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antibiótics stewardship

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https://www.readbyqxmd.com/read/29781595/-results-of-the-implementation-of-an-antimicrobial-stewardship-program-in-the-gerencia-de-atenci%C3%A3-n-integrada-of-alcazar-de-san-juan-castilla-la-mancha
#1
M A Asencio Egea, O Herráez Carrera, M Huertas Vaquero, H D Patiño Ortega, M Franco Huerta, P Alcázar Carmona, M C Conde García, C Muñoz-Cuevas, C Román Ortiz, J Gaitán Pitera, R Carranza González, J R Barberá
OBJECTIVE: Our aim was to evaluate the efficiency of an ASP after its implementation in 2016 in a Spanish hospital quality system. METHODS: Efficiency of the ASP was measured by process and outcome indicators at the level of the patient's quality of life, antimicrobial consumption and percentage of resistance to them during the 2016-2017 period. In 2017, the failures mode and effects analysis (FMEA) methodology was applied. An annual satisfaction survey was conducted...
May 18, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29775092/a-prospective-multi-centre-us-clinical-trial-to-determine-accuracy-of-febridx-point-of-care-testing-for-acute-upper-respiratory-infections-with-and-without-a-confirmed-fever
#2
Nathan I Shapiro, Wesley H Self, Jeffrey Rosen, Stephan C Sharp, Michael R Filbin, Peter C Hou, Amisha D Parekh, Michael C Kurz, Robert Sambursky
BACKGROUND: FebriDx is a 10-minute disposable point-of-care test designed to identify clinically significant systemic host immune responses and aid in the differentiation of bacterial and viral respiratory infection by simultaneously detecting C-reactive protein (CRP) and myxovirus resistance protein A (MxA) from a fingerstick blood sample. FebriDx diagnostic accuracy was evaluated in the emergency room and urgent care setting. METHODS: A prospective, multicentre, observational cohort study of acute upper respiratory tract infections (URIs), with and without a confirmed fever at the time of enrolment, was performed to evaluate the diagnostic accuracy of FebriDx to identify clinically significant bacterial infection with host response and acute pathogenic viral infection...
May 18, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29771900/inappropriate-prescribing-of-antibiotics-following-discharge-after-major-surgery-an-area-for-improvement
#3
Mary De Almeida, Catherine Gerrard, Joshua T Freeman, Eamon Duffy, Sally A Roberts
AIM: This study aims to determine the indications for antibiotic use in patients discharged following major surgery at Auckland City Hospital (ACH); to determine if the indications were appropriate and to identify opportunities where antimicrobial stewardship interventions would be beneficial. METHODS: This was a retrospective study of adult patients who were dispensed an antibiotic within the first two days of discharge after major surgery at ACH between 1 January 2013 and 31 December 2013...
May 18, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29771104/-appropriateness-of-antimicrobial-prescriptions-in-the-emergency-department-of-a-tertiary-hospital
#4
L Yunquera-Romero, I Márquez-Gómez, A Henares-López, M J Morales-Lara, C Gallego Fernández, R Asensi-Díez
OBJECTIVE: Antibiotics are widely prescribed in the Emergency Department (ED), representing 26-62% of outpatient antibiotic prescriptions. Around 40% of antibiotic prescriptions in hospitalized patients are inappropriate or unnecessary. The aim of the study was to assess the appropriateness of antibiotic prescriptions according to local empirical antibiotic treatment guidelines, in the ED of a tertiary hospital. METHODS: Observational, retrospective study including patients attending the ED in November 2016, with an antibiotic prescription, excluding those from residents...
May 16, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29769028/-careful-goodbye-at-the-door-is-there-role-for-antimicrobial-stewardship-interventions-for-antimicrobial-therapy-prescribed-on-hospital-discharge
#5
R Chavada, J Davey, L O'Connor, D Tong
BACKGROUND: Antimicrobial stewardship (AMS) interventions largely target inpatient antimicrobial prescribing. Literature on appropriateness of antimicrobials prescribed at the interface between hospital and the community is minimal. This study was designed to assess the appropriateness of antimicrobials prescribed on hospital discharge and evaluate the impact of AMS interventions. METHODS: Patients with discharge medications processed by the pharmacy were identified using a computerized pharmacy medication tracker over a four week period...
