The administration of approved antifungals via unapproved formulations or administration routes (such as aerosol, direct injection, irrigation, topical formulation and antifungal-impregnated orthopedic beads or cement) may be resorted to in an attempt to optimize drug exposure while minimizing toxicities and/or drug interactions associated with conventional (systemic) administrations. Existing data regarding such administrations are mostly restricted to uncontrolled case reports of patients with diseases refractory to conventional therapies.
The impact of the U.S. Centers for Medicare and Medicaid Services (CMS) Severe Sepsis and Septic Shock: Management Bundle (SEP-1) Core Measure on overall antibacterial utilization is unknown. Our team took a look at all adult patients admitted to 26 DASON hospitals within a specified time frame to analyze antibacterial utilization.
Announcement and implementation of the CMS SEP-1 process measure was associated with increased diagnosis of sepsis and antibacterial utilization and decreased mortality among hospitalized patients.
In 2019, DASON hosted a group from Oxford University Research Unit in Ha Noi, Vietnam who were in the process of developing antimicrobial stewardship programs for their local hospitals. After spending some time here with us at Duke, Drs. Libby Dodds Ashley and Dev Anderson have continued to assist them in this process over the last few years.
DASON and ASET faculty/staff took a look at the impact of antibiotic stewardship round in the intensive care setting.
The impact of an effective antimicrobial stewardship on patient safety, better patient outcomes, hospital costs, and reducing antimicrobial resistance are enormous.
The resources and support we have received from DASON have allowed us to move projects forward in our antimicrobial stewardship efforts much more quickly and effectively than we could ever have done on our own.