New guidelines aiming to reduce antibiotic resistance in hospitals call for shorter courses, and more targeted use of drugs for pneumonia.
Doctors should streamline treatment for hospital patients who develop pneumonia by targeting antibiotics to specific infections and offering a shorter course of treatment, according to new guidelines.
The Infectious Diseases Society of America and American Thoracic Society published the update of their 2005 guidelines in the July edition of the journal Clinical Infectious Diseases.
The previous guidelines called on doctors to adjust the length of antibiotic treatment based on the strain of bacterium causing the infection. The new guidelines call for treatment limits of seven days or fewer.
The panel notes that "newer evidence suggests that the shorter course of treatment does not reduce the benefits of therapy."
The guidelines apply to both hospital-acquired pneumonia and "ventilator-associated pneumonia." The groups estimate that these two conditions make up 20% to 25% of hospital-acquired infections, with 10% to 15% of those cases leading to death.
Targeting Pneumonia Treatment
Hospitals are urged to generate "antibiograms" to test the sensitivity of local bacterial strains to various antibiotics.
"We suggest that patients with suspected HAP (non-VAP) be treated according to the results of microbiologic studies performed on respiratory samples obtained noninvasively, rather than being treated empirically," the guidelines state.
The goal is to decrease the unnecessary use methicillin-resistant Staphylococcus aureus (MRSA) antibiotic treatment. The guidelines also call for "antibiotic de-escalation," where providers either discontinue antibiotics or switch to an agent that targets fewer strains.
The guidelines are voluntary, but rules proposed by the Centers for Medicare & Medicaid Services in June will require that hospitals have "antibiotic stewardship programs for the surveillance, prevention, and control of healthcare-associated infections."
In May, the National Quality Forum released an antibiotic "stewardship playbook" to help hospitals comply with Centers for Disease Control recommendations. Drug-resistant bacteria cause two million illnesses and 23,000 deaths annually, according to the CDC.