Antibiotic Awareness Week

       Antibiotic Awareness Week – November 18 – 24th 2022

Some may not think of an effective environmental hygiene program being part of Infection Prevention and Control and antibiotic stewardship.

But let’s exam how it is actually an integral part of both programs.

The CDC states that ~ 2.8 million antibiotic – resistant infections occur in the United States each year and more than 35,000 of these cases result in death.

CDC’s 7 core elements are the following: 1. Hospital Leadership Commitment, 2. Accountability, 3. Pharmacy Expertise (previously “Drug Expertise”), 4. Action, 5. Tracking, 6. Reporting, and 7. Education.

Three types of infections account for about half of all antibiotics given. These are lower respiratory tract infections which are community acquired, urinary tract infections and skin and soft tissue infections. All of which the environmental hygiene program would not impact.

But what about the other half? Last month we celebrated Infection Prevention week - Infection Prevention with Intention. Our focus on Infection Prevention engages not just Environmental Services to perform environmental hygiene but to engage all HCWs in the process of cleaning and disinfecting equipment that they have used between patients to reduce the risk of transmission.

There are several studies in which the data demonstrates that patients who were placed in a patient room that was last occupied by a  patient who had a multi-drug resistant organism (MDRO) that there is a greater risk that they would acquire that same pathogen. Up to 3.5 greater risk for resistant Acinetobacter. (Otter 2011) Effective environmental hygiene helps to reduce or eliminate that risk.

Studies by Alfa (2015) and Boyce (2017) demonstrated 20% -23% reductions of MRSA, VRE and CDI respectively with changes to the environmental hygiene program, which included implementation of validation of cleaning and a change in the disinfectant used.

Boyce’s article which was a prospective cluster controlled crossover trial showed results reflecting a reduction of the Defined Daily Dose (DDD) of antibiotics on the “intervention” unit which used an IHP wipe vs a dilutable Quat with a wipe   

As IP & C and AS programs review additional interventions to impact the use of antibiotics, assess the current EH program to identify how this department can bring increased value to both programs.