Last summer, Intermountain Healthcare published a study on the effects of broad-spectrum antibiotics on patients with pneumonia. The study summarized that often the use of administering the antibiotics to these patients could do more harm than good. We asked AARC Member Mike Hess, MPH, RRT, RPFT, to share his key takeaways from the study.
Mike’s key takeaways:
Antibiotics are not harmless! We tend to look at many of our front-line pharmaceutical agents with a “couldn’t hurt” attitude, but there can be significant risks involved with ANY med administration (including our old friend albuterol). Therefore, we absolutely must be cautious when deciding on a treatment plan and stick with evidence-based indications and not use a kitchen-sink approach.
This provides RTs with an opportunity to advocate for patient safety. In almost 20% of the cases that ended in death, the study group found an antibiotic-associated event. That’s not necessarily causation but having an adverse effect while already sick certainly doesn’t make anything easier. Pretty much every person with pneumonia will be seen by an RT at some point (even if only an evaluation in the ED) because of the inherent breathing problems. This is a chance to peek through the medical record to see if antibiotics are being ordered safely and prudently to avoid not only death, but the other complications and costs noted in the study.
Finally, we must be cautious about looking for the worst-case scenario and remember that when we hear the pounding of hooves, we should think horses instead of zebras. While there’s always a chance an exotic, resistant organism might be infecting, they are seen much more with health care-associated pneumonias, so that tends to bias clinical judgment. This bias makes it all that much more important to follow the evidence and treat appropriately, with narrow-spectrum therapy, in order to reduce exposures to HCAP and to be proper stewards of the antibiotics we still have.
Ｅｘｔｒａｃｔｅｄ ｆｒｏｍ ＡＡＲＣ
（Ａｍｅｒｉｃａｎ Ａｓｓｏｃｉａｔｉｏｎ ｆｏｒ ｒｅｓｐｉｒａｔｏｒｙ ｃａｒｅ）