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Prestigious medical journal recommends new approach to treating drug-resistant bacteria, cites Mount Sinai Hospital’s successful program as a best practice

Prestigious medical journal recommends new approach to treating drug-resistant bacteria, cites Mount Sinai Hospital’s successful program as a best practice

Dr. Andrew Morris, Director of the Mount Sinai Hospital-University Health Network Antimicrobial Stewardship Program

Antimicrobial stewardship programs such as the program pioneered at Mount Sinai Hospital by Dr. Andrew Morris, staff physician and Director of the Mount Sinai Hospital-University Health Network Antimicrobial Stewardship Program (ASP) should be mandatory in all Intensive Care Units (ICU) according to an editorial published in November edition of the prestigious Critical Care journal.  

According to Critical Care, “The global spread of antimicrobial resistance has become a pressing problem.” The editorial goes on to say that “ASPs should be employed routinely in order to maximize the effectiveness of antibiotic therapy, not only for the infected patient but for all patients in the ICU environment.”

The editorial is based on a study published in the same journal conducted by Dr. Morris and his colleagues that focused on identifying appropriate antimicrobial treatments (such as antibiotics) to use in Intensive Care Units based on sterile or non-sterile samples.

The World Health Organization also recommends that one way of reducing antibiotic-resistant infections such as hospital-acquired infections is to ensure that infected patients who need antimicrobial therapy have access to quality medicines which conform to policy recommendations and standard treatment guidelines and to discourage the indiscriminate use of antimicrobials in patients unlikely to derive any benefit.

Since 2009, Mount Sinai Hospital’s ASP has been successful in ensuring that patients receive the right antimicrobials, only when they need them. The program engages the physicians, pharmacists and support staff from both Mount Sinai Hospital and UHN to optimize use of antimicrobials to patients in the ICU. Using the program in these hospitals has reduced the number of antibiotic-resistant infections, decreased the antimicrobial consumption by approximately 15% and reduced costs for these drugs by approximately 30%.

The Mount Sinai Hospital-developed ASP was recognized in 2011 as one of the Adopting Research to Improve Care projects by the Council of Academic Hospitals of Ontario and has been implemented in 12 academic hospitals across the province. In addition, the team has worked in partnership with Accreditation Canada to develop antimicrobial stewardship best practices as a Required Organizational Practice beginning in 2013.

Quote
“We know that when patients in the ICU are given the right antimicrobials at the right time, they have better outcomes and they have a reduced risk of developing a hospital-acquired infection. We are pleased that Critical Care has recognized our leadership in this field and are recommending that all hospitals develop antimicrobial stewardship programs.”
Dr. Andrew Morris, Director of the Mount Sinai Hospital-University Health Network Antimicrobial Stewardship Program

Quick Facts
• Patients in the intensive care units (ICU) are the sickest and most vulnerable patients in the hospital, and upwards of 70% of ICU patients are on antimicrobials at any one time.
• Based on the experience at Mount Sinai Hospital and University Health Network, it is anticipated that antimicrobial stewardship programs will reduce ICU antimicrobial use by 12-25% and will reduce ICU antimicrobial costs by 23-41%.

About Mount Sinai Hospital
Mount Sinai Hospital began almost 90 years ago as a small maternity and convalescent hospital. Today Mount Sinai stands tall and proud as an internationally recognized 472-bed academic health sciences centre affiliated with the University of Toronto, focused on delivering excellence in patient and family-centered care, innovative education and leading-edge research. Mount Sinai consistently demonstrates its commitment to excellence, compassion and improving the quality of health care in Canada through its Big Hearts and Bright Minds who are delivering the Best Medicine. For more information about Mount Sinai Hospital, please visit www.mountsinai.ca