VUMC recognized for antimicrobial drug stewardship efforts

Vanderbilt Antimicrobial Stewardship Program personnel include (front row, from left) Chelsea Gorsline, MD, Sophie Katz, MD, Gowri Satyanarayana, MD. Not pictured, Ritu Banerjee, MD, PhD, Jessica Gillon, PharmD, (back row, from left) Milner Staub, MD, George Nelson, MD, Ben Ereshefsky, PharmD, and Jeff Frieberg, MD, PhD. — Vanderbilt Antimicrobial Stewardship Program personnel include (front row, from left) Chelsea Gorsline, MD, Sophie Katz, MD, Gowri Satyanarayana, MD, (back row, from left) Milner Staub, MD, George Nelson, MD, Ben Ereshefsky, PharmD, and Jeff Frieberg, MD, PhD. (photo by Erin O. Smith). Not pictured, Ritu Banerjee, MD, PhD, Jessica Gillon, PharmD.

The Infectious Diseases Society of America (IDSA) has designated Vanderbilt University Medical Center an Antimicrobial Stewardship Center of Excellence.

Antimicrobial stewardship is the effort to measure and improve how antibiotics and other antimicrobial drugs are prescribed by clinicians and used by patients.

Bacteria, viruses, fungi and other pathogens can become resistant to antibiotics and other antimicrobial drugs, and drug resistance has been significantly accelerated by the misuse and overuse of these drugs. A 2019 report from the United Nations warned that resistance had reached a critical stage and if no action were taken, drug-resistant infections could cause 10 million deaths a year by 2050 and cripple the global economy.

“We salute the IDSA for their efforts to promote awareness of antimicrobial stewardship and the measures health care organizations can take to optimize use of antimicrobial drugs,” said infectious diseases specialist George Nelson, MD, assistant professor of Medicine and director of the Vanderbilt Antimicrobial Stewardship Program (VASP). “This is very welcomed recognition for our program at VUMC, and it reflects a tremendous amount of work that our stewardship team has accomplished.”

Nelson added, “We’re here to optimize therapy, hopefully with the major benefits of reducing drug resistance and improving outcomes, through multidisciplinary collaborative programs and a focus on individual patient care.”

VASP pharmacists and physicians monitor antimicrobial use and clinical laboratory results through electronic health records. As apparent opportunities arise to change or adjust a patient’s antimicrobial therapy, VASP contacts the care team to learn more about the patient and supply information and suggestions as appropriate.
VASP conducts surveillance and periodic internal reporting of antimicrobial use, looking for any patterns of misuse and bringing them to the attention of clinical services as needed.
Under the authority of the Pharmacy and Therapeutics Committee, VASP has established a list of 25 antimicrobials that require approval from an infectious diseases specialist before an order can be executed. Many of these are newer broad-spectrum antibiotics.
For testing and treatment of inpatients with certain infections, VASP writes guidelines for use across VUMC.
VASP contributes oversight for the VUMC drug formulary, as well as for pharmacy processes pertaining to antimicrobials.
VASP collaborates extensively with Quality, Safety and Risk Prevention on initiatives to improve patient safety.
VASP works with VUMC’s clinical lab to support appropriate use and interpretation of infectious disease diagnostic tests.

According to the IDSA, its center of excellence designation is reserved for health care organizations that go above and beyond the antimicrobial stewardship practices recommended by the Centers for Disease Control and Prevention.

Since the IDSA introduced the program in 2017, a total of 145 organizations have received its center of excellence designation. (Tennessee’s other designees include St. Jude Children’s Research Hospital in Memphis and Williamson Medical Center in Franklin.)

VASP was established in 2009 by infectious diseases specialists Patty Wright, MD, and Titus Daniels, MD, MPH, MMHC, with a focus on inpatient areas of Vanderbilt University Hospital. In 2012, the program was expanded to inpatient areas of Monroe Carell Jr. Children’s Hospital at Vanderbilt, and more recently has expanded to include VUMC outpatient clinics.

“We welcome this recognition from IDSA,” said Ritu Banerjee, MD, PhD, associate professor of Pediatrics and director of Children’s Hospital’s Antimicrobial Stewardship Program. “If you can prevent overuse and misuse of antibiotics, you’ll hopefully also reduce the emergence and spread of resistant bacteria and achieve cost savings,” she said.

The application for center of excellence designation from IDSA was spearheaded by Clinical Pharmacist Jessica Gillon, PharmD, a care team member at Children’s Hospital. For more information, see the VASP website.