May 16, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29758063/the-impact-of-antibiotic-use-on-transmission-of-resistant-bacteria-in-hospitals-insights-from-an-agent-based-model
#6
Jonatan Almagor, Elizabeth Temkin, Itzhak Benenson, Noga Fallach, Yehuda Carmeli
Extensive antibiotic use over the years has led to the emergence and spread of antibiotic resistant bacteria (ARB). Antibiotic resistance poses a major threat to public health since for many infections antibiotic treatment is no longer effective. Hospitals are focal points for ARB spread. Antibiotic use in hospitals exerts selective pressure, accelerating the spread of ARB. We used an agent-based model to explore the impact of antibiotics on the transmission dynamics and to examine the potential of stewardship interventions in limiting ARB spread in a hospital...
2018: PloS One
https://www.readbyqxmd.com/read/29757387/e-learning-on-antibiotic-prescribing-the-role-of-autonomous-motivation-in-participation-a-prospective-cohort-study
#7
Martine G Caris, Jonne J Sikkens, Rashmi A Kusurkar, Michiel A van Agtmael
Objectives: E-learning is increasingly used in education on antimicrobial stewardship, but participation rates are often low. Insight into factors that affect participation is therefore needed. Autonomous motivation is associated with higher achievements in medical education and could also play a role in e-learning participation. We therefore aimed to investigate the role of residents' autonomous motivation in their participation in e-learning on antibiotic prescribing. Methods: We performed a multicentre cohort study in two academic and two teaching hospitals...
May 10, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29757101/identifying-and-predicting-profiles-of-medical-noncompliance-pediatric-caregivers-antibiotic-stewardship
#8
Rachel A Smith, Youllee Kim, Nkuchia M M'Ikanatha
Sometimes compliance with medical recommendations is problematic. We investigated pediatric caregivers' (N = 606) patterns of noncompliance with antibiotic stewardship based on the obstacle hypothesis. We tested predictors of noncompliance framed by the obstacle hypothesis, dissonance theory, and psychological reactance. The results revealed four profiles of caregivers' stewardship: one marked by compliance (Stewards) and three marked by types of noncompliance (Stockers, Persuaders, and Dissenters). The covariate analysis showed that, although psychological reactance predicted being noncompliant, it was types of obstacles and discrepant experiences that predicted caregivers' patterns of noncompliance with antibiotic stewardship...
May 14, 2018: Journal of Health Communication
https://www.readbyqxmd.com/read/29756072/managing-antibiotics-wisely-a-quality-improvement-programme-in-a-tertiary-neonatal-unit-in-the-uk
#9
Vasiliki Makri, Gemma Davies, Stephanie Cannell, Katherine Willson, Lucy Winterson, Joanna Webb, Amit Kandhari, Maha Mansour, Joanne Thomas, Geraint Morris, Jean Matthes, Sujoy Banerjee
Microbial resistance to antibiotics is a serious global health problem compounded by antibiotic overuse and limited investment in new antibiotic research. Inappropriate perinatal antibiotic exposure is increasingly linked to lifelong adverse outcomes through its impact on the developing microbiome. Antibiotic stewardship may be the only effective preventative strategy currently available. As the first tertiary neonatal unit in the UK to collaborate in an international quality improvement programme (QIP) with Vermont Oxford Network (VON), we present the results of our antibiotic stewardship initiative...
2018: BMJ open quality
https://www.readbyqxmd.com/read/29750767/potential-for-more-rational-use-of-antibiotics-in-hospitalized-children-in-a-country-with-low-resistance-data-from-eight-point-prevalence-surveys
#10
Christian Magnus Thaulow, Dag Berild, Beate Horsberg Eriksen, Tor Åge Myklebust, Hege Salvesen Blix
BACKGROUND: Antimicrobial resistance (AMR) is low in Norway, but to prevent an increase the Norwegian Government has launched a National Strategy including a 30% reduction of broad-spectrum antibiotics (BSA) in hospitals within 2020. BSA are defined as second- and third-generation cephalosporins, carbapenems, piperacillin/tazobactam and quinolones. There are no recent studies of antibiotic use in Norwegian hospitalized children. AIM OF THE STUDY: To describe the use of antibiotics with emphasis on BSA in Norwegian hospitalized children and neonates in order to detect possibilities for optimization...
