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Are You an Antibiotics Steward or Deadbeat?

By Philip Betbeze  
   November 20, 2015


Everyone understands that major brain surgery is highly risky. But the initial surgery was successful, which made what happened next especially cruel. I spoke to Albert the day following his first surgery. He was himself, he was feeling well, and he had just eaten a hamburger. He got to go home the next day.

The prognosis for him, at least in the short term, was excellent. Within a few days, however, he was back in the hospital with an abscess—an infection at the surgical site. He lasted two more days following emergency surgery to address that abscess. Then he was gone.

Granted, there's no guarantee my friend wouldn't have died eventually from the cancer. But we will never know. What we do know is that he certainly died sooner, and in more pain, than he would have had he simply elected not to have the surgery. Is that a choice people should have to make in 2015? A roll of the dice on whether to suffer with operable brain cancer rather than subject yourself to the not unlikely chance that you will contract a deadly infection from a surgery meant to heal?

If you're running a hospital or health system, your challenges are real and significant. Healthcare is being disrupted on all levels, and your top goal is keeping your organization healthy financially and strategizing a way forward to ensure its continued existence. You can't help the community if you can't keep your doors open.

All that makes it easier to shift this problem to the back burner and pay more attention to problems and challenges that may directly affect your health system's revenue, yet perhaps nothing else is such a chronic public health issue, and potentially involves your organization so directly.

So let's just state this plainly. If you're not paying attention to antibiotic stewardship, and actually doing something about it clinically, your promises that your health system is committed to improving the health of the community ring hollow.

Senior executives frequently tout improving the health of the community as one of their highest and most sacred goals—in fact the reason for their organization's existence. Yet evidence is overwhelming that overuse of antibiotics by physicians may be among the top threats to public health now and into the future.

Philip Betbeze is the senior leadership editor at HealthLeaders.

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