Key points
CDC sat down with experts to discuss opportunities to reduce health disparities through strengthening antibiotic stewardship, including identification of risk factors that can contribute to health inequity and how to help healthcare providers improve prescribing practices.
Improving antibiotic use through a health equity lens
Posted on: January 2023
CDC is committed to reducing health inequities and ensuring everyone has the opportunity to be as healthy as possible through implementation of CDC's CORE Health Equity Science and Innovation Strategy. As part of this effort, Arjun Srinivasan, Deputy Director for Program Improvement in CDC's Division of Healthcare Quality Promotion (DHQP), sat down with U.S. antibiotic stewardship experts to discuss improving antibiotic use and prescribing efforts through a health equity lens as part of CDC's AMR Exchange webinar series.
Health disparities are closely linked with social, economic and environmental disadvantages or other characteristics historically linked to discrimination or exclusion. These disparities could be created or worsened in communities with fewer resources to allocate to antibiotic stewardship activities that focus on improving antibiotic prescribing and use.
Inaction to address these disparities risks the development of harms resulting from the inappropriate use of antibiotics. This includes allergic reactions, side effects, overmedication, medication errors, Clostridioides difficile infections or greater burden of antimicrobial resistance. That's why CDC and partners are dedicated to strengthening antibiotic stewardship activities to achieve quality of care and equity in healthcare settings and our communities.
Kicking off the AMR Exchange conversation, CDC's Lauri Hicks, Director of DHQP's Office of Antibiotic Stewardship, acknowledged the need to understand the drivers and underlying risk factors that contribute to health inequity, such as variation in healthcare access and physician prescription behavior. Hicks noted that people from racial and ethnic minority groups and Medicare and Medicaid patients are disproportionately impacted likely due to inadequate resources and implicit bias from physicians. To help address some of the challenges faced understanding the different variables that can impact antibiotic use and prescribing, CDC encourages optimizing collection of health equity data across healthcare settings to enable more robust health equity analyses.
David Hyun, Project Director of the Antibiotic Resistance Project at The Pew Charitable Trusts, highlighted that healthcare facilities across the nation require sustainable resources to strengthen antibiotic stewardship. Dedicated resources can empower healthcare professionals and networks to implement data-driven solutions, share knowledge and integrate resources to address gaps that worsen known health inequities in antibiotic prescribing and use—a message that ran throughout the discussion.
Natalia Vargas, Program Lead for Medicare Beneficiary Quality Improvement in the Health Resources & Services Administration (HRSA), joined the conversation to offer firsthand insight from rural and underserved hospital settings. Vargas emphasized that HRSA encourages antibiotic stewardship as an important tool for health sustainability as well as embracing variability in rural communities and meeting them where they are. She also mentioned educational development and telemedicine as opportunities for sustainable long-term impacts for rural facilities and smaller healthcare settings that lack resources.
Zanthia Wiley, Associate Professor of Medicine at Emory University School of Medicine, emphasized the need for diversity in clinical trials to reflect the populations that we serve. Wiley recommended better representation in clinical trials and randomized control trials as two approaches that can be used to eliminate implicit bias and ensure equitable distribution of representation and resources across health care.
Efforts to address health inequities while also addressing antimicrobial resistance must remain grounded in targeted, solution-oriented strategies. CDC and partners prioritize strategies to address antimicrobial resistance health equity through CDC's CORE Health Equity Science and Implementation Strategy, an agency-wide approach to address health equity.
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AMR Exchange: Addressing Health Inequities by Addressing Antibiotic Stewardship
In October 2022, CDC sat down with U.S. antibiotic stewardship experts to discuss improving antibiotic use and prescribing efforts through a health equity lens as part of CDC's AMR Exchange webinar series. Watch the video below to listen to the entire discussion led by CDC and follow @CDC_AR to learn more about CDC's antimicrobial resistance activities, resources, and upcoming events, including the next webinar in the AMR Exchange Series.
Resources
Antimicrobial resistance resources
Visit CDC's Antimicrobial Resistance website and follow us @CDC_AR to learn more about CDC's antimicrobial resistance activities, resources and upcoming events, including the next webinar in the AMR Exchange Series.
Health equity resources
Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social and other obstacles to health and health care; and eliminate preventable health disparities. Visit CDC's Health Equity website to learn more.
Antibiotic stewardship
Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Visit CDC's Antibiotic Use website for free resources.