From the Guidelines
Hospital-acquired infections (HAIs) are a significant concern in healthcare facilities, and preventing them requires a multifaceted approach that includes hand hygiene, proper use of invasive devices, and awareness of individual infection risks, as emphasized by the guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia 1. To protect against HAIs, it is essential to understand that they commonly include urinary tract infections, surgical site infections, pneumonia, bloodstream infections, and C. difficile infections. These infections often spread through contaminated hands, medical equipment, and surfaces. Some key considerations for preventing HAIs include:
- Hand hygiene: ensuring healthcare workers clean their hands before touching patients, as it is the single most important prevention measure 1.
- Invasive devices: asking about the necessity of devices like catheters and requesting their removal as soon as possible, as they are common infection sources 1.
- Personal hygiene: maintaining good personal hygiene, including regular handwashing and showering with antiseptic soap if recommended.
- Awareness of infection risks: being aware of individual infection risks, especially if patients have diabetes, are elderly, or immunocompromised.
- Speaking up: not hesitating to speak up if patients notice concerning symptoms like fever, unusual drainage from wounds, or increased pain. HAIs are serious because they can extend hospital stays, increase healthcare costs, and may involve antibiotic-resistant bacteria, making them difficult to treat and potentially life-threatening. The guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia provide a framework for the initial evaluation and management of patients with these infections, emphasizing the importance of early, appropriate antibiotics, avoiding excessive antibiotics, and shortening the duration of therapy to the minimum effective period 1. Overall, preventing HAIs requires a proactive and multifaceted approach that involves healthcare workers, patients, and families working together to reduce the risk of infection and promote a safe healthcare environment.
From the FDA Drug Label
The following in vitro data are available, but their clinical significance is unknown: ... Susceptibility Tests When available, the clinical microbiology laboratory should provide the results of in vitro susceptibility test results for antimicrobial drug products used in the resident hospitals to the physician as periodic reports that describe the susceptibility profile of nosocomial and community-acquired pathogens
- Nosocomial Infections: The key consideration is that levofloxacin has in vitro activity against certain Gram-negative and Gram-positive bacteria that can cause nosocomial infections, such as Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus.
- Susceptibility Testing: It is essential to perform susceptibility testing to determine the effectiveness of levofloxacin against specific nosocomial pathogens.
- Clinical Significance: The clinical significance of in vitro data is unknown, and the safety and effectiveness of levofloxacin in treating clinical infections due to certain bacteria have not been established in adequate and well-controlled clinical trials 2.
From the Research
Key Considerations for Nosocomial Infections
- Nosocomial infections increase morbidity, mortality, and medical costs, with approximately 1.7 million infections and 99,000 deaths per year in the USA alone 3
- These infections can be spread through various routes, including surfaces, air, water, intravenous routes, oral routes, and surgery 3
- Effective interventions to reduce nosocomial infection rates include:
- Implementing multiple infection control techniques and strategies simultaneously ('bundling') may offer the best opportunity to reduce the morbidity and mortality toll of nosocomial infections 3
- Patient hand hygiene is also crucial in preventing hospital-acquired infections, and educating patients on proper hand hygiene can lead to significant reductions in infection rates 5
- Antimicrobial stewardship is essential in reducing the risk of antibiotic-resistant organisms and improving the efficacy of antibiotics, with principles including selecting the correct drug, dose, and duration of therapy, and avoiding unnecessary prescriptions 6
- National surveys have shown that the use of preventive practices, such as those to prevent central line-associated bloodstream infection, ventilator-associated pneumonia, and catheter-associated urinary tract infection, has increased in hospitals over time 7