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Changing the way we use antibiotics

Posted Jan 22nd, 2014

The Niagara Health System is taking an aggressive approach with the use of antibiotics to treat patients and improve quality of care.

“Good hand hygiene and facility cleaning are two key infection prevention and control strategies,” says Dr. Jeff Powis, an infectious diseases expert. “However, the other side of the coin is the need to tackle the antibiotics prescribed to patients to ensure they are absolutely necessary.”

We are building the Cadillac of stewardship programs, a program that is far above what the standards are in the province and far above what other hospitals are doing. — Dr. Jeff Powis

“The Niagara Health System is taking a leading role among hospitals in Ontario in advancing both of these areas simultaneously,” says Dr. Powis, who oversees the antimicrobial stewardship program at the NHS. “It’s the two-punch shot that is needed to knock down antibiotic-resistant micro-organisms like C. difficile. We have seen a lot of positive progress since implementing the antimicrobial stewardship program at the NHS.”

A risk benefit analysis is conducted of each patient case in which an antibiotic is prescribed. Key to an effective antimicrobial stewardship program is the use of antibiotics only when necessary and selecting the appropriate antibiotic at the right dose, frequency and duration to optimize patient outcomes.

“Limiting the use of antibiotics is key to minimizing the spread of infection in hospitals,” says Dr. Powis, who works hand in hand with physicians and pharmacists at the NHS.

 The antimicrobial stewardship program was introduced in the ICU in St. Catharines last fall and is expanding to other units at the NHS.

The goal is to reduce broad-spectrum antibiotic use by 30 per cent. This goal has been achieved in the ICU, and we will be expanding across the NHS over the next two years. Broad-spectrum antibiotics act against a wide range of bacteria, while more narrow-spectrum antibiotics are designed to target specific bugs.

“We are building the Cadillac of stewardship programs,” says Dr. Powis, “a program that is far above what the standards are in the province and far above what other hospitals are doing.”

Changing the way we use antibioticsFrom left, Dr. Jennifer Tsang, Dr. Jeff Powis and Pharmacist Gina Fleming in the ICU at the St. Catharines Site.

Niagara Health System