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antibiótics stewardship

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https://www.readbyqxmd.com/read/29151013/decreasing-the-incidence-of-surgical-site-infections-following-joint-replacement-surgery
#1
Lorraine Hutzler, Jarrett Williams
OBJECTIVE: Despite the generalized use of prophylactic antibiotics in orthopaedic surgery, Surgical Site Infections (SSIs) are still a major source of morbidity, mortality, and hospital cost. This is due in part to the increasing prevalence of antibiotic resistant organisms. METHODS: A review of local epidemiology, the importance of an antibiotic stewardship program, patient optimization, and risk stratification options to reduce SSIs. RESULTS: The proportion of revisions due to infection is projected to rise rapidly over the next 25 years...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#2
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29149338/multiplex-respiratory-virus-testing-for-antimicrobial-stewardship-a-prospective-assessment-of-antimicrobial-use-and-clinical-outcomes-among-hospitalized-adults
#3
Makeda Semret, Ian Schiller, Barbara Ann Jardin, Charles Frenette, Vivian G Loo, Jesse Papenburg, Shelly A McNeil, Nandini Dendukuri
Background: Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults. Methods: Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada...
November 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29146178/use-of-mathematical-modelling-to-assess-the-impact-of-vaccines-on-antibiotic-resistance
#4
REVIEW
Katherine E Atkins, Erin I Lafferty, Sarah R Deeny, Nicholas G Davies, Julie V Robotham, Mark Jit
Antibiotic resistance is a major global threat to the provision of safe and effective health care. To control antibiotic resistance, vaccines have been proposed as an essential intervention, complementing improvements in diagnostic testing, antibiotic stewardship, and drug pipelines. The decision to introduce or amend vaccination programmes is routinely based on mathematical modelling. However, few mathematical models address the impact of vaccination on antibiotic resistance. We reviewed the literature using PubMed to identify all studies that used an original mathematical model to quantify the impact of a vaccine on antibiotic resistance transmission within a human population...
November 13, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29145465/hospital-associated-methicillin-resistant-staphylococcus-aureus-a-cross-sectional-analysis-of-risk-factors-in-south-african-tertiary-public-hospitals
#5
Liliwe L Shuping, Lazarus Kuonza, Alfred Musekiwa, Samantha Iyaloo, Olga Perovic
INTRODUCTION: Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. METHODS: We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture...
2017: PloS One
https://www.readbyqxmd.com/read/29138099/effect-of-an-antimicrobial-stewardship-programme-on-antimicrobial-utilisation-and-costs-in-patients-with-leukaemia-a-retrospective-interventional-controlled-study
#6
Miranda So, Muhammad Mamdani, Andrew Morris, Tim Lau, Raewyn Broady, Uday Deotare, Jennifer Grant, Dennis Dong Hwan Kim, Aaron D Schimmer, Andre Schuh, Salomeh Shajari, Marilyn Steinberg, Chaim M Bell, Shahid Husain
OBJECTIVES: To examine the effectiveness of an antimicrobial stewardship programme (ASPs) on utilisation and cost of antimicrobials in leukaemia patients in Canada. METHODS: We conducted a multisite, retrospective, observational time-series study from 2005 to 2013. We implemented academic detailing as the intervention of an ASP in leukaemia units at a hospital, piloted February-July 2010, then fully implemented December 2010-March 2013, with no intervention in August-November 2010...
November 11, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29136126/risk-of-subsequent-sepsis-within-90-days-of-a-previous-hospital-stay-by-type-of-antibiotic-exposure
#7
James Baggs, Johm A Jernigan, Alison Laufer Halpin, Lauren H Epstein, Kelly M Hatfield, L Clifford McDonald
Background: We examined the risk of sepsis within 90 days after discharge from a previous hospital stay by type of antibiotic received during the previous stay. Methods: We retrospectively identified a cohort of hospitalized patients from the Truven Health MarketScan Hospital Drug Database. We examined the association between the use of certain antibiotics, determined a priori, during the initial hospital stay and risk of post-discharge sepsis controlling for potential confounding factors in a multivariable logistic regression model...
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29134582/long-term-efficacy-of-comprehensive-multidisciplinary-antibiotic-stewardship-programs-centered-on-weekly-prospective-audit-and-feedback
#8
Takeshi Kimura, Atsushi Uda, Tomoyuki Sakaue, Kazuhiko Yamashita, Tatsuya Nishioka, Sho Nishimura, Kei Ebisawa, Manabu Nagata, Goh Ohji, Tatsuya Nakamura, Chihiro Koike, Mari Kusuki, Takeshi Ioroi, Akira Mukai, Yasuhisa Abe, Hiroyuki Yoshida, Midori Hirai, Soichi Arakawa, Ikuko Yano, Kentaro Iwata, Issei Tokimatsu
OBJECTIVE: To evaluate the long-term effects of comprehensive antibiotic stewardship programs (ASPs) on antibiotic use, antimicrobial-resistant bacteria, and clinical outcomes. DESIGN: Before-after study. SETTING: National university hospital with 934 beds. INTERVENTION: Implementation in March 2010 of a comprehensive ASPs including, among other strategies, weekly prospective audit and feedback with multidisciplinary collaboration...