May 10, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29750765/ideal-and-actual-impact-of-rapid-diagnostic-testing-and-antibiotic-stewardship-on-antibiotic-prescribing-and-clinical-outcomes-in-children-with-positive-blood-cultures
#11
Caroline H Reuter, Hannah L Palac, Larry K Kociolek, Xiaotian T Zheng, Yusuf Y Chao, Rupal Patel, Sameer J Patel
BACKGROUND: Implementing matrix assisted laser desorption ionization time of flight (MALDI-TOF) and multiplex PCR (mPCR) has been associated with decreased mortality and hospital length of stay in adults, but the impact in pediatrics is less understood. METHODS: This pre-post quasi-experimental study compared antibiotic prescribing for positive blood cultures in patients ≤21 years collected in 2012 (pre-intervention) and in 2015 (after MALDI-TOF/mPCR). Time to effective and optimal antimicrobial therapy were evaluated using Cox proportional hazards regression...
May 10, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29750044/successful-control-of-resistance-in-pseudomonas-aeruginosa-using-antibiotic-stewardship-and-infection-control-programs-at-a-chinese-university-hospital-a-6-year-prospective-study
#12
Lei Liu, Bin Liu, Yu Li, Wei Zhang
Objective: Pseudomonas aeruginosa is emerging as a highly multidrug-resistant (MDR) nosocomial pathogen. Data on the efficacy of infection control measures in endemic situations are lacking. We investigated the effect of antimicrobial stewardship (AMS) and infection control programs (ICPs) in controlling the resistance of P. aeruginosa at a tertiary hospital center. Methods: Susceptibility and resistance were investigated using broth microdilution, as per the guidelines of the Clinical and Laboratory Standards Institute...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29746682/improving-antibiotic-prescribing-skills-in-medical-students-the-effect-of-e-learning-after-6-months
#13
Jonne J Sikkens, Martine G Caris, Tim Schutte, Mark H H Kramer, Jelle Tichelaar, Michiel A van Agtmael
Background: Antimicrobial prescribing behaviour is first established during medical study, but teachers often cite lack of time as an important problem in the implementation of antimicrobial stewardship in the medical curriculum. The use of electronic learning (e-learning) is a potentially time-efficient solution, but its effectiveness in changing long-term prescribing behaviour in medical students is as yet unknown. Methods: We performed a prospective controlled intervention study of the long-term effects of a short interactive e-learning course among fourth year medical students in a Dutch university...
May 9, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29743225/ambulatory-antibiotic-stewardship-through-a-human-factors-engineering-approach-a-systematic-review
#14
Sara C Keller, Pranita D Tamma, Sara E Cosgrove, Melissa A Miller, Heather Sateia, Julie Szymczak, Ayse P Gurses, Jeffrey A Linder
INTRODUCTION: In the United States, most antibiotics are prescribed in ambulatory settings. Human factors engineering, which explores interactions between people and the place where they work, has successfully improved quality of care. However, human factors engineering models have not been explored to frame what is known about ambulatory antibiotic stewardship (AS) interventions and barriers and facilitators to their implementation. METHODS: We conducted a systematic review and searched OVID MEDLINE, Embase, Scopus, Web of Science, and CINAHL to identify controlled interventions and qualitative studies of ambulatory AS and determine whether and how they incorporated principles from a human factors engineering model, the Systems Engineering Initiative for Patient Safety 2...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29738295/antibiotic-resistance-and-biofilm-tolerance-a-combined-threat-in-the-treatment-of-chronic-infections
#15
Philip G Bowler
Since the introduction of antibiotics into human medicine in the 1940's, antibiotic resistance has emerged at an alarming rate and is now a major threat to public health. This problem is amplified by pathogenic bacteria existing most commonly in biofilm form, creating additional bacterial tolerance to antimicrobial agents. Biofilm is now considered to be a primary cause of chronic infection, and antibiotic-resistant bacteria are prevalent in biofilm form. In particular, chronic non-healing wounds commonly harbour complex polymicrobial, pathogenic biofilm that is tolerant to systemic and topical antimicrobial therapy...
