Policies & Guidelines That Will Help Drive Antimicrobial Stewardship in 2020

By the bioMérieux Connection Editors

Every year in the United States, at least 2.8 million people get an antibiotic-resistant infection and according to IDSA, as many as 162,044 people die from them, making antimicrobial resistance the third leading cause of death. Combatting antimicrobial resistance requires collaboration across sectors—significant action from national and international leadership is needed to encourage and require antimicrobial stewardship programs in healthcare organizations.

2019 saw guidelines and policies put into place that will help propel antimicrobial stewardship in 2020. We break down three of these drivers below:

1. Congress provided $21 million in fiscal year 2020  with the goal of increasing hospital reporting of antibiotic use and resistance.

These congressional appropriations will enable the CDC to provide the critical technical assistance and resource support that hospitals—particularly smaller ones—need to report antibiotic use and improve their stewardship programs. In addition to the sizeable appropriation, Congress instructed the CDC to work with the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information and Technology (ONC) to plan and execute a multiyear strategy to boost antibiotic reporting.

2. CMS released a final rule that requires all acute-care hospitals that participate in Medicare or Medicaid to develop and implement an antibiotic stewardship program (ASP) as part of their infection control efforts.

Ideally, the new CMS rule will strengthen stewardship programs across the United States, since virtually all hospitals bill to Medicare and Medicaid. The condition does not require that hospitals adhere to a specific set of guidelines when implementing their ASP, but does state that “nationally recognized” sources, such as the CDC’s Core Elements, must be adhered to.

Learn more about the implications of this rule here

3. The Joint Commission introduced new antimicrobial stewardship requirements that are applicable to accredited ambulatory health care organizations that routinely prescribe antimicrobial medications.

This action is a continuation of The Joint Commission’s initiative to encourage stewardship in hospitals and nursing care center programs. Accredited ambulatory health care organizations must meet five new elements of performance which address stewardship:

  • Identify individuals responsible for antimicrobial prescribing practices
  • Set at least one annual stewardship goal
  • Use evidence-based practice guidelines related to the goal
  • Provide educational resources to staff associated with the goal
  • Collect, analyze, and report data pertaining to the goal

Needed Policy Changes Ahead

The policies and guidelines set forth in 2019 will encourage better antibiotic reporting and stimulate stewardship programs around the country in 2020. Although we are not far into the new year, major events last year in the antibiotic industry have made stewardship-related policy and legislature even more urgent.

A major antibiotic developer filed for Chapter 11 bankruptcy on December 27, 2019, a major blow for an industry whose work is desperately needed to fight antimicrobial resistance. Because there are so few companies developing antibiotics now, losing any of them is a major public health concern. To counter situations such as this, senators from Georgia and Pennsylvania introduced the DISARM Act in June 2019, and a corresponding bill was introduced in the House in July 2019. According to the Infectious Diseases Society of America, the bill has the potential to “stabilize the antibiotics market, spur the development of new infection-fighting drugs, and preserve the effectiveness of existing medicines.”  As of this writing, the bill remains with the House Committee on Ways and Means, the House Committee on Energy and Commerce, and the Senate Finance Committee.


Opinions in this article are not necessarily those of bioMérieux, Inc.

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