By Wayne A Mathews, MS, PA-C, DFAAPA
UNMC will observe Get Smart with Antibiotics Week November 14-20, 2016, an annual observance to raise awareness of antibiotic resistance and the importance of appropriate antibiotic prescribing and use.
Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die as a direct result of these infections. Many more people die from other conditions that were complicated by an antibiotic-resistant infection.
UNMC is committed both to the prudent stewardship of antibiotic use, and to research to develop new antibiotics for resistant infections. The use of antibiotics is the single most important factor leading to antibiotic resistance around the world.
Antibiotics are among the most commonly prescribed drugs used in human medicine; however, up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed. Antibiotics are also commonly used for promoting growth in livestock, which allows bacteria to develop new resistances through constant exposure to antibiotics.
One way UNMC and Nebraska Medicine have approached this problem is through the use of a mobile smart phone app that puts the program’s clinical guidelines, protocols, and dosing adjustments for antimicrobial use into a clinician’s hands using the AgileMD platform.
“The app is aimed at any treating clinician — physicians, nurse practitioners, PAs — and it’s designed to take what’s on our website and put it on a handheld device in an easy-to-use format,” said Trevor VanSchooneveld, M.D., assistant professor of infectious diseases and medical director of Nebraska Medicine’s Antimicrobial Stewardship Program.
Another approach to preventing antibiotic resistance is a ‘One Health’ or ‘System Science’ approach. This involves an interdisciplinary team, which may consist of microbiologists, infectious disease clinicians, animal science practitioners, epidemiologists, and engineers to analyze the ecological factors of the entire environment, including food production, which may contribute to antibiotic resistance.
On October 28, various teams of researchers from the Nebraska university campuses from UNMC, UNO, UNL, and UNK convened at the UNL Innovation campus to develop ‘System Science’ teams to research and solve large-scale problems, such as antibiotic resistance.
There are three reasons antibiotic prescribing guidelines may not be followed: belief that non-recommended antibiotics are a better option, concern for patient satisfaction, and fear of infection complications. Effective antibiotic stewardship programs assist in guiding clinicians in overcoming these obstacles.
According to Wayne Mathews, MS, PA-C, associate professor in the College of Allied Health Professions Physician Assistant program, more of this guidance and support needs to occur in the outpatient setting, where 70% of antibiotics for human use are prescribed.