November 13, 2017: Infection
https://www.readbyqxmd.com/read/29132695/thai-clinicians-attitudes-toward-antimicrobial-stewardship-programs
#9
Nantanit Sutthiruk, Julie Considine, Ana Hutchinson, Andrea Driscoll, Kumthorn Malathum, Mari Botti
BACKGROUND: Effective hospital-wide antimicrobial stewardship (AMS) programs need multidisciplinary engagement; however, clinicians' attitudes have not been investigated in Thailand where AMS is in early development. The aim of this study was to explore Thai clinicians' (doctors, nurses, and pharmacists) perceptions and attitudes toward AMS. METHODS: A paper-based survey was distributed in a 1,000-bed university hospital in Bangkok, Thailand, between November 9, 2015, and December 21, 2015...
November 10, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29132017/antibiotic-stewardship-the-role-of-clinical-nurses-and-nurse-educators
#10
EDITORIAL
Sharon Sumner, Sandra Forsyth, Katreena Collette-Merrill, Caroline Taylor, Todd Vento, John Veillette, Brandon Webb
No abstract text is available yet for this article.
November 6, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29126268/duration-of-antibiotic-use-among-adults-with-uncomplicated-community-acquired-pneumonia-requiring-hospitalization-in-the-united-states
#11
Sarah H Yi, Kelly M Hatfield, James Baggs, Lauri A Hicks, Arjun Srinivasan, Sujan Reddy, John A Jernigan
Background: Previous studies suggest duration of antibiotic therapy for community-acquired pneumonia (CAP) often exceeds national recommendations and might represent an important opportunity to improve antibiotic stewardship nationally. The objective of this study was to determine average length of antibiotic therapy (LOT) for patients treated for uncomplicated CAP in US hospitals and proportion of patients with excessive durations. Methods: Records of retrospective cohorts of patients 18-64 years with private insurance and ≥65 years with Medicare hospitalized for CAP in 2012-13 were utilized...
November 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29122393/how-do-professional-relationships-influence-surgical-antibiotic-prophylaxis-decision-making-a-qualitative-study
#12
Jennifer K Broom, Alex F Broom, Emma R Kirby, Jeffrey J Post
BACKGROUND: Surgical antibiotic prophylaxis (SAP) is a critical area to optimize to reduce the escalation of antimicrobial resistance. This article explores the ways by which interpersonal relationships influence SAP decision making. METHODS: Twenty surgeons and anesthetists participated in in-depth semistructured interviews on SAP prescribing. Results were analyzed using the framework approach. RESULTS: Analysis revealed 3 ways by which interpersonal relationships influence SAP: relationship dynamics between the surgeon and the anesthetist determine appropriateness of SAP, particularly operative risk ownership; perceived hierarchies within, and between, surgical and anesthetist specialties influence antibiotic prescribing decisions; and surgical distance from the antimicrobial stewardship team, which influences use of antimicrobial stewardship principles...
November 7, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29120606/management-of-respiratory-infections-with-use-of-procalcitonin-moving-toward-more-personalized-antibiotic-treatment-decisions
#13
Yannick Wirz, Angela Branche, Michel Wolff, Tobias Welte, Vandack Nobre, Konrad Reinhart, Ann R Falsey, Pierre Damas, Albertus Beishuizen, Rodrigo O Deliberato, Yahya Shehabi, Jens-Ulrik S Jensen, Beat Mueller, Philipp Schuetz
Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics...
November 9, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/29118939/escherichia-coli-pathotypes-and-shigella-sero-groups-in-diarrheic-children-in-nairobi-city-kenya
#14
Peter Lokamar Nyanga, Jackson Onyuka, Mark Kilongosi Webale, Tom Were, Valentine Budambula
Aim: In the present study, we investigated the prevalence of E. coli pathotypes and Shigella sero-groups and their antimicrobial profiles among diarrheic children in Nairobi city, Kenya. Background: Although diarrheagenic E. coli pathotypes and Shigella sero-groups are leading causes of diarrhea in children under five years in developing countries, their distribution and antimicrobial resistance vary from place to place and over time in a given region. Methods: In a cross-sectional study, we enrolled diarrheic children (n=354) under five years seeking treatment at Mbagathi Hospital, Nairobi city, Kenya,...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/29113637/nurses-knowledge-perception-and-self-confidence-regarding-evidence-based-antibiotic-use-in-the-long-term-care-setting
#15
LaDonna S Hale, Lindsey L Votaw, Janell E Mayer, Kristen F Sobota
OBJECTIVE: Describe knowledge, perceptions, and self-confidence of nurses in the long-term care setting before and after online antibiotic stewardship education, and assess effectiveness and satisfaction with the education. DESIGN: Pre-/postsurvey. SETTING: Three long-term care facilities, Topeka, Kansas. PARTICIPANTS: Convenience sample of 140 licensed practical and registered nurses. INTERVENTIONS: Nurses viewed a 12-minute online module developed by long-term care consultant pharmacists...
