MERIDIAN— In an effort to help improve care of U.S veterans, Idaho State University researcher Karl Madaras-Kelly is at the forefront of efforts to research the dangers posed by unnecessary antimicrobial use.
Antibiotics, a staple in health care for almost 80 years, have greatly reduced illnesses and deaths from infectious diseases. However, an unfortunate consequence of antibiotics and other antimicrobials is that bacteria can become resistant to the treatment. According to the Centers for Disease Control and Prevention (CDC), antimicrobial-resistant bacteria known as superbugs are causing certain antimicrobials to become less effective—and sometimes completely ineffective.
This year Madaras-Kelly, an ISU College of Pharmacy professor, co-authored a publication that looked at millions of hospitalizations across the Veterans Health Administration (VHA) and described how a number of national systematic policy changes were associated with a 12 percent reduction in antimicrobial use, a reduction in Clostridium difficile (C. diff.) bacterium infections and a reduction in antimicrobial-resistant organisms. C.diff causes colitis, an inflammation of the colon, and is responsible for over 450,000 infections each year.
The systematic approach used in the 2017 study is known as antimicrobial stewardship, which is designed to improve and measure the appropriate use of antimicrobials through promoting optimal selection, dosing, and duration of therapy prescribed by providers.
In 2012, Madaras-Kelly joined part of a national team of physician and pharmacy experts charged with implementing antimicrobial stewardship programs across the VHA. The Antimicrobial Stewardship Task Force (ASTF) focused on implementing its strategy within the VHA and its 8 million veterans in more than 140 health care systems.
“It truly has been gratifying to be part of the ASTF in leading efforts to design, implement and evaluate policy and stewardship-related interventions with the potential to influence patient care on a national level,” Madaras-Kelly said.
Long before joining the ASTF, the fight against antimicrobial resistance inspired Madaras-Kelly to transition his research focus from a bench laboratory-based research program with a microbiology focus to one with a health service focus that aligned closely with antimicrobial stewardship.
He has been in his current position at the Boise Veterans Affairs Medical Center since 1994 where he maintains active infectious disease and research programs. His work in this field led to the awarding of more than $1.6 million in grant support from the VHA, National Institute of Health, CDC, pharmacy professional societies and the pharmaceutical industry. In 2017, Madaras-Kelly was named an Idaho State University Outstanding Researcher.
“It is always nice to be recognized by peers for one's efforts,” Madaras-Kelly said. “The beauty of the research I conduct is that I can see the direct impact it has on patients.”
The CDC says that each year in the United States at least 2 million people develop infections with bacteria that are resistant to antimicrobials and at least 23,000 people die as a direct result of these infections. Taking antimicrobials increases risk for developing C. diff. infection and the CDC estimates that up to 50 percent of antimicrobials prescribed to patients are unnecessary, indicating a missed opportunity to prevent these infections.