In August 2022, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for FY 2023 Medicare Hospital Inpatient Prospective Payment System for Acute Care Hospitals and Long-term Care Hospital Prospective Payment System. Beginning with calendar year 2024, facilities participating or planning to participate in the CMS Promoting Interoperability (PI) Program will be required to submit both antimicrobial use and antimicrobial resistance data to the National Healthcare Safety Network (NHSN).

Recently, we observed U.S. Antibiotic Awareness Week (USAAW), an initiative that highlights the threat of antimicrobial resistance and the importance of appropriate antimicrobial use. Antimicrobial resistance continues to threaten lives in the U.S. with more than 2.8 million antibiotic-resistant infections occurring each year resulting in over 35,000 deaths.¹ To honor Lantana’s continued partnership with the Centers for Disease Control and Prevention (CDC), we once again provide an update on the nation’s primary system for tracking inpatient antimicrobial use and resistance: the NHSN Antimicrobial Use and Resistance (AUR) Module.

The CDC launched the NHSN Antimicrobial Use (AU) Option in 2011 to provide a mechanism for hospitals to report and analyze antimicrobial use. Through partner engagement, targeted education, and availability of a standardized risk-adjusted metric and various analysis reports, AU Option enrollment and reporting grew to over 2,500 hospitals voluntarily submitting AU data today. The Antimicrobial Resistance (AR) Option, which launched in 2014, has grown to over 1,100 participating hospitals through outreach and promotion of available NHSN analysis reports. With the new CMS final rule, we are expecting participation for the AU and AR Option to continue to grow in the next few years.

The NHSN AUR Module continues to evolve to meet the needs of antimicrobial stewardship programs and other stakeholders. In a recent NHSN application release, Targeted Assessment for Antimicrobial Stewardship (TAS) reports and dashboards became available to all hospitals participating in the NHSN AU Option and groups. The TAS Framework was adapted from the CDC’s Targeted Assessment for Prevention (TAP) Strategy and developed to use AU Option data for action to optimize antimicrobial use at facilities.

Future NHSN application releases will include AR Option benchmark metrics using 2019 baseline data, AR incidence and prevalence reports, and an expansion of data quality reports. These reports will provide stewards with a better picture of antimicrobial resistance within their facilities.

To celebrate USAAW this year, the AUR Team published the 2021 AU Option Data Report. The 2021 report, an update to the 2020 report, summarizes Standardized Antimicrobial Administration Ratio (SAAR) distributions and percentages of antimicrobial use for adult, pediatric, and neonatal locations. This report provides actionable data that allows hospitals to compare their SAARs to the national distribution and see where their prescribing practices can improve. This report also includes the percentage of antimicrobial use by class and drug within SAAR antimicrobial agent categories, which further provides insight into prescribing practices. This year, the AU Report Data Tables also include SAAR distributions by state.

The Antibiotic Resistance & Patient Safety Portal (AR & PSP) is an interactive web-based application that was created to innovatively visualize data of healthcare associated infections, antimicrobial resistance, and antimicrobial stewardship uptake across U.S. hospitals. The AR & PSP was recently updated to include 2021 hospital antimicrobial use data, 2021 Hospital Core Element uptake, and the release of Priorities of Hospital Core Element Implementation.

Check out an American Society of Health System Pharmacists (ASHP) podcast featuring Dr. Melinda Neuhauser from the CDC, Dr. Libby Dodds Ashley from Duke University, Dr. Chris Evans from the Tennessee State Department of Health, and Amy Webb from the Lantana NHSN AUR Team. The podcast, Be Antibiotics Aware: Pharmacists Leveraging the NHSN AU Option, is available to listen to here: https://www.ashp.org/professional-development/ashp-podcasts/hot-topics-in-pharmacy-practice/be-antibiotics-aware-pharmacists-leveraging-the-nhsn-au-option.

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References

1. Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2019. https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf. Accessed November 2, 2022.