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antibiótics stewardship

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https://www.readbyqxmd.com/read/28433726/managing-responsible-antimicrobial-use-perspectives-across-the-healthcare-system
#1
REVIEW
Oliver J Dyar, Gianpiero Tebano, Céline Pulcini
BACKGROUND: Healthcare systems consist of building blocks. Shaping how these building blocks function and interact can promote responsible antimicrobial use, and this represents an important opportunity for managers at different points within healthcare systems to act upon. AIMS: To review real-world examples of how healthcare systems can promote responsible antimicrobial use, focusing on the role of governance and managers. SOURCES: We searched and reviewed existing literature and official documents, which mostly focused on antibiotics...
April 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28432607/impact-of-the-medical-specialty-on-knowledge-regarding-multidrug-resistant-organisms-and-strategies-toward-antimicrobial-stewardship
#2
Steffen Lebentrau, Christian Gilfrich, Malte W Vetterlein, Harald Schumacher, Philipp J Spachmann, Sabine D Brookman-May, Hans M Fritsche, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Matthias May
PURPOSE: Evidence is scarce on subject-specific knowledge of multidrug-resistant organisms and rational use of antibiotics. We aimed at evaluating attitude, perception, and knowledge about multidrug-resistant organisms (MDRO) and antibiotic prescribing among urologists versus other medical specialties. METHODS: Within the MR2-study (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria), a questionnaire was conducted targeting general surgeons, internists, gynecologists, and urologists in 18 German hospitals...
April 21, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28431847/guideline-compliance-and-clinical-outcomes-among-patients-with-staphylococcus-aureus-bacteremia-with-infectious-diseases-consultation-in-addition-to-antimicrobial-stewardship-directed-review
#3
Kevin Buehrle, Jennifer Pisano, Zhe Han, Natasha N Pettit
OBJECTIVE: Previous studies have shown infectious diseases consultation (IDC) for Staphylococcus aureus bacteremia (SAB) improves management and outcomes. The influence of IDC on outcomes for SAB in addition to an antimicrobial stewardship program (ASP) review for adult inpatients with SAB has not been evaluated. The purpose of this study was to investigate the effect of IDC on SAB management with concomitant ASP review and resulting outcomes. METHODS: Adult inpatients with SAB admitted December 2012-October 2014 were included...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28426527/us-antibiotic-stewardship-and-penicillin-allergy
#4
Kara J Wada, Karen H Calhoun
PURPOSE OF REVIEW: The purpose of this review is to improve otolaryngologists' antibiotic stewardship by detailing current approaches to penicillin allergy. RECENT FINDINGS: Although up to 15% of hospitalized patients in the United States have a penicillin allergy recorded on their charts, fewer than 10% of these have a true penicillin allergy. SUMMARY: Using a combination of a detailed allergy history, skin testing and graded-dose administration, many patients whose charts say 'penicillin-allergic' can safely be treated with penicillin and cross-reacting antibiotics...
April 19, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28425828/compliance-to-guidelines-for-the-prescribing-of-antibiotics-in-acute-infections-at-namibia-s-national-referral-hospital-a-pilot-study-and-the-implications
#5
S Nakwatumbah, D Kibuule, B Godman, V Haakuria, F Kalemeera, A Baker, M Mwangana
BACKGROUND: Sub-optimal antibiotic prescribing remains a public health concern in Namibia. The objective is to determine the level and predictors of compliance to guidelines in the prescribing of antibiotics in acute infections at a national referral hospital in Namibia to improve future prescribing. METHODS: Descriptive observational cross-sectional study. The clinical records of patients receiving care were reviewed. Prescribing practices were assessed using a self- administered questionnaire with reference to Namibia Standard Treatment Guidelines (NSTG)...
April 20, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28421978/improving-patient-safety-through-antibiotic-stewardship-the-veterans-health-administration-leads-the-way-again
#6
Arjun Srinivasan, Lisa E Davidson
No abstract text is available yet for this article.
May 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28417918/high-prevalence-of-blandm-1-blavim-qace-and-qace%C3%AE-1-genes-and-their-association-with-decreased-susceptibility-to-antibiotics-and-common-hospital-biocides-in-clinical-isolates-of-acinetobacter-baumannii
#7
Fatma Alzahraa M Gomaa, Zeinab H Helal, Mazhar I Khan
The objective of this study was to evaluate the susceptibility of metallo-β-lactamase (MBL)-producing Acinetobacter baumannii (A. baumannii) clinical isolates to biocides. We also determined the prevalence and correlation of efflux pump genes, class 1 integron and MBL encoding genes. In addition, blaVIM, blaNDM-1, qacE and qacEΔ1 nucleotide sequence analysis was performed and compared to sequences retrieved from GenBank at the National Center for Biotechnology Information database. A. baumannii had a resistance rate to carbapenem of 71...
