use in small community hospitals are similar to those of large community hospitals and academic medical centers, according to a new study published in the journal Clinical Infectious Diseases.

For the study, researchers from Intermountain Medical Center and the University of Utah School of Medicine, both in Salt Lake City, analyzed monthly antibiotic use reports compiled from 2011 to 2013 at four large hospitals and 15 small community hospitals across the Intermountain Healthcare System. The median use rate for small community hospitals was 436 days of antibiotic therapy per 1,000 patient days. For the large hospitals, the average rate was 509 days of therapy per 1,000 patient days.

The comparable rates of antibiotic use may be cause for concern because larger hospitals tend to treat more complex patients and the small community hospitals examined in the study did not have antibiotic stewardship programs in play.

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"In order to holistically address the growing problem of antibiotic-resistant bacteria, the infectious disease community must respond to antibiotic use in all hospitals, not just the large academic medical facilities," said lead author Eddie Stenehjem, MD, an infectious disease physician and researcher at Intermountain Medical Center. "Small hospitals are least likely to have stewardship programs even though antibiotic usage patterns are similar to larger facilities. We need to bring stewardship support to all hospitals, but the challenges come in knowing how to do that."

Many small community hospitals have limited access to the resources necessary to build effective antimicrobial stewardship programs and meet the new national standards requiring all hospitals to have such programs in place by 2017.

More articles on antibiotic resistance: 
CDC adds $14M to fight against antibiotic resistance 
Researchers develop new device to test for antibiotic-resistant bacteria 
How hospitals code superbugs has big impact on bottom line

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