Division of Infectious Diseases

Nebraska Antimicrobial Stewardship Summit: A Step Forward in Fighting Antibiotic Resistance

The CDC estimates 30% of all antibiotics prescribed in outpatient setting in the US are unnecessary. Similarly 30% of antibiotics used in hospitals are estimated to be unnecessary or incorrectly prescribed. Inappropriate antibiotic prescribing in long-term care facilities have been found to be even higher in some studies (up to 75%). Improving antibiotic use is essential in the fight against antibiotic resistance. In the US,… Continue Reading

ID Journal Club Presents… Molecular Rapid Diagnostic Tests Improve Clinical Outcome

Bloodstream infections are associated with high mortality.  Blood cultures are a reliable and accurate method for the identification of bloodstream infections but can take up to 5 days or even more being finalized, leading to delays in initiation of effective antibiotic therapy. The Infectious Disease Society of America (IDSA) recommends the use of rapid diagnostic testing with support of antimicrobial stewardship for better clinical outcomes,… Continue Reading

Antimicrobial Stewardship Program Takes Patient Safety Personally

At Nebraska Medicine, our Antimicrobial Stewardship Program’s (ASP) clinical mission is to optimize the utilization of antimicrobial agents, thereby improving patient outcomes (by reducing the risk of adverse events and Clostridium difficile infection) and limiting the spread of antimicrobial resistance.   These Antimicrobial Stewardship activities have been mandated by the Joint Commission and our program has been expanding its reach to include our satellite hospitals and… Continue Reading

Stewardship-driven Ertapenem Restriction: Can Reduced Utilization Affect the Antibiogram?

In this article review we learn about the impact of a large-scale, multi-institutional Antimicrobial Stewardship Intervention on significantly reducing the overall use of ertapenem without subsequent downstream effect on carbapenem-resistant Enterobacteriaceae (CRE) non-susceptibility patterns. Delgado A, Gawrys GW, Duhon BM, Lee GC (2017). Impact of an Antimicrobial Stewardship Initiative on Ertapenem Use and Carbapenem Susceptibilities at Four Community Hospitals. J Infect Dis Ther 5: 341…. Continue Reading

At Nebraska Medicine, we are proud to Be Antibiotics Aware!

At Nebraska Medicine, we have been supporting Antimicrobial Stewardship activities for over a decade, and we are proud to Be Antibiotics Aware. The CDC has recognized our efforts by including the Nebraska Medicine Stewardship Program as an example for other institutions to model. We have recently partnered with the state of Nebraska to promote these activities at the state level through the Nebraska Antimicrobial Stewardship Assessment and… Continue Reading

Be Antibiotics Aware…in the Outpatient Clinics

Nebraska Medicine and Antimicrobial Stewardship in the Outpatient Setting Antimicrobial stewardship is not only about inpatient prescribing. Recent studies measuring antibiotic use in ambulatory settings have estimated that antibiotics are prescribed inappropriately 30-77% of visits(1).  Despite being one of the leaders in implementing antimicrobial stewardship in hospitals, Nebraska ranks 44th (out of 50 states and District of Columbia) in outpatient antibiotic prescriptions dispensed. The practice of inappropriate antibiotic… Continue Reading

Be Antibiotics Aware…in Small and Critical Access Hospitals

In 2014, the CDC published The Core Elements of Hospital Antibiotic Stewardship Programs to assist acute care facilities implement antimicrobial stewardship program (ASP).  While these efforts were relatively successful in hospitals with more than 50 beds, they were less successful in hospitals with 25 beds or less.  In response to this disparity based on hospital size, the CDC published The Implementation of Antibiotic Stewardship Core… Continue Reading