4 strategies for combating antibiotic resistance


Oscar Guzman, Pharm D, BCPS

Clinical Director
Infectious Disease and Clinical Care
Innovative Delivery Solutions
Cardinal Health

The Nov. 6, 2014 New England Journal of Medicine articleAntibiotic Resisance – Problems, Progress and Prospects, by doctors Carl Nathan and Otto Cars, highlights one of the biggest challenges faced by modern healthcare today: how to combat the growing threat of antibiotic resistance.

The Centers for Disease Control and Prevention (CDC) in the Department of Health and Human Services (HHS) estimates that at least 2 million illnesses and 23,000 deaths are caused, annually, by antibiotic-resistent bacteria in the United States alone.

The ‘golden age’ of antibiotics (from the 1930s to 1960s), when more than half of the drugs commonly used today were discovered, has long since come to an end. Clinical isolates of pathogenic bacterial species are becoming increasingly resistant to most antibiotics. And unfortunately, we have not kept pace with the development of new drugs to combat them.

The United States, many other countries and major world healthcare organizations have recognized this issue, and have formed partnerships aimed at improving awareness of antimicrobial misuse and the advancement of infection prevention efforts. Just this past September, the White House issued an executive order confirming a long-held belief of many clinicians…that “detecting, preventing, and controlling antibiotic resistance requires a strategic, coordinated, and sustained effort. It also depends on the engagement of governments, academia, industry, healthcare providers, the general public, and the agricultural community, as well as international partners.”

I believe that healthcare leaders across the continuum of care should leverage this recent executive order to catapult antimicrobial stewardship programs to top priority status on their health care agendas.

Nathan and Otto’s aforementioned research points out that as a whole, the healthcare industry still has significant room for improvement in several areas that are key to advancing antimicrobial stewardship. In future posts in this series, I’ll explore how clinicians and healthcare administrators can play important roles in this effort, particularly when it comes to:

  • Encouraging collaboration and engagement among clinicians;
  • Better using data analytics to combat antimicrobial resistance; and
  • Implementing strategies for conserving antibiotic use.

I believe that hospitals that implement these best practices will lay the groundwork for antimicrobial stewardship programs that can help preserve access to life-saving medications, reduce harm, drive down healthcare costs and ultimately save lives.