April 12, 2017: Microorganisms
https://www.readbyqxmd.com/read/28411959/implementation-and-outcomes-of-an-antimicrobial-stewardship-program-effectiveness-of-education
#8
Yea-Yuan Chang, Hsin-Pai Chen, Chia-Wei Lin, Jen-Jen Tang, Ti-Ying Hsu, Yueh-Chun Weng, Yuan-Ming Lee, Wei-Shu Wang, Su-Shun Lo
BACKGROUND: Unnecessary use of antibiotics is a common occurrence in hospitals. Implementation of antibiotic stewardship programs (ASPs) has been shown to reduce both unnecessary antibiotic use and drug-resistant bacteria. Education is a fundamental component of an ASP. However, the effectiveness of proper uses of antibiotics education has not been clearly analyzed. METHODS: In a 520-bed university hospital located in northeastern Taiwan, a significantly increasing prescription of carbapenems, specifically imipenem and meropenem, was observed...
April 12, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28407067/evaluation-of-a-second-sign-process-for-antimicrobial-prior-authorization
#9
Aimee M Dassner, Jennifer E Girotto
Background.: A second-sign prospective restriction of select broad-spectrum antimicrobials was fully implemented in January 2015 as a pediatric antimicrobial stewardship program (ASP) initiative to help ensure the most appropriate empiric use of ceftaroline, cefepime, fidaxomicin, linezolid, and vancomycin (intravenous). The objective of this evaluation is to assess the effectiveness of a forced second-sign process in the electronic medical record as a pediatric ASP strategy. We anticipated that the second-sign process for antibiotics would increase the appropriateness of empiric antibiotic use, as defined by preapproved criteria, clinical pathways, national guidelines, and pediatric-specific infectious diseases reference texts, while not causing significant delay in the initial administration of antibiotic therapy...
April 12, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28406949/antimicrobial-resistant-infections-among-postpartum-women-at-a-ugandan-referral-hospital
#10
Lisa M Bebell, Joseph Ngonzi, Joel Bazira, Yarine Fajardo, Adeline A Boatin, Mark J Siedner, Ingrid V Bassett, Dan Nyehangane, Deborah Nanjebe, Yves Jacquemyn, Jean-Pierre van Geertruyden, Juliet Mwanga-Amumpaire, David R Bangsberg, Laura E Riley, Yap Boum
INTRODUCTION: Puerperal sepsis causes 10% of maternal deaths in Africa, but prospective studies on incidence, microbiology and antimicrobial resistance are lacking. METHODS: We performed a prospective cohort study of 4,231 Ugandan women presenting to a regional referral hospital for delivery or postpartum care, measured vital signs after delivery, performed structured physical exam, symptom questionnaire, and microbiologic evaluation of febrile and hypothermic women...
2017: PloS One
https://www.readbyqxmd.com/read/28403049/clinical-and-microbiologic-characteristics-of-early-onset-sepsis-among-very-low-birth-weight-infants-opportunities-for-antibiotic-stewardship
#11
Sagori Mukhopadhyay, Karen M Puopolo
BACKGROUND: Most very low birth weight (VLBW, birth weight <1500 g) infants receive empiric antibiotics for risk of early-onset sepsis (EOS). The objective of this study was to determine the characteristics of VLBW infants with culture-confirmed EOS at a single center during 25 years and to identify opportunities for antibiotic stewardship. METHODS: Retrospective cohort study includes VLBW infants admitted from 1990 to 2015. EOS was defined as isolation of a pathogen in blood or cerebrospinal fluid culture obtained at <72 hours of age...
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28400686/convergence-of-minds-for-better-patient-outcome-in-intensive-care-unit-infections
#12
Chand Wattal, Yash Javeri, Neeraj Goel, Debashish Dhar, Sonal Saxena, Sarman Singh, Jaswinder Kaur Oberoi, B K Rao, Purva Mathur, Vikas Manchanda, Vivek Nangia, Arti Kapil, Ashok Rattan, Supradip Ghosh, Omender Singh, Vinod Singh, Iqbal Kaur, Sanghamitra Datta, Sharmila Sen Gupta
BACKGROUND: There is emergence of resistance to the last-line antibiotics such as carbapenems in Intensive Care Units (ICUs), leaving little effective therapeutic options. Since there are no more newer antibiotics in the armamentarium in the near future, it has become imperative that we harness the interdisciplinary knowledge for the best clinical outcome of the patient. AIMS: The aim of the conference was to utilize the synergies between the clinical microbiologists and critical care specialists for better patient care and clinical outcome...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399946/impact-of-a-multifaceted-antimicrobial-stewardship-program-a-front-line-ownership-driven-quality-improvement-project-in-a-large-urban-emergency-department
#13
Adam Jonathan Kaufman, Janine McCready, Jeff Powis
BACKGROUND: Antibiotic overuse has promoted growing rates of antimicrobial resistance and secondary antibiotic-associated infections such as Clostridium difficile (C. difficile). Antimicrobial stewardship programs (ASPs) are effective in reducing antimicrobial use in the inpatient setting; however, the unique environment of the emergency department (ED) lends itself to challenges for successful implementation. Front-line ownership (FLO) methodology has been shown to be a potentially effective strategy for the implementation of inpatient ASPs through an iterative multi-pronged approach driven by front-line providers...