November 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29107767/prevalence-of-methicillin-resistant-staphylococcus-aureus-isolated-from-burn-patients-a-systematic-review-and-meta-analysis
#16
REVIEW
Mohammad Emaneini, Reza Beigverdi, Willem B van Leeuwen, Hosseinali Rahdar, Morteza Karami-Zarandi, Faride Hosseinkhani, Fereshteh Jabalameli
OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) has considered as a major cause of infection and mortality in burn patients, especially when nosocomially acquired. Limited information is available on the prevalence of MRSA among burn patient in Iran. METHODS: We performed a systematic search by using different electronic databases including: Medline (via Pubmed), Embase, Web of Science, and Iranian Database. Meta-analysis was performed by Comprehensive Meta-Analysis (Biostat V2...
October 28, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29107038/routine-urine-testing-at-the-spinal-cord-injury-annual-evaluation-leads-to-unnecessary-antibiotic-use-a-pilot-study-and-future-directions
#17
Felicia Skelton, Larissa Grigoryan, Sally Ann Holmes, Ivy Oiyee Poon, Barbara Trautner
OBJECTIVE: To measure the prevalence of ASB in persons with spinal cord injury (SCI) at the time of their annual examination, and examine the impact on urine testing during the annual examination on subsequent antibiotic use. DESIGN: retrospective cohort study SETTING: a major Veterans Health Administration SCI center PARTICIPANTS: Veterans with SCI seen for an outpatient annual evaluation in 2012 or 2013 (n=393) MAIN OUTCOME MEASURE: antibiotic use for bacteriuria within seven days of the annual evaluation encounter RESULTS: Of the 327 clinic visits that met inclusion criteria, of which 249 had a urine culture performed...
October 26, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29106917/variation-in-prophylactic-antibiotic-use-for-laparoscopic-cholecystectomy-need-for-better-stewardship-in-pediatric-surgery
#18
Kibileri Williams, Lauren Baumann, Fizan Abdullah, Shawn D St Peter, Tolulope A Oyetunji
PURPOSE: The role of prophylactic antibiotics for elective laparoscopic cholecystectomy has been questioned over the last decade. Although gradually being discontinued in the adult population, the practice among pediatric surgeons remains unknown. Our aim was to investigate the use of perioperative antibiotics in children undergoing elective laparoscopic cholecystectomy (LC) for symptomatic cholelithiasis and biliary dyskinesia. METHODS: We retrospectively reviewed the Pediatric Health Information System (PHIS) database for 2015 and selected all patients 18years old or younger who underwent LC for cholelithiasis (without cholecystitis) or biliary dyskinesia...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29105600/microbiology-in-burns-patients-with-blood-stream-infections-trends-over-time-and-during-the-course-of-hospitalization
#19
Dolores Sousa, Alejandra Ceniceros, Rita Galeiras, Sonia Pértega-Díaz, José-María Gutiérrez-Urbón, María Rodríguez-Mayo, Eugenia López-Suso, Mónica Mourelo-Fariña, Pedro Llinares
BACKGROUND: Bloodstream infections (BSI) are a major cause of mortality in burns patients. Knowledge of the microbiology is crucial to direct empirical therapy. We sought to determine the causative microorganisms and antibiotic resistance in burns patients with BSI. METHODS: All consecutive BSI episodes in a tertiary hospital burns unit from 2000 to 2014 were included. The following three subperiods were compared: 2000-2004, 2005-2009 and 2010-2014. Changes in BSI occurring during early and late hospitalization periods were evaluated...
November 6, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/29102989/universal-or-targeted-approach-to-prevent-the-transmission-of-extended-spectrum-beta-lactamase-producing-enterobacteriaceae-in-intensive-care-units-a-cost-effectiveness-analysis
#20
Lidia Kardaś-Słoma, Jean-Christophe Lucet, Anne Perozziello, Camille Pelat, Gabriel Birgand, Etienne Ruppé, Pierre-Yves Boëlle, Antoine Andremont, Yazdan Yazdanpanah
OBJECTIVE: Several control strategies have been used to limit the transmission of multidrug-resistant organisms in hospitals. However, their implementation is expensive and effectiveness of interventions for the control of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) spread is controversial. Here, we aim to assess the cost-effectiveness of hospital-based strategies to prevent ESBL-PE transmission and infections. DESIGN: Cost-effectiveness analysis based on dynamic, stochastic transmission model over a 1-year time horizon...
November 3, 2017: BMJ Open
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