CVPH ED Team Promotes Proper Use of Antibiotics - Overuse of antibiotics a national concern
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For Immediate Release
CVPH ED Team Promotes Proper Use of Antibiotics
Overuse of antibiotics a national concern
PLATTSBURGH, NY (12/11/2018) – Because the overuse of antibiotics can reduce their effectiveness and support the increase of antibacterial resistant infections, the University of Vermont Health Network – Champlain Valley Physicians Hospital (CVPH) Emergency Department is committed to both decreasing antibiotic use for conditions in which they provide no clinical benefit as well as educating patients about the appropriate use of the drugs.
With a focus on acute bronchitis, the initiative was prompted by a quality study led by Daniel Anhalt, MD, Emergency Department Physician. Acute bronchitis is a temporary inflammation of the bronchial tubes caused by a viral infection. “Antibiotics are not the answer (in treating acute bronchitis),” said Dr. Anhalt, a 25-year veteran of the CVPH Emergency Department. “Acute bronchitis is caused by viruses, and antibiotics don’t help to kill viruses,” he explained.
At the beginning of the local study, only 37.6 percent of Emergency Department patients with acute bronchitis were not receiving antibiotics. The study’s goal was to bring that number up to 100 percent, and the department has been reaching that goal consistently.
For decades, according to Anhalt, the Centers for Disease Control (CDC) has emphasized the need to reduce the amount of antibiotics being prescribed across the nation. When antibiotics are overused, bacteria can develop resistance to the medicine, reducing the effectiveness of antibiotics when treating bacterial infections. Organizations like Healthcare Association of New York State (HANYS) and the New York State Department of Health have ongoing initiatives aimed at promoting the appropriate use of antibiotics.
In 2016, the CVPH ED began looking at ways to decrease antibiotic use, specifically for conditions in which they provide little or no benefit. The Adirondack Accountable Care Organization (ACO), representing eight counties in northern New York, had also been studying the issue region-wide. The decision to collaborate has helped improve awareness about the initiative across the North Country, Anhalt said.
Anhalt said the team focused on a specific group of people, ages 18 to 65, excluding anybody with lung disease, anybody with cancer and everyone that is immune compromised.
Today, when a patient comes to the Emergency Room with a persistent cough, doctors will first determine the cause. If the patient has pneumonia, which can be caused by bacteria, the patient will receive antibacterial treatment. However, if initial tests conclude the patient is suffering from bronchitis, treatment will focus more on reducing the cough and other symptoms while the viral infection clears up.
“Cough expectorants can help (reduce a persistent cough),” Anhalt explained. “Honey can also decrease a cough. If a patient has wheezing, we may give an inhaler to help clear the condition. But we are also providing a lot of education that antibiotics are not the solution.”
Increasing patient awareness and understanding was part of the study. Patients often come in to health care with the expectation that an antibiotic will be the “magic bullet” that alleviates their illness, explained the seasoned physician. He said providers are working to change that expectation with factual information.
“It involves a lot of education for both providers and for patients,” Anhalt said. “We want to make sure our staff is on board and that patients are aware of the differences between viral and bacterial infections.”
Staff members have placed flyers on the walls of patient rooms in the Emergency Department that list a variety of medical conditions and whether they are caused by viral or bacterial infections. Those that are treated with antibiotics are marked “yes,” and those that do not need antibiotics are marked “no.”
For instance, patients with colds, flu and sore throats not associated with a strep throat would not receive antibiotics, but patients with whooping cough, strep throat and pneumonia would be treated with antibiotics.
The Emergency Department staff signed on as “antibacterial stewards” and continue to educate the public and the region’s health-care community on proper use of antibiotics. Anhalt said the team has been doing a tremendous job.
“Bacterial overgrowth (caused by resistant forms of bacteria) can be deadly,” Anhalt said. “If we are overusing antibiotics, it can lead to resistance in the overall community and less-effective treatment for bacterial infections.”
He said providers are noticing an increase in antibacterial-resistant infections, including some serious conditions such as clostridium difficile (C-diff), a bacteria that causes severe diarrhea and can lead to death. According to CDC statistics at least 2 million Americans are infected with antibiotic-resistant bacteria each year, and at least 23,000 people die as a result.
Bacteria have several ways of developing resistance to antibiotics. Some develop a method of destroying the antibiotic before it can be effective. Others can rapidly pump the antibiotic out of the infected cells. The more antibiotics are used improperly, the more opportunity bacteria has to become resistant.
The improved use of antibiotics also has a financial benefit. Insurance companies have identified the move to reduce antibiotic use as a positive measure in overall treatment of patients, Anhalt noted.
Nationally, antibiotic misuse has caused $2 billion in extra costs to the health-care system. Anhalt said he believes proper use of antibiotics will continue to improve locally, regionally and nationally with that proper education.
About Champlain Valley Physicians Hospital
The University of Vermont Health Network - Champlain Valley Physicians Hospital is a private, not-for profit hospital and a subsidiary of Community Providers Inc., (CPI). Established in 1967 with the merger of Champlain Valley and Physicians hospitals, CVPH joined Fletcher Allen Partners in 2012, which in 2014, became The University of Vermont Health Network. Together with its partners, Alice Hyde Medical Center, Central Vermont Medical Center, Elizabethtown Community Hospital and the University of Vermont Medical Center, CVPH provides high quality, cost effective care, close to home. Services include an award winning cardiac services program, accredited cancer center, freestanding ambulatory surgery center, comprehensive rehabilitation services and a 24 hour physician-staffed Emergency Care Center. Governed by a 15-member Board of Directors, CVPH is accredited by the Joint Commission and licensed by New York State and Medicare/Medicaid approved. Learn more at UVMHealth.org/CVPH or follow us on Facebook, Twitter, LinkedIn and YouTube.
About The University of Vermont Health Network
The University of Vermont Health Network is an academic health system that is comprised of six affiliate hospitals, a multi-specialty medical group, and a home health agency. We serve the residents of Vermont and northern New York with a shared mission: working together, we improve people’s lives. Our partners include:
- The University of Vermont Medical Center
- The University of Vermont Health Network Medical Group
- The University of Vermont Health Network – Alice Hyde Medical Center
- The University of Vermont Health Network – Central Vermont Medical Center
- The University of Vermont Health Network – Champlain Valley Physicians Hospital
- The University of Vermont Health Network – Elizabethtown Community Hospital
- The University of Vermont Health Network – Porter Medical Center
- The University of Vermont Health Network – Visiting Nurses Association of Chittenden and Grand Isle Counties
Our 4,000 health care professionals are driven to provide high-quality, cost-efficient care as close to home as possible. Strengthened by our academic connection to the University of Vermont, each of our hospitals remains committed to its local community by providing compassionate, personal care shaped by the latest medical advances and delivered by highly skilled experts.