April 12, 2017: CJEM
https://www.readbyqxmd.com/read/28397171/pediatric-antibiotic-stewardship-successful-interventions-to-reduce-broad-spectrum-antibiotic-use-on-general-pediatric-wards
#14
Katharina Kreitmeyr, Ulrich von Both, Alenka Pecar, Johannes P Borde, Rafael Mikolajczyk, Johannes Huebner
PURPOSE: Antibiotic stewardship programs (ASP) optimize antibiotic usage and combat antibiotic resistance of bacteria. The objective of this study was to assess the impact of specific ASP interventions on antibiotic consumption in general pediatric wards. METHODS: We conducted a prospective study to compare a pre-intervention (Sept.-Dec. 2014) and post-intervention (Sept.-Dec. 2015) period. An ASP bundle was established including (1) infectious diseases (ID) ward rounds (prospective-audit-with-feedback), (2) ID consultation service, (3) internal guidelines on empiric antibiotic therapy...
April 10, 2017: Infection
https://www.readbyqxmd.com/read/28396730/the-incidence-of-mrsa-infections-in-the-united-states-is-a-more-comprehensive-tracking-system-needed
#15
Kevin T Kavanagh, Said Abusalem, Lindsay E Calderon
A review of epidemiological studies on the incidence of MRSA infections overtime was performed along with an analysis of data available for download from Hospital Compare (https://data.medicare.gov/data/hospital-compare). We found the estimations of the incidence of MRSA infections varied widely depending upon the type of population studied, the types of infections captured and in the definitions and terminology used to describe the results. We could not find definitive evidence that the incidence of MRSA infections in U...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28395369/antibiotics-prescriptions-in-the-neonatal-intensive-care-unit-how-to-overcome-everyday-challenges
#16
D Donà, E Mozzo, V Mardegan, U Trafojer, P Lago, S Salvadori, E Baraldi, C Giaquinto
Antimicrobial prescriptions in neonatal intensive care units (NICUs) represent a point of concern for the emergence of MDROs and for morbidity associated with prolonged antibiotic exposure (e.g., invasive candidiasis, necrotizing enterocolitis, and late-onset sepsis). Antimicrobial stewardship programs (ASPs) have shown to be a valuable tool for the prevention of resistance with the goals of optimizing clinical outcomes while decreasing unnecessary prescribing. The most frequent ASP strategies include the correct collection and interpretation of microbiological specimens, prescription of the narrowest-spectrum antibiotic appropriate for a particular case, and de-escalation or discontinuation of therapy in defined situations...
April 10, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28391232/antibiotic-prescriptions-for-inpatients-having-non-bacterial-diagnosis-at-medicine-departments-of-two-private-sector-hospitals-in-madhya-pradesh-india-a-cross-sectional-study
#17
Kristoffer Landstedt, Ashish Sharma, Fredrik Johansson, Cecilia Stålsby Lundborg, Megha Sharma
OBJECTIVES: To present and compare antibiotic prescribing for inpatients among the most common non-bacterial diagnoses groups at medicine departments of a teaching (TH) and a non-teaching hospital (NTH) in central India. SETTING: An observational cross-sectional study was conducted at two tertiary care settings in Ujjain district, Madhya Pradesh, India. DATA AND PARTICIPANTS: The data were collected manually, using a customised form. Complete records of all inpatients, who were >15 years of age and had stayed for at least one night in either of the hospitals during 2008-2011, were analysed...
April 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28385463/clinical-and-social-barriers-to-antimicrobial-stewardship-in-pulmonary-medicine-a-qualitative-study
#18
Jennifer K Broom, Alex F Broom, Emma R Kirby, Alexandra F Gibson, Jeffrey J Post
BACKGROUND: The treatment of pulmonary infections is one of the largest indications for antibiotics in human health care, offering significant potential for antibiotic optimization internationally. This study explores the perspectives of pulmonary clinicians on antibiotic use in hospital pulmonary infections. METHODS: Twenty-eight pulmonary doctors and nurses from 2 hospitals participated in semi-structured interviews focusing on their experiences of antibiotic use...
April 3, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28384858/antimicrobial-resistance-surveillance-among-intensive-care-units-of-a-tertiary-care-hospital-in-southern-india
#19
Kailash Moolchandani, Apurba Sankar Sastry, R Deepashree, Sujatha Sistla, B N Harish, Jharna Mandal
INTRODUCTION: Hospital Acquired Infections (HAIs) are the rising threat in the health care facilities across the globe. As most Intesive Care Unit (ICU) patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. AIM: To study the occurrence of different types of HAIs in patients admitted to various ICUs of JIPMER and the AMR pattern of the bacterial pathogens isolated from them...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28378151/-antibiotic-stewardship-and-staphylococcus-aureus-bacteremia
#20
S Weis, A Kimmig, S Hagel, M W Pletz
Rates of antibiotic resistance are increasing worldwide and impact on the treatment of patients with bacterial infections. A broad and uncritical application in inpatient and outpatient settings as well as in agriculture has been recognized as the main driving force. Antibiotic stewardship (ABS) programs aim at countering this worrisome development using various direct interventions such as infectious disease counseling. Blood stream infections caused by Staphylococcus (S.) aureus are severe infections associated with high mortality rates...
April 4, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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