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antibiótics stewardship

Haim Ben-Zvi, Genady Drozdinsky, Shiri Kushnir, Tomer Avni, Oded Scheuerman, Jihad Bisahra, Dafna Yahav
Use of GeneXpert MRSA/SA in diagnostic algorithms of Staphylococcus aureus bacteremia may influence both patients' clinical outcomes and antibiotic stewardship. We evaluated these outcomes in a retrospective cohort before (1/6/2015-31/5/2016) and after (1/6/2016-31/8/2017) the introduction of the test in adult patients with Gram-positive cocci in clusters in blood cultures. We included 254 patients (125 preintervention, 129 postintervention). No significant difference in 30-day mortality or clinical success was demonstrated between periods...
August 29, 2018: Diagnostic Microbiology and Infectious Disease
Birgitta Schweickert, Marcel Feig, Marc Schneider, Niklas Willrich, Michael Behnke, Luis Alberto Peña Diaz, Petra Gastmeier, Doreen Richter, Hans-Peter Blank, Tim Eckmanns, Muna Abu Sin
Objectives: The features of a newly established, web-based surveillance system for hospital antibiotic consumption are described and data on broad-spectrum antibiotic use in German acute care hospitals are presented. Methods: The watch- and reserve-group antibiotics, two categories of antibiotics derived from the WHO Essential Medicines List comprising key agents for antimicrobial stewardship, were used as a framework for data analysis. The median antibiotic consumption densities (ACDs; DDD/100 patient days) for the years 2015/16 based on data from 137 acute care hospitals have been calculated for whole facilities, ICUs and medical and surgical departments, stratified by type of care...
September 17, 2018: Journal of Antimicrobial Chemotherapy
Catia Cillóniz, Cristina Dominedò, Carolina Garcia-Vidal, Antoni Torres
PURPOSE OF REVIEW: Despite the improvements in its management, community-acquired pneumonia (CAP) still exhibits high global morbidity and mortality rates, especially in elderly patients. This review focuses on the most recent findings on the epidemiology, cause, diagnosis and management of CAP. RECENT FINDINGS: There is consistent evidence that the trend in CAP mortality has declined over time. However, the mortality of pneumococcal CAP has not changed in the last two decades, with an increase in the rate of hospitalization and more severe forms of CAP...
September 18, 2018: Current Opinion in Critical Care
Sean T H Liu, Mark J Bailey, Allen Zheng, Patricia Saunders-Hao, Adel Bassily-Marcus, Maureen Harding, Meenakshi Rana, Roopa Kohli-Seth, Gopi Patel, Shirish Huprikar, Talia H Swartz
No abstract text is available yet for this article.
September 20, 2018: Infection Control and Hospital Epidemiology
Florian M Wagenlehner, Dimitri Abramov-Sommariva, Martina Höller, Hubert Steindl, Kurt G Naber
INTRODUCTION: This randomized, controlled, Phase III non-inferiority clinical trial aimed to determine whether herbal therapy with Canephron® N (BNO 1045) is non-inferior to fosfomycin trometamol (FT) in treating acute lower uncomplicated urinary tract infections (uUTIs). MATERIALS AND METHODS: Women aged 18-70 years with typical symptoms of newly diagnosed acute lower uUTIs were randomized to BNO 1045 (n = 325) or FT (n = 334), with corresponding matched placebo...
September 19, 2018: Urologia Internationalis
Maria Lyn Quintos-Alagheband, Estela Noyola, Sejal Makvana, Gladys El-Chaar, Shan Wang, Rose Calixte, Leonard R Krilov
Objective: The increased incidence of multidrug-resistant organisms is associated with increased morbidity, mortality, hospital length of stay, and cost. Estimates show that up to 50% of antimicrobial use is inappropriate. This initiative focuses on inappropriate use of antibiotics in respiratory syncytial virus (RSV) infections. This virus is the most common cause of bronchiolitis during childhood. Methods: Baseline data from the 2011-2012 RSV season showed that 56...
November 2017: Pediatric Quality & Safety
Anucha Apisarnthanarak, Andrea Lay-Hoon Kwa, Cheng-Hsun Chiu, Suresh Kumar, Le Thi Anh Thu, Ban Hock Tan, Zhiyong Zong, Yin Ching Chuang, Anis Karuniawati, Maria Fe Tayzon, Thomas Man-Kit So, Lance R Peterson
Inappropriate use of antibiotics is contributing to a serious antimicrobial resistance problem in Asian hospitals. Despite resource constraints in the region, all Asian hospitals should implement antimicrobial stewardship (AMS) programs to optimize antibiotic treatment, improve patient outcomes, and minimize antimicrobial resistance. This document describes a consensus statement from a panel of regional experts to help multidisciplinary AMS teams design programs that suit the needs and resources of their hospitals...
