Einstein/Montefiore Department of Medicine

Antibiotic Stewardship Program Designated as Center of Excellence

Priya Nori, MD

The Antimicrobial Stewardship Program (ASP) at Montefiore has been designated as a Center for Excellence by The Infectious Diseases Society of America (IDSA).

Montefiore is among 25 academic sites in the nation – and one of few in New York City, to receive this prestigious recognition, which was announced on August 15, 2018.  IDSA’s Center of Excellence recognizes institutions that have created stewardship programs led by infectious diseases (ID) physicians and ID pharmacists that are of the highest quality and have achieved standards established by the Centers for Disease Control and Prevention (CDC).

Each year, more than 700,000 people worldwide die due to antimicrobial resistant infections, making it one of the greatest threats facing health care across the globe. Antimicrobial stewardship programs are recognized as the most effective means of reducing antimicrobial resistance on a large scale.

“This designation recognizes Montefiore’s impact in antimicrobial stewardship and motivates us to continue to strive for excellence and innovate in this area,” said Priya Nori, MD, medical director of the Antimicrobial Stewardship program and assistant professor in the department of Medicine (Infectious Diseases). “We are honored that IDSA has recognized our multidisciplinary program in which physicians, pharmacists and analytic experts collaborate effortlessly to advance a shared goal.”

It is estimated that half of all antibiotic prescriptions are considered “inappropriate” – meaning they are prescribed for non-bacterial infections, the spectrum of coverage is overly broad and potentially toxic, the dose is inaccurate, or the duration is too long. This contributes directly to poor patient outcomes, Clostridium difficile infections (CDI), and the emergence of multi-drug resistant pathogens.  

To address this growing issue, in July 2008, Montefiore initiated an interdisciplinary stewardship program, developed by Dr. Belinda Ostrowsky, to educate, support, and advise healthcare providers on prescribing best practices. Montefiore’s antimicrobial stewardship team commits to patient safety by promoting judicious use of antimicrobials to prevent the collateral consequences of inappropriate use.

Today, stewardship operations occur at each of Montefiore’s academic campuses (Moses, Einstein, and Wakefield) the Children's Hospital at Montefiore (CHAM), and the ambulatory network in partnership with the departments of pharmacy, microbiology, and infection prevention and control.

“This interdisciplinary collaboration is the key to our success,” said Yi Guo, PharmD, co-director of the Antimicrobial Stewardship program, clinical pharmacy manager of infectious diseases and assistant professor in the department of Medicine. 

In recent years, the program has expanded its reach optimize care of vulnerable patients, such as solid organ and hematologic transplant recipients. Dr. Rachel Bartash, who specializes in stewardship of compromised-host populations, leads this effort. The program also offers specialized training to infectious diseases fellows seeking to become future stewardship leaders.

Together with institutional liaisons and stewardship champions, the ASP team promotes antimicrobial prescribing best practices. Montefiore/Einstein Stewardship members and partners have published in the areas of rapid diagnostic technology and stewardship, quality improvement initiatives to improve community acquired pneumonia management, stewardship and Clostridium difficile infection, stewardship and antiretroviral therapy, stewardship and outpatient parenteral antibiotic therapy, carbapenem-resistant Enterobacteriaceae, medical education in stewardship and infection prevention, and stewardship in special populations.

To learn more about the Montefiore Antibiotic Stewardship Program and access their educational resources, click here.  To read the IDSA press release click here.

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