Nurses as Vital Partners in the Fight Against Antimicrobial Resistance

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Reducing the impact of antimicrobial therapy is a part of fundamental practice for health care providers, pharmacists, microbiologists, and public health professionals. Inclusion of nurses in the conversation regarding actions and implementation to achieve this end has often been an afterthought.

However, the number of nurses practicing across every health care setting makes us critical and active partners. What, specifically, are the roles and actions of nurses in addressing antimicrobial resistance, antimicrobial stewardship (AMS), and safe patient care and outcomes? Let’s first review the basics of the problem.

Nursing Activities Relevant to Antimicrobial Use and Stewardship

The approximately 5.77 million active nurses in the United States are widely trusted and well positioned to provide education on antibiotic use and influence behavior related to antimicrobial therapy. Their universal presence in health care settings empowers them to play a role as frontline actors in antimicrobial stewardship across inpatient, outpatient, and community settings. To make this happen, programs supporting appropriate use require commitment from health care leadership, available expertise in antimicrobial drug use, regular performance […]

2025-07-14T10:38:24-04:00July 14th, 2025|Nursing, patient safety|0 Comments
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What if Our Antibiotic Prescribing Practices are Wrong?

How often have you emphasized to patients, family, and friends that they must finish their prescribed antibiotics, even if they feel better? A provocative new analysis in BMJ takes a close look at why standard antibiotic protocols may promote, rather than prevent, antibiotic resistance.

The authors’ arguments center around two key points:

  • The length of a course of antibiotic therapy is not evidence based, but rather “set by precedent [and] driven by fear of undertreatment.”
  • Typical, prolonged courses of these drugs cause endogenous or colonizing bacteria to become antibiotic resistant. It is these “collateral” organisms, they argue, and not the organism that has actually caused the infection, that drive the spread of antibiotic resistance.

Individualized antibiotic courses.

The BMJ authors present a strong argument for more individualized courses of antibiotic treatment. Unfortunately, when the news media picked up this story, much of what was written and broadcast erroneously suggested that everyone should simply stop their antibiotics when they feel better. […]

2017-12-13T10:41:02-05:00December 13th, 2017|infection control, Nursing, Public health|0 Comments
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The Real and Evolving Threat of Superbugs: A Primer

pillsinspaceJust how super is the latest superbug? The good news is that the infected U.S. patient has recovered. The bad news:  mcr-1, the resistance gene identified in this strain of E. coli, has brought us another frightening step closer to a “post-antibiotic” era.

In recent years, antimicrobial resistance among Gram-negative bacteria (E. coli, Klebsiella, Pseudomonas, Acinetobacter, Salmonella, and others) has been a growing public health concern. Most of the increase in resistance has been the result of mobile genetic elements that can easily transfer resistance from one bacterium to another, allowing bacteria to “catch” antibiotic resistance from one another.

To make matters worse, resistance enzymes are often packaged together. One genetic “cassette” can carry multiple resistance determinants, thereby spreading resistance to more than one class of antibiotics at the same time.

Early on, we relied on the carbapenem class of antibiotics to treat infections caused by multidrug-resistant (MDR) organisms such as the “ESBLs” (extended-spectrum beta-lactamase-producing organisms). But carbapenemase-producing organisms soon developed, and resistance to carbapenems spread quickly.

In 2009, the emergence of a “super” kind of carbapenem resistance gene, ndm-1 (New Delhi metallo-beta-lactamase) was found to be highly resistant to many antibiotic classes, including:

  • the carbapenems and other beta-lactams (penicillin derivatives and cephalosporins)
  • the fluoroquinolones (ciprofloxacin, levofloxacin, et al)
  • the aminoglycosides (gentamicin, amikacin, et al).

These antibiotic classes include the main drugs used to treat […]

2016-11-21T13:01:11-05:00June 6th, 2016|infectious diseases, Nursing, Public health|1 Comment
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Anti-Antibiotics Week

Not only is antibiotic resistance dangerous and expensive, it’s on the rise. Unfortunately cold and flu season can make people so uncomfortable they’ll do anything to feel better, including insisting their health care provider write a prescription for a medication that can’t help them. In an effort to change this, the CDC and FDA have teamed up for the 3rd annual Get Smart about Antibiotics Week (November 15–21).

2016-11-21T13:14:54-05:00November 18th, 2010|patient engagement, Public health|3 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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