September 19, 2018: Infection Control and Hospital Epidemiology
Joan Guzik, Gopi Patel, Pooja Kothari, Misha Sharp, Belinda Ostrowsky
OBJECTIVE: To assess the status of antibiotic prescribing in the ambulatory setting for adult patients with acute respiratory infections (ARIs) and to identify opportunities and barriers for outpatient antibiotic stewardship programs (ASPs). DESIGN: Mixed methods including point prevalence using chart reviews, surveys, and collaborative learning. SETTING: Hospital-owned clinics in the New York City area.Participants/PatientsIn total, 31 hospital-owned clinics from 9 hospitals and health systems participated in the study to assess ARI prescribing practices for patients >18 years old...
September 18, 2018: Infection Control and Hospital Epidemiology
Emilio Bouza, Raffaella Onori, María Auxiliadora Semiglia-Chong, Ana Álvarez-Uría, Luis Alcalá, Almudena Burillo
PURPOSE: This study examines the impacts of a skin and soft tissue infection (SSTI) management program involving a rapid diagnostic algorithm (Gram stain plus real-time PCR, GeneXpert® MRSA/SA SSTI) performed directly on clinical samples plus antimicrobial stewardship (AMS) counseling of the responsible physician. METHODS: Participants were 155 consecutive adult inpatients with SSTI and good quality clinical samples submitted to the microbiology laboratory from April 2016 to January 2017...
August 31, 2018: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Carina Schuster, Sebastian Sterz, Daniel Teupser, Mathias Brügel, Michael Vogeser, Michael Paal
There is an ever-increasing demand for the therapeutic drug monitoring of antibiotics in many clinical facilities, particularly with regard to the implementation of hospital antibiotic stewardship programs. In the current work, we present a multiplex high-performance liquid chromatography-tandem mass spectrometry (HPCL-MS/MS) protocol for the quantification of cefepime, meropenem, ciprofloxacin, moxifloxacin, linezolid, and piperacillin, commonly used antibiotics in intensive care units. The method was previously comprehensively validated according to the guideline of the European Medicines Agency...
August 30, 2018: Journal of Visualized Experiments: JoVE
Darren Langdridge, Mark Davis, Lucyna Gozdzielewska, Joanna McParland, Lynn Williams, Mairi Young, Fraser Smith, Jennifer MacDonald, Lesley Price, Paul Flowers
OBJECTIVES: In an innovative approach to improve the contribution of health psychology to public health we have analysed the presence and nature of affect within the visual materials deployed in antimicrobial stewardship interventions targeting the public identified through systematic review. DESIGN: A qualitative analysis focused on the affective content of visual materials garnered from a systematic review of antibiotic stewardship (k = 20). METHODS: A novel method was devised drawing on concepts from semiotics to analyse the affective elements within intervention materials...
September 16, 2018: British Journal of Health Psychology
Kyle A Richards, Stacy Cesario, Sara L Best, Susan M Deeren, Wade Bushman, Nasia Safdar
OBJECTIVES: To evaluate the performance characteristics of urinalysis and urine microscopy parameters for predicting urine culture results and to implement a reflex urine culture program. METHODS: We reviewed the charts of all patients presenting to our clinic January-March 2013 and June-August 2014, excluding those who were catheter-dependent or with urinary diversions. We assessed the association of urinalysis and urine microscopy parameters on urine culture outcomes defining a positive urinalysis as nitrite-positive and/or the presence of ≥5 white blood cells per high-powered field with bacteria and a positive urine culture as ≥10 000 colony-forming units/mL excluding diphtheroids...
