The Question

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The health and economic burden of resistance has not escaped the attention of federal legislators, who have proposed policies to slow the emergence and spread of resistance and resistant infections in communities, health care facilities, and food-producing animals. Bills introduced during the 2009–2010 session of Congress focused on three important strategies for curbing resistance: (1) encouraging judicious antibiotic use; (2) reducing hospital infections using public reporting programs; and (3) stimulating the development of new antibiotics (Table 1).

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Background

Knowledge of seasonal trends in hospital-associated infection incidence may improve surveillance and help guide the design and evaluation of infection prevention interventions. We estimated seasonal variation in the frequencies of inpatient bloodstream infections (BSIs) caused by common bacterial pathogens and examined associations of monthly BSI frequencies with ambient outdoor temperature, precipitation, and humidity levels.

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We show that respiratory fluoroquinolone use is extremely seasonal and that fluoroquinolone use is strongly associated with influenza. In our time series model, instantaneous influenza activity was a significant predictor of use ([Formula: see text]). Also, we estimated that reducing influenza activity by 20% would reduce prescriptions by 8%.

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Sales for a drug may be correlated with the prevalence of a condition treated by the drug. We found that state data revealed a strong spatial association and national data a strong temporal association between Clostridium difficile and oral vancomycin prescription sales, suggesting a new “signal” for detecting disease activity.

Objective: To describe the prevalence and characteristics of antimicrobial stewardship programs (ASPs) in hospitals across the United States and to describe financial support provided for these programs.

Design:  Electronic and paper 14-question survey of infectious diseases physician members of the Infectious Diseases Society of America Emerging Infections Network (IDSA EIN). Participants. All 1,044 IDSA EIN members who care for adult patients were invited to participate.

Inappropriate antibiotic prescribing in the United States is a common problem and imposes a significant cost on society in two ways. First, it increases the rate at which bacteria that are resistant to clinically important antibiotics emerge and spread both in hospitals and the community. And second, it comes in the way of the patient being treated for the true underlying cause of disease.