By Christina Baum, Program Analyst, Infectious Disease, NACCHO and Sara Chang, Program Analyst, Infectious Disease, NACCHO

On June 2, NACCHO joined over 150 major food companies, retailers, and human and animal health stakeholders at the White House Forum on Antibiotic Stewardship to announce its commitment to implement changes over the next five years to slow the emergence of antibiotic-resistant bacteria, detect resistant strains, preserve the efficacy of existing antibiotics, and prevent the spread of resistant infections. NACCHO’s Executive Director Dr. LaMar Hasbrouck represented NACCHO at the forum, joining other nonprofit organizations, consumer and patient advocates, and foundations committing to advocate and support changes in practice related to antibiotic use and antibiotic resistance.

The development and use of antibiotics has revolutionized healthcare worldwide, but their continued application and overuse has resulted in infectious microorganisms becoming immune to these treatments. The Centers for Disease Control and Prevention (CDC) report, Antibiotic Resistance Threats in the United States, 2013 estimates that antibiotic resistance is responsible for at least 23,000 deaths in the United States each year and that 2 million people are infected with bacteria resistant to at least one antibiotic. Antibiotic resistance represents a problem that requires leaders in diverse fields to proactively take a stand and support the responsible use of antibiotics through antibiotic stewardship policies, programs, and activities.

NACCHO submitted a statement of interest to the White House emphasizing past efforts and renewed commitments for antibiotic stewardship going forward. “NACCHO remains committed to improving antibiotic stewardship and preventing the emergence and spread of antibiotic-resistant organisms,” the statement of interest declares. “During 2015-2020, NACCHO will sustain or expand existing demonstration projects that enable local health departments to engage with local healthcare partners and other stakeholders to improve antibiotic stewardship and address resistance.”

Local health departments are on the frontlines of protecting their communities every day from infectious disease threats, and the rise of antibiotic resistance means that once treatable diseases are becoming increasingly difficult to manage and treatment options are more challenging and more expensive. NACCHO, through a five year agreement with CDC, is providing technical assistance to demonstration projects in three local health departments that exemplify how supporting local expertise and building capacity can effectively promote antibiotic stewardship. In collaboration with state health departments providing additional assistance, these local health departments have expanded statewide efforts to work with local healthcare partners in tackling the emergence and spread of antibiotic-resistant organisms. Their work includes the following:

DuPage County Health Department in Wheaton, IL engages long-term care facilities and acute care hospitals to improve their understanding of local needs and approaches to the prevention of healthcare-associated infections and multidrug-resistant organisms. These partnerships enable the health department to support regional planning and activities and assist local facilities in their efforts to decrease inappropriate use of antibiotics. More specifically, the health department provides resources to staff supporting infection prevention, including 1) facilitating quarterly educational sessions, 2) disseminating relevant reference materials, and 3) distributing customized “Get Smart About Antibiotics” posters to facilitate communication among staff and with residents, visitors, and family members about the appropriate use of antibiotics.

The Florida Department of Health in Orange County in Orlando, FL launched a partnership with the state’s Department of Health to collaborate in healthcare-associated infection prevention efforts and increase local capacity to respond to active outbreaks. After successfully piloting a joint project with a local long-term care facility, the health department is documenting their work in decreasing unnecessary antibiotic use through urine specimen collection and prescribing practices. The project will be presented at a statewide meeting in late June alongside a toolkit so others may duplicate this work elsewhere.

The Philadelphia Department of Public Health established a region-wide antimicrobial stewardship collaborative that includes acute care hospitals, long-term care facilities, non-profit organizations, and government agencies. The health department is offering an educational webinar series on antimicrobial stewardship, with the next one in July and presented by an infectious disease pharmacists from the Chicago area.

These projects and similar future activities will enable NACCHO to generate and promote additional strategies and resources to implement antibiotic stewardship in local communities and continue working with partners to ensure national approaches reflect the needs and capacities of local stakeholders. By leveraging the perspectives and lessons learned from local health departments, NACCHO continues to support antibiotic stewardship efforts and foster meaningful collaboration between state health departments, local health departments, and other critical partners.

Learn more about the White House Forum on Antibiotic Stewardship and steps the administration is taking to combat antimicrobial resistance.

About Christina Baum
Christina Baum is a program analyst for NACCHO’s Infectious Disease team. She works with local health departments on such topics as biosurveillance, epidemiology, and informatics.

About Sara Chang
Sara Chang is a program analyst for NACCHO’s Infectious Disease team. She works with local health departments on such topics as outbreak response, infectious disease prevention and control, and healthcare-associated infections. Twitter: @changsara