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IDSA Submits Comments on Joint Commission’s Antibiotic Stewardship Requirements

The Infectious Diseases Society of America has expressed support for several proposed revisions to The Joint Commission’s antibiotic stewardship requirements for hospitals, while also providing additional recommendations to ensure the changes align with the Society’s strategic priorities. IDSA’s comments were submitted via a survey hosted by The Joint Commission to ensure its revisions are aligned with federal recommendations and guidance from expert professional societies.

The Joint Commission’s proposed revisions include:

  • An increased focus on hospital allocation of staffing, financial and information technology resources to support stewardship.
  • Ensuring that multi-disciplinary stewardship teams are led by physicians or pharmacists.
  • An outline of specific duties of a stewardship program, including coordination of antibiotic use, implementation of strategies to optimize antibiotic prescribing, adherence to guidelines, documentation and reporting (including to the CDC National Healthcare Safety Network Antibiotic Use and Resistance Module), collaboration with hospital staff, training and education.

In its comments, IDSA emphasized strong support for efforts to ensure hospitals provide sufficient resources and staffing to antibiotic stewardship programs and recommends The Joint Commission provide greater specificity, such as recommended FTE according to hospital size, to support increased staffing. Studies have found consistent gaps between necessary levels of physician and pharmacist staffing and existing staffing levels. The COVID-19 pandemic has further stressed hospital budgets, diverting resources from stewardship programs despite the unprecedented need for stewardship to manage high levels of antibiotic use among hospitalized patients with COVID-19.

ID physician leadership of stewardship programs remains a high priority for IDSA, along with strong partnerships with ID trained pharmacists. IDSA noted in its comments that ID expertise can be provided through off-site contracting agreements to allow for additional flexibility when ID experts are not available on-site. Studies have indicated that well-trained leaders, specifically infectious diseases trained physicians and pharmacists, improve the outcomes of stewardship programs.

IDSA also highlighted the need to empower stewardship programs to implement the evidence-based protocols that will best address the local needs of their hospitals. Flexibility is also needed to allow stewardship programs to direct limited resources to the most beneficial activities without undue burden.

Hospital reporting to the CDC National Healthcare Safety Network Antibiotic Use and Resistance Module remains an important priority, as the data gathered will better inform our responses to antimicrobial resistance. However, IDSA emphasized that resources must be provided to hospitals to support reporting. In addition, IDSA recommends that NHSN should solicit feedback from prospective users and implement resulting recommendations to improve the functionality and usability of its Antibiotic Use and Resistance Module.

In addition to The Joint Commission’s efforts, IDSA will continue its own initiatives on numerous fronts to advance antimicrobial stewardship. One example is IDSA’s Antimicrobial Stewardship Centers of Excellence program, which identifies institutions performing at the highest level in optimizing antimicrobial use and combating antimicrobial resistance. Institutions designated as Centers of Excellence exceed existing standards and set the bar toward which all hospitals should thrive.

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