Effective antibiotic stewardship in spinal cord injury: Challenges and a way forward

Felicia Skelton; Katie Suda; Charlesnika Evans; Barbara Trautner

doi:10.1080/10790268.2017.1396183

Effective antibiotic stewardship in spinal cord injury: Challenges and a way forward

Felicia Skelton^*, Katie Suda, Charlesnika Evans, Barbara Trautner

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Context: Antibiotic stewardship, defined as a multidisciplinary program to reduce the misuse of antibiotics, and in turn, antibiotic resistance, is a high priority. Persons with spinal cord injury/disorder (SCI/D) are vulnerable to receiving multiple courses of antibiotics over their lifetime given frequent healthcare exposure, and have high rates of bacterial infection with multi-drug resistant organisms. Additional challenges to evaluating appropriate use of antibiotics in this population include bacterial colonization in the urine and the differences in the presenting signs and symptoms of infection. Therefore, Veterans Health Administration (VHA) facilities with SCI/D centers need effective antibiotic stewardship programs. Results: We analyzed the results of a 2012 VHA-wide survey evaluating available antibiotic stewardship resources, and compared the resources present at facilities with SCI/D (n=23) versus non-SCI/D facilities (n=107). VHA facilities with SCI/D centers are more likely to have components of an antibiotic stewardship program that have led to reduced antibiotic use in previous studies. They are also more likely to have personnel with infectious diseases training. Conclusion: VHA facilities with SCI/D centers have the resources needed for antibiotic stewardship. The next step will be to determine how to implement effective antibiotic stewardship tailored for this patient care setting.

Original language	English (US)
Pages (from-to)	251-254
Number of pages	4
Journal	Journal of Spinal Cord Medicine
Volume	42
Issue number	2
DOIs	https://doi.org/10.1080/10790268.2017.1396183
State	Published - Mar 4 2019

Funding

Funding This work was supported by Drs. Skelton and Trautner are supported with resources and use of facilities at the IQuESt center (CIN13–413); Dr. Evans is supported by VA QUERI grant SCI 98-001 and VA HSR&D Presidential Early Career Award for Scientists and Engineers Grant (USA 12-564). We would like to thank the VA Healthcare Analysis and Information Group for generously providing our team access to the raw data analyzed for this manuscript. The opinions expressed are those of the authors and do not represent the VA or the US government.

Keywords

Antibiotic resistance
Antibiotic stewardship
Antimicrobial stewardship
SCI
Spinal cord injury

ASJC Scopus subject areas

Clinical Neurology

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10.1080/10790268.2017.1396183

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title = "Effective antibiotic stewardship in spinal cord injury: Challenges and a way forward",

abstract = "Context: Antibiotic stewardship, defined as a multidisciplinary program to reduce the misuse of antibiotics, and in turn, antibiotic resistance, is a high priority. Persons with spinal cord injury/disorder (SCI/D) are vulnerable to receiving multiple courses of antibiotics over their lifetime given frequent healthcare exposure, and have high rates of bacterial infection with multi-drug resistant organisms. Additional challenges to evaluating appropriate use of antibiotics in this population include bacterial colonization in the urine and the differences in the presenting signs and symptoms of infection. Therefore, Veterans Health Administration (VHA) facilities with SCI/D centers need effective antibiotic stewardship programs. Results: We analyzed the results of a 2012 VHA-wide survey evaluating available antibiotic stewardship resources, and compared the resources present at facilities with SCI/D (n=23) versus non-SCI/D facilities (n=107). VHA facilities with SCI/D centers are more likely to have components of an antibiotic stewardship program that have led to reduced antibiotic use in previous studies. They are also more likely to have personnel with infectious diseases training. Conclusion: VHA facilities with SCI/D centers have the resources needed for antibiotic stewardship. The next step will be to determine how to implement effective antibiotic stewardship tailored for this patient care setting.",

keywords = "Antibiotic resistance, Antibiotic stewardship, Antimicrobial stewardship, SCI, Spinal cord injury",

author = "Felicia Skelton and Katie Suda and Charlesnika Evans and Barbara Trautner",

