Expert Council Pushes for Hospital Antibiotic Stewardship Requirement

The Presidential Advisory Council on Combating Antibiotic Resistant Bacteria (PACCARB), which provides recommendations to Health and Human Services (HHS) on federal programs and policies to combat antibiotic resistance, is urging the finalization of a policy that would make antibiotic stewardship programs a requirement for U.S. hospitals.

In an April letter to HHS Secretary Alex Azar, PACCARB states the following: "There is a critical need for mandatory, not voluntary, implementation of antibiotic stewardship programs in our nation's hospitals to curtail the over-prescription of antibiotics — a lead cause in the rise in antibiotic resistance. We urge the immediate finalization of the proposed Centers for Medicare and Medicaid Services (CMS) conditions of participation (CoP) rule, in advance of the upcoming June 2019 deadline. This rule requires the adoption of antibiotic stewardship programs in hospitals, especially critical access hospitals (CAHs), to help reduce the daunting overtreatment of patients with unnecessary broad-spectrum antibiotics and, thereby, improve the care of patients receiving the appropriate antibiotics.

"… The PACCARB believes that requiring hospitals and CAHs to develop and implement antibiotic stewardship programs will have a direct, positive and immediate impact on antibiotic prescribing practices, thus aiding in the fight against antibiotic resistance and preserving of our nation's health in the face of this increasing public health threat."

As a report from the Center for Infectious Disease Research and Policy (CIDRAP), a center within the University of Minnesota, notes, the Centers for Disease Control and Prevention (CDC) recommended in 2014 that all U.S. hospitals have an antibiotic stewardship program and has published guidelines to support such program implementation. The report also notes that while the Joint Commission has a stewardship program requirement, this covers only about 75% of U.S. hospitals.

PACCARB includes human and animal health experts from a variety of fields, including pharmacy, biomedicine, public health, healthcare and epidemiology. It was established in 2015 and is presently chaired by Martin J. Blaser, MD, Henry Rutgers Chair of the Human Microbiome and author of Missing Microbes: How the Overuse of Antibiotics is Fueling our Modern Plagues.