Public Release: 

Children's Hospital Colorado combats antibiotic resistance with 'handshake stewardship'

Children's Colorado's program led to a 10.9 percent reduction in inpatient use of antibiotics from 2010 to 2014

Children's Hospital Colorado

Aurora, Colo. (April 17, 2017) - Recent research from Children's Hospital Colorado (Children's Colorado) has shown the effectiveness of a unique type of antimicrobial stewardship program in the fight against antibiotic (antiviral, antifungal and antibacterial) resistance. The research examined the impact a strategy known as "handshake stewardship" could have on the use of antibiotics in a freestanding children's hospital. This strategy was characterized by:

  • A lack of the restriction and pre-authorization commonly found in antimicrobial stewardship programs
  • A daily pharmacist-physician review of every inpatient antibiotic prescription, including dosages, type of medication and type of infection
  • Daily rounding on inpatient floors by a pharmacist-physician team to monitor antibiotic usage and give advice in-person to every unit in the hospital that is using antibiotics

The program was dubbed "handshake stewardship" because of the personal contact, trust and sealing of deals associated with handshakes.

Led by Sarah Parker, MD, pediatric infectious diseases physician and medical director of the Antimicrobial Stewardship Program at Children's Colorado, the research retrospectively measured antibiotic use hospitalwide and by unit before, during and after the implementation of the handshake stewardship program to determine the effectiveness of such an approach. All antibiotics prescribed to inpatients between October 2010 and September 2014 were included in the review. The study found that handshake stewardship led to a 10.3 percent decrease in antibacterial use hospitalwide, a 12.1 percent decrease in antifungal use, and a 16.4 percent decrease in antiviral use, for an overall decrease in antimicrobial use of 10.9 percent hospitalwide. The study results were published in The Pediatric Infectious Disease Journal.

"Very few hospitals have a medical doctor involved in the day-to-day running of this kind of program," Dr. Parker says. "And very few programs review every single antibiotic prescription. However, the risks associated with antibiotics require that we find an effective way to limit their use. Not only do 30 percent of children who take antibiotics experience a side effect such as diarrhea, but antibiotics can also kill good bacteria in the body, which can lead to more serious illnesses down the line. And perhaps most compelling, according to the CDC, more than 23,000 deaths and $20 billion in indirect health care costs are attributed to resistant bacteria in the United States each year."

"This type of stewardship also helps ensure the appropriate use of antibiotics - that is, that they are only used when needed, and that they are given at the right dosage for the right duration of time," continues Parker. "Ultimately, this leads to better patient outcomes."

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A PDF of the full study is available upon request.

About Children's Hospital Colorado

Children's Hospital Colorado (Children's Colorado) has defined and delivered pediatric health care excellence for more than 100 years. Founded in 1908, Children's Colorado is a leading pediatric network entirely devoted to the health and well-being of children. Continually acknowledged as one of the nation's outstanding pediatric hospitals by U.S. News & World Report and ranked on its Best Children's Hospitals 2016-17 Honor Roll, Children's Colorado is known for both its nationally and internationally recognized medical, research, education and advocacy programs, as well as comprehensive everyday care for kids throughout Colorado and surrounding states. Children's Colorado is the winner of the 2015 American Hospital Association-McKesson Quest for Quality Prize, and is a 2013-2016 Most Wired hospital according to Hospitals & Health Networks magazine. Children's Colorado also is recognized for excellence in nursing from the American Nurses Credentialing Centers and has been designated a Magnet® hospital since 2005. The hospital's family-centered, collaborative approach combines the nation's top pediatric doctors, nurses and researchers to pioneer new approaches to pediatric medicine. With urgent, emergency and specialty care locations throughout Metro Denver and Southern Colorado, including its campus on the Anschutz Medical Campus, Children's Colorado provides a full spectrum of pediatric specialties. For more information, visit http://www.childrenscolorado.org and connect with Children's Colorado on Facebook, Twitter and Pinterest.

Children's Hospital Colorado complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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