VA stewardship program reduces antibiotic use, C. diff infections, study shows

The Veterans Health Administration's Antimicrobial Stewardship Initiative led to a 12 percent decrease in overall antibiotic use and reduced readmissions, mortality and Clostridium difficile infections, according to a study in Infection Control & Hospital Epidemiology.

The VHA started the initiative in 2010, holding in-person educational conferences, supporting champions, creating online resources and hosting monthly webinars. By 2014, the VA published Directive 1031, which requires all VA facilities to implement, maintain and evaluate an antimicrobial stewardship program, according to Medical Xpress.

By 2015, 92 percent of facilities had written stewardship policies in place, according to the study. The VHA allowed for an a la carte approach to these programs, allowing facilities to include varied, but evidence-based, practices depending on what worked for them.

"One of the key findings of this report is that a 'one-size-fits-all' strategy to implementation of an antimicrobial stewardship program is not necessary to assure success," Allison Kelly, MD, manager of the VHA's National Antimicrobial Stewardship Initiative, told Medical Xpress.

These programs led to a 12 percent decrease in antibiotic use from 2010 through the first quarter of 2015. The VHA also reported decreasing readmission and mortality rates and fewer C. diff infections, which the study attributed to the stewardship programs.

"The VHA has shown that improving antimicrobial usage in a large healthcare system may be achieved through national guidance and resources with local implementation of antimicrobial stewardship programs," the study concludes.

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