May 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29734957/hospital-level-variability-in-broad-spectrum-antibiotic-use-for-children-with-acute-leukemia-undergoing-hematopoietic-cell-transplantation
#16
Caitlin W Elgarten, Staci D Arnold, Yimei Li, Yuan-Shung V Huang, Marcie L Riches, Jeffrey S Gerber, Richard Aplenc, Wael Saber, Brian T Fisher
OBJECTIVETo explore the prevalence and drivers of hospital-level variability in antibiotic utilization among hematopoietic cell transplant (HCT) recipients to inform antimicrobial stewardship initiatives.DESIGNRetrospective cohort study using data merged from the Pediatric Health Information System and the Center for International Blood and Marrow Transplant Research.SETTINGThe study included 27 transplant centers in freestanding children's hospitals.METHODSThe primary outcome was days of broad-spectrum antibiotic use in the interval from day of HCT through neutrophil engraftment...
May 8, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29733352/adaptation-of-a-hospital-electronic-referral-system-for-antimicrobial-stewardship-prospective-audit-and-feedback-rounds
#17
Matthew D M Rawlins, Edward Raby, Frank M Sanfilippo, Rae Douglass, Jonathan Chambers, Duncan McLellan, John R Dyer
Objective: To evaluate the impact of the adaptation of an existing electronic referral application for use in antimicrobial stewardship prospective audit and feedback rounds (antimicrobial rounds). Design: Retrospective, single-centre observational study between March 2015 and February 2016. Setting: A new quaternary referral centre. Study Participants: Adults referred for antimicrobial rounds outside of the intensive care and haematology units...
May 4, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29729830/integrating-staff-nurses-in-antibiotic-stewardship-opportunities-and-barriers
#18
Elizabeth Monsees, Lori Popejoy, Mary Anne Jackson, Brian Lee, Jennifer Goldman
BACKGROUND: Nursing has been called for greater participation in antibiotic stewardship. Although many of the functions that are integral to successful stewardship are within the scope of bedside nurses, data evaluating nursing engagement in stewardship are limited. The objective of this study was to identify nurses' roles and confidence in engaging in stewardship practices by conducting a survey of pediatric staff nurses employed at a 354-bed freestanding children's hospital with a well-established prospective audit and feedback stewardship program...
May 2, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29729160/-dynamics-of-staphylococcus-aureus-antibiotic-resistance-to-fluoroquinolones-in-vitro-in-patients-with-overweight
#19
Tetiana V Dukhovich, Ivan V Chopei, Kseniya I Chubirko
OBJECTIVE: Introduction:S. aureus is the main pathogen of skin, soft tissue and otorhinolaryngological infections as well as the cause of osteomyelitis, meningitis and endocarditis. In recent years the importance of S. aureus mediated infections has grown not only because of their widespread, but also due to their antibiotic resistance. Recent observations showed that the resistance is developed to each new antibacterial agent after 5 years of its intensive use. Based on the studies conducted in Ukraine, it is known that the resistance of S...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29726725/patient-perceptions-of-antibiotic-use-and-resistance-at-a-single-university-dermatology-clinic
#20
Lainee S Goettsche, Emily A Weig, Jina Chung, Brian M Hoff, Dilek Ince, Karolyn A Wanat
Antibiotic resistance is an important problem which requires continued patient education and important prescribing stewardship. Dermatologists prescribe the most antibiotics per provider in comparison to other specialties and have an important role to play in the campaign of mindful prescribing. Data on the dermatology patients' knowledge and perception regarding antibiotic resistance is lacking and could play a role in providers' continuation of medications. We conducted a single institution survey of 512 dermatology clinic patients to understand patient's knowledge and potential gaps...
May 4, 2018: Journal of Dermatological Treatment
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