note = "Funding Information: Funding This work was supported by Drs. Skelton and Trautner are supported with resources and use of facilities at the IQuESt center (CIN13–413); Dr. Evans is supported by VA QUERI grant SCI 98-001 and VA HSR&D Presidential Early Career Award for Scientists and Engineers Grant (USA 12-564). Funding Information: We would like to thank the VA Healthcare Analysis and Information Group for generously providing our team access to the raw data analyzed for this manuscript. The opinions expressed are those of the authors and do not represent the VA or the US government. Publisher Copyright: {\textcopyright}, {\textcopyright} 2018 This work was authored as part of the Contributor's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 USC. 105, no copyright protection is available for such works under US Law.",

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AU - Evans, Charlesnika

AU - Trautner, Barbara

N1 - Funding Information: Funding This work was supported by Drs. Skelton and Trautner are supported with resources and use of facilities at the IQuESt center (CIN13–413); Dr. Evans is supported by VA QUERI grant SCI 98-001 and VA HSR&D Presidential Early Career Award for Scientists and Engineers Grant (USA 12-564). Funding Information: We would like to thank the VA Healthcare Analysis and Information Group for generously providing our team access to the raw data analyzed for this manuscript. The opinions expressed are those of the authors and do not represent the VA or the US government. Publisher Copyright: ©, © 2018 This work was authored as part of the Contributor's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 USC. 105, no copyright protection is available for such works under US Law.

PY - 2019/3/4

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N2 - Context: Antibiotic stewardship, defined as a multidisciplinary program to reduce the misuse of antibiotics, and in turn, antibiotic resistance, is a high priority. Persons with spinal cord injury/disorder (SCI/D) are vulnerable to receiving multiple courses of antibiotics over their lifetime given frequent healthcare exposure, and have high rates of bacterial infection with multi-drug resistant organisms. Additional challenges to evaluating appropriate use of antibiotics in this population include bacterial colonization in the urine and the differences in the presenting signs and symptoms of infection. Therefore, Veterans Health Administration (VHA) facilities with SCI/D centers need effective antibiotic stewardship programs. Results: We analyzed the results of a 2012 VHA-wide survey evaluating available antibiotic stewardship resources, and compared the resources present at facilities with SCI/D (n=23) versus non-SCI/D facilities (n=107). VHA facilities with SCI/D centers are more likely to have components of an antibiotic stewardship program that have led to reduced antibiotic use in previous studies. They are also more likely to have personnel with infectious diseases training. Conclusion: VHA facilities with SCI/D centers have the resources needed for antibiotic stewardship. The next step will be to determine how to implement effective antibiotic stewardship tailored for this patient care setting.

AB - Context: Antibiotic stewardship, defined as a multidisciplinary program to reduce the misuse of antibiotics, and in turn, antibiotic resistance, is a high priority. Persons with spinal cord injury/disorder (SCI/D) are vulnerable to receiving multiple courses of antibiotics over their lifetime given frequent healthcare exposure, and have high rates of bacterial infection with multi-drug resistant organisms. Additional challenges to evaluating appropriate use of antibiotics in this population include bacterial colonization in the urine and the differences in the presenting signs and symptoms of infection. Therefore, Veterans Health Administration (VHA) facilities with SCI/D centers need effective antibiotic stewardship programs. Results: We analyzed the results of a 2012 VHA-wide survey evaluating available antibiotic stewardship resources, and compared the resources present at facilities with SCI/D (n=23) versus non-SCI/D facilities (n=107). VHA facilities with SCI/D centers are more likely to have components of an antibiotic stewardship program that have led to reduced antibiotic use in previous studies. They are also more likely to have personnel with infectious diseases training. Conclusion: VHA facilities with SCI/D centers have the resources needed for antibiotic stewardship. The next step will be to determine how to implement effective antibiotic stewardship tailored for this patient care setting.

KW - Antibiotic resistance

KW - Antibiotic stewardship

KW - Antimicrobial stewardship

KW - SCI

KW - Spinal cord injury

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Effective antibiotic stewardship in spinal cord injury: Challenges and a way forward

Abstract

Funding

Keywords

ASJC Scopus subject areas

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