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Why ASPs Should be Included in Healthcare Emergency Preparedness Efforts

The COVID-19 pandemic sharply illustrated why antimicrobial stewardship programs (ASPs) should be incorporated into a healthcare organization's disaster preparedness plans, according to the authors of a letter in Infection Control and Hospital Epidemiology.1 The pandemic "highlights numerous opportunities where ASPs can support emerging pathogen response and planning efforts," the letter states.

The Role of ASPs

ASPs are multidisciplinary programs that are intended to support the appropriate use of antimicrobials. Optimal use of antimicrobials can improve patient outcomes and reduce the expansion of antimicrobial resistance (including antibiotic resistance). ASPs are mandated in the United States and often include infectious disease physicians, pharmacists, microbiologists, and infection prevention specialists, among others.

According to the letter authors, ASPs that are already integrated with a hospital's infection prevention efforts are uniquely suited to respond to emerging pathogens for several reasons. First, they most likely have experience with infection prevention. Second, they are likely to be involved in response efforts early. And third, ASPs will have already established relationships with key stakeholders, bolstering their influence with them.

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How ASPs Can Make a Difference

There are many ways that ASP involvement can help with emergency preparedness, particularly related to new and emerging pathogens. Early in the COVID-19 pandemic, for example, critically ill patients often received broad-spectrum antibiotics for secondary bacterial pneumonia infections. ASPs can help monitor prescribing to ensure compliance with established guidelines. In fact, post-prescriptive review conducted by ASPs can, in theory, help with early identification of potential cases, according to the letter authors.

As ASPs already manage antimicrobial use within institutions, they are uniquely equipped to manage antimicrobial therapies for emerging pathogens. The letter states, "Additionally, ASPs can help in the development of local treatment protocols involving repurposed antivirals; they can monitor and manage drug shortages due to supply chain interruptions; and they can assist frontline providers with expanded access investigational new drug applications (eINDs) and local institutional review board procedures for investigational agents."

Syndromic Testing and ASPs

Syndromic infectious disease testing from BIOFIRE can be a useful tool for ASPs as they work to address emerging pathogens and outbreaks of known pathogens. The BIOFIRE® FILMARRAY® Panels utilize rapid multiplex PCR to target pathogens and antimicrobial resistance markers at the molecular level. Syndromic testing from BIOFIRE is more sensitive than culture and more efficient than serial individual tests.

Rapid answers on a comprehensive menu of pathogens and antimicrobial resistance markers can enable physicians to optimize patient therapy quickly and avoid unnecessary antimicrobials. In fact, studies have found that combining antimicrobial stewardship efforts with the BIOFIRE® FILMARRAY® Blood Culture Identification Panel shows the greatest benefit in quickly optimizing therapy for patients with a bloodstream infection.2

BIOFIRE has also applied its syndromic approach to COVID-19 testing. BIOFIRE's respiratory solutions include SARS-CoV-2 within a broader menu of possible respiratory pathogens, including influenza A and influenza B.  While SARS-CoV-2 is understandably a top concern for physicians and ASPs, several respiratory pathogens can cause nearly indistinguishable symptoms. That's why BIOFIRE's respiratory solutions remove the guesswork by combining the ability to detect several of these possible pathogens into one, rapid test.

 

 

References

  1. Stevens M, et al. Infect Control Hosp Epidemiol. (2020) 41;6: 744-745.
  2. Banerjee R, et al. Clin Infect Dis. 2015;61:1071-80.

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