The discovery of antibiotics was a revolution in medicine, allowing doctors to treat patients with life-threatening bacterial infections. Unfortunately, bacteria can adapt to antibiotics, becoming antibiotic-resistant. This resistance is reducing the efficacy of antibiotic drugs and threatening to return the U.S. to the pre-antibiotic era, when bacterialinfection deaths were common. We know that antibiotic stewardship — training doctors, nurses and pharmacists to use antibiotics more sparingly, if at all — is a powerful tool in reducing antibiotic resistance. UW Medicine’s Antibiotic Stewardship Program (ASP) has made a big difference in our hospitals, resulting in plummeting rates of antibiotic-resistant bacterial infections. However, resistance rates remain high in local nursing homes and long-term care facilities. To combat this problem, UW Medicine’s Division of Allergy and Infectious Diseases aims to create the Tele-antimicrobial Stewardship Program (TASP), a medical education program that will train doctors, nurses and pharmacists across the Pacific Northwest on how and when to use antibiotics. We invite you to join us in halting the spread of antibiotic resistance in our region.
THE DANGER OF ANTIBIOTIC RESISTANCE
When it comes to antibiotic resistance, overuse of antibiotics is part of the problem. Estimates indicate that up to 50 percent of antimicrobial use in the hospital is inappropriate — and this percentage increases in outpatient settings. Antibiotic resistance is especially problematic in long-term care facilities and nursing homes. They are often crowded, and the physicians and pharmacists who work with those patients aren’t familiar with the threats posed by resistance. The consequences can be dire for patients who have developed antibiotic resistance: less effective antimicrobials result in longer hospital stays, higher pharmacy costs and increased mortality. In the United States, at least 2 million people are infected with micro-organisms that are resistant to treatment, and at least 23,000 people die each year from these drug-resistant infections.
A CALL TO ACTION: TASP
The World Health Organization, the Centers for Disease Control and Prevention, the White House and the Centers for Medicare and Medicaid Services have all called for a national plan of action to slow the emergence of antibiotic-resistant bacteria. Developing and implementing antimicrobial stewardship programs across the country is a highly effective solution. The UW Division of Allergy and Infectious Diseases recognizes the need for antimicrobial expertise, education and leadership in the Pacific Northwest region. And we have the experience and knowledge to create a rich repository of information for scholarship, research and rapid dissemination of best practices in treating and halting antimicrobial resistance. The implementation of TASP will help meet this need by creating antibiotic stewardship programs throughout the five-state WWAMI (Washington, Wyoming, Alaska, Montana, Idaho) region and ensuring far-reaching impact with the use of telemedicine. By using TASP to teach other practitioners what we’ve learned in UW Medicine’s hospitals, we will protect entire communities.
Some key features of TASP include:
EXPANDED TELEHEALTH SERVICES
UW Medicine’s telehealth program allows our expert faculty to videoconference on topics such as hepatitis C, tuberculosis and HIV treatment with doctors in rural and underserved areas. We plan to expand our telehealth services to include ASP development and implementation for nursing homes and small community hospitals. These are the institutions that most frequently generate and transfer highly antibiotic-resistant bacteria to UW Medicine’s care facilities.
CONSULTATION AND MANAGEMENT
UW Medicine will connect our antibiotic stewardship experts — via live telemedicine hookup — with hospitals, nursing homes and healthcare facilities across the WWAMI region. This will help those organizations address newly instituted ASP reporting regulations from the state and federal government. It will also enhance information-sharing by facilitating discussion of practical cases and issues in microbial resistance.
A STANDARDIZED CURRICULUM
We will create a standardized curriculum for infectious disease fellows, allowing them to specialize in infection control and antibiotic stewardship. During weekly videoconference sessions, UW physicians, pharmacists, nurses and clinical microbiologists will present short clinical updates in line with the new TASP curriculum.
By providing guidance and active telemedicine consultation across the WWAMI region, we will dramatically reduce antibiotic resistance and meet UW Medicine’s mission: improving the health of the public. Given the severity of this problem and the opportunity at hand, we seek $150,000 to cover the startup costs for TASP for the first two years. After the first two years, we anticipate the program will become self-sustaining with a modest subscription fee.
For more information on the Tele-antimicrobial Stewardship Program (TASP) or the Division of Allergy and Infectious Diseases at UW Medicine, please contact Elizabeth Perera, director for philanthropy, at 206.221.2915 or firstname.lastname@example.org. Thank you for your interest in our work.
Wes Van Voorhis, M.D., Ph.D., is a UW professor of medicine and was the head of the Division of Allergy and Infectious Diseases. He is also the director of the UW Center for Emerging and Re-emerging Infectious Diseases. For the past 25 years, Dr. Van Voorhis has worked on drug development for malaria, trypanosomes, leishmania, cryptosporidium, and, most recently, antibiotic-resistant bacteria. His clinical practice brings him in constant contact with the ravages of antibioticresistant bacteria.
John B. Lynch, M.D., MPH, is a UW associate professor of medicine in the Division of Allergy & Infections Diseases. He is the medical director of Harborview Medical Center’s infection control, antibiotic stewardship, and employee health programs.
Paul S. Pottinger, M.D., DTM&H, is a UW associate professor of medicine in the Division of Allergy & Infectious Diseases. He is the associate director of the division’s fellowship program and directs the antimicrobial stewardship program at UW Medical Center.
John D. Scott, M.D., M.Sc., is a UW associate professor of medicine in the Division of Allergy & Infectious Diseases. He is the medical director for telehealth at UW Medicine.