Minnesota hospitals using antibiotics more carefully

Minnesota hospitals have ramped up their efforts to prevent antibiotic overuse and the drug-resistant infections that can follow.

The share of hospitals in the state meeting national guidelines for appropriate use of antibiotics is now 76% — up from a rate of 24% in 2015 that was one of the lowest in the nation, the Minnesota Department of Health announced on Wednesday.

Minnesota still trails the national rate of 85% but has closed the gap through efforts at its many small, rural hospitals, said Jan Malcolm, state health commissioner.

"The steps being taken … to improve their stewardship programs help ensure that all of us will have effective antibiotics when we need them," she said.

Antibiotics are critical drugs in fighting bacterial infections, but their overuse to treat illnesses caused by viruses, which they offer no benefits against, has contributed to the development of drug-resistant infections. Federal authorities have confirmed thousands of U.S. cases of infections caused by bacteria resistant to carbapenem antibiotics — one of the last-line antibiotic drug classes in the medical arsenal.

A more common concern has been the rise of Clostridium difficile, a stomach illness that typically occurs in patients after they have received antibiotic therapy for other infections. The rate of C. diff cases has increased in Minnesota from 50 per 100,000 people in 2009 to more than 200 in 2017, according to state health department data.

To be considered effective antibiotic stewards, hospitals must meet seven guidelines outlined by the U.S. Centers for Disease Control and Prevention, including employing experts in antibiotic drug management, tracking prescribing, and educating doctors.

Research has given hospitals incentives to meet these guidelines, including findings that they ultimately save money by spending less on antibiotics and preventing drug allergies and interactions. The Joint Commission, the primary accrediting body of U.S. hospitals, also required hospitals as of 2017 to have antibiotic stewardship programs.

State leaders highlighted Essentia Health for creating online training and other steps to improve antibiotic practices at its mix of small and large hospitals in northern Minnesota. They also warned that preventing antibiotic resistance requires good judgments by outpatient clinicians, dentists and even veterinarians.

Patients can help as well, they said, by not pressuring doctors to prescribe antibiotics for questionable uses and by taking their entire regimens of antibiotics when they do receive them.

Jeremy Olson • 612-673-7744