Growth of antibiotic resistance: a Becker’s 2017 Top 10 Patient Safety Issue

N.B. — This post is one in a series of ten, based on Becker’s Infection Control & Clinical Quality article 10 top patient safety issues for 2017 by Heather Punke & Brian Zimmerman and published on January 18, 2017 (

Growth of antibiotic resistance. Bacteria and fungi continue to grow more resistant to antimicrobials, even last-resort antibiotics like carbapenem and colistin. CDC Director Tom Frieden, MD, told The Washington Post in May that ‘the end of the road isn’t very far away for antibiotics — that we may be in a situation where we have patients in our intensive care units, or patients getting urinary tract infections for which we do not have antibiotics.’

Hospitals can do their part to stymie the growth of antibiotic resistance by implementing antibiotic stewardship programs. The CDC [the U.S. Federal Centers for Disease Control and Prevention] and the National Quality Forum released ‘Antibiotic Stewardship in Acute Care: A Practical Playbook,’ in May to help hospitals set up such programs, which are so vital to stopping the growth of antibiotic resistance that the Joint Commission added an antimicrobial stewardship standard to its accreditation process for 2017.”

The foregoing quote from the from the Becker’s Infection Control & Clinical Quality e-publication cited above encourages hospitals to “… to stymie the growth of antibiotic resistance by implementing antibiotic stewardship programs.” The CDC-prescribed Program includes the following “Core Elements of Hospital Antibiotic Stewardship Programs” (re p, 4,

“• Leadership Commitment: Dedicating necessary human, financial and information technology resources.
• Accountability: Appointing a single leader responsible for program outcomes. Experience with successful programs show that a physician leader is effective.
• Drug Expertise: Appointing a single pharmacist leader responsible for working to improve antibiotic use.
• Action: Implementing at least one recommended action, such as systemic evaluation of ongoing treatment need after a set period of initial treatment (i.e. “antibiotic time out” after 48 hours).
• Tracking: Monitoring antibiotic prescribing and resistance patterns.
• Reporting: Regular reporting information on antibiotic use and resistance to doctors, nurses and relevant staff.
• Education: Educating clinicians about resistance and optimal prescribing.”

An IT solution compliant with the Cloud Healthcare Appliance Real-Time Solution as a Service Reference Architecture (CHARTSaaS RA) can facilitate implementation of many  of these “core elements” or implement them completely for continuous and reliably repeating execution. The “Action,” “Tracking” and “Reporting elements are particularly important examples. Please validate this proposition to your own satisfaction by reviewing the details of CHARTSaaS and the CHARTSaaS RA by reviewing these presentations, and then by imagining a CHARTSaaS-enabled IT solution:

Healthcare providers and their patients will benefit significantly from appreciating and then applying a CHARTSaaS RA-compliant IT solution. To do so will mitigate medical mistakes (currently the  third leading cause of patient deaths, per Makaray and Daniel,, thereby minimizing  patient adverse events; and also will optimize clinical case outcomes while maximizing the cost-effectiveness of care and treatment and accelerating the accrual of medical knowledge.


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