September 16, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
Aina Gomila, Evelyn Shaw, Jordi Carratalà, Leonard Leibovici, Cristian Tebé, Irith Wiegand, Laura Vallejo-Torres, Joan M Vigo, Stephen Morris, Margaret Stoddart, Sally Grier, Christiane Vank, Nienke Cuperus, Leonard Van den Heuvel, Noa Eliakim-Raz, Cuong Vuong, Alasdair MacGowan, Ibironke Addy, Miquel Pujol
Background: Patients with complicated urinary tract infections (cUTIs) frequently receive broad-spectrum antibiotics. We aimed to determine the prevalence and predictive factors of multidrug-resistant gram-negative bacteria in patients with cUTI. Methods: This is a multicenter, retrospective cohort study in south and eastern Europe, Turkey and Israel including consecutive patients with cUTIs hospitalised between January 2013 and December 2014. Multidrug-resistance was defined as non-susceptibility to at least one agent in three or more antimicrobial categories...
2018: Antimicrobial Resistance and Infection Control
Lindsay M Daniels, Wesley D Kufel
Clostridium difficile infection (CDI) has become a significant healthcare-associated infection and is strongly associated with antibiotic use. Practice guidelines have recently been revised incorporating updated recommendations for diagnosis, treatment, and prevention. Areas Covered: This review discusses updated aspects of CDI management. New and emerging pharmacologic options for treatment and prevention are reviewed. Expert opinion: Metronidazole is associated with lower rates of treatment success compared to vancomycin and should no longer be used as primary therapy for the first episode of CDI or recurrent disease...
September 15, 2018: Expert Opinion on Pharmacotherapy
(no author information available yet)
Improving antibiotic stewardship by dentists may help.
September 14, 2018: British Dental Journal
Jannicke Slettli Wathne, Lars Kåre Selland Kleppe, Stig Harthug, Hege Salvesen Blix, Roy M Nilsen, Esmita Charani, Ingrid Smith
Background: There is limited evidence from multicenter, randomized controlled studies to inform planning and implementation of antibiotic stewardship interventions in hospitals. Methods: A cluster randomized, controlled, intervention study was performed in selected specialities (infectious diseases, pulmonary medicine and gastroenterology) at three emergency care hospitals in Western Norway. Interventions applied were audit with feedback and academic detailing. Implementation strategies included co-design of interventions with stakeholders in local intervention teams and prescribers setting local targets for change in antibiotic prescribing behaviour...
2018: Antimicrobial Resistance and Infection Control
Rosemary Hill, Monique Y Rennie, Joshua Douglas
The urgent need to eliminate unnecessary use of antibiotics in wound patients has been hampered by diagnostic uncertainty and the time required to obtain culture results. The authors evaluated bedside use of a handheld bacterial fluorescence imaging device for real-time visualization of bacteria within and around wounds, used in addition to monitoring of clinical signs and symptoms of infection, in a series of 7 patients (5 women, 2 men; age range 57-93 years) with varying comorbidities who were referred to the wound ostomy continence clinician for wound assessment...
August 2018: Ostomy/wound Management
Holly M Frost, Huong Q McLean, Brian D W Chow
OBJECTIVE: To evaluate variation in antibiotic prescribing between pediatric and nonpediatric providers for common upper respiratory illnesses. STUDY DESIGN: Patient encounters for children aged <18 years from a regional health care system were identified. Electronic medical records from 2011 to 2016 were extracted for diagnoses of upper respiratory infection, pharyngitis, acute otitis media, and sinusitis. Encounters with competing medical diagnoses, recent hospitalization, and antibiotic prescriptions within 30 days were excluded...
September 5, 2018: Journal of Pediatrics
Magdalena Rzewuska, Esmita Charani, Janet E Clarkson, Peter G Davey, Eilidh M Duncan, Jill J Francis, Katie Gillies, Winfried V Kern, Fabiana Lorencatto, Charis A Marwick, Jo McEwen, Ralph Möhler, Andrew M Morris, Craig R Ramsay, Susan Rogers Van Katwyk, Brita Skodvin, Ingrid Smith, Kathryn N Suh, Jeremy M Grimshaw
SCOPE: Antibiotic stewardship programmes (ASPs) are necessary in hospitals to improve the judicious use of antibiotics. While ASPs require complex change of key behaviours on individual, team, organisation and policy levels, evidence from the behavioural sciences is underutilised in antibiotic stewardship studies across the world, including high-income countries (HICs). A consensus procedure was performed to propose research priority areas for optimising effective implementation of ASPs in hospital settings, using a behavioural perspective...
September 6, 2018: Clinical Microbiology and Infection
Anne O Summers, Andrew G Wiggins, Stephen P LaVoie, Joy Wireman, Anne O Summers
No abstract text is available yet for this article.
September 4, 2018: Plasmid
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