Monday, April 8, 2019

PAC CARB Votes: HHS Should Tell CMS to Finalize Antibiotic Stewardship Rules for Hospitals

We live in a world where antibiotic stewardship and antibiotic resistance are major public health topics.  Just this weekend the New York Times ran two stories on the antibiotic resistance crisis (here, here).

One major federal effort was announced by CMS in 2016 with some fanfare:  Requires all hospitals serving Medicare to have official Antibiotic Stewardship Programs in operation. 

However, the rule has never been finalized, and it will expire if not finalized by June 2019.   Stakeholders who think this requirement would be a good idea have a major forum:  PAC CARB, the President's Advisory Commission on Combating Antibiotic Resistant Bacteria.

Today, April 8, 2019, the PAC CARB held a special session and its commissioners voted that CMS should move forward with the ASP requirement.   All the commissioners voted "Yay."   The letter (as currently drafted) is online here

Several government bodies like FDA, NIH, CDC, BARDA, CMS, are assigned to the committee.  However, in today's meeting, like the January 30 meeting, the CMS delegate to PAC CARB did not attend the meeting.
  • See an unofficial meeting transcript in the cloud here.  

Get a window into stakeholder positions and politics here, at the website of APIC, the Association of Professionals in Infection Control.


I made a personal professional comment to the committee; here.


Some additional entry points into the topic of Antibiotic Stewardship Programs for hospitals...

  • In 2014, CDC released "Core Elements of ASP" (24pp), here, web here.
  • In 2016, Joint Commission released standards for ASP, see short summary 4pp here.  Register for 96pp PDF "Toolkit," here.  (Note - cobranded JC/Janssen).
  • In 2016, National Quality Partnership (NQP) of National Quality Forum (NQF) released a strategic consensus viewpoint, the 38pp "Playbook" for ASP, here.
  • IDSA has numerous subject-specific guidelines and has an accreditation for Centers of Excellence in ASP, here.