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antibiótics stewardship

Katherine E Fleming-Dutra, Monina Bartoces, Rebecca M Roberts, Lauri A Hicks
Our objective was to identify characteristics associated with high-volume antibiotic prescribing among office-based primary care physicians to target antibiotic stewardship efforts. Physicians aged 40 years and older who were male, located in the South, and in solo or 2-physician practices prescribed higher volumes of antibiotics than their peers by specialty.
January 2018: Open Forum Infectious Diseases
Ekaterina Kulchavenya
No abstract text is available yet for this article.
July 15, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
Tommaso Cai, Paolo Lanzafame, Patrizio Caciagli, Serena Migno, Liliana Mereu, Daniele Mattevi, Lorenzo G Luciani, Saverio Tateo, Gianni Malossini, Truls E Bjerklund Johansen
OBJECTIVES: To evaluate the importance of leukocyturia in detecting the transition from asymptomatic bacteriuria to symptomatic infection in women with recurrent urinary tract infections. METHODS: In this cross-sectional study, we evaluated all women with recurrent urinary tract infection and asymptomatic bacteriuria who had been enrolled in two previous studies. Data from urological visits, urine analyses and microbiological evaluations were collected. Patients were divided into two groups: patients with symptomatic recurrence (group A) and patients without recurrence (group B), with a mean follow-up period of 38...
July 15, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
Lisa Blanchette, Timothy Gauthier, Emily Heil, Michael Klepser, Karl Madaras Kelly, Michael Nailor, Wenjing Wei, Katie Suda
OBJECTIVES: The objective of this position statement is to describe the essential role of pharmacists in antimicrobial stewardship in outpatient care. DATA SOURCES: N/A. SUMMARY: The majority of antibiotic prescribing occurs in outpatient care settings highlighting the need for antibiotic stewardship in the community. Given their expertise on medication management, pharmacists are essential to any antibiotic stewardship effort. CONCLUSION: As the regulations for antibiotic stewardship in outpatient settings continue to evolve and optimal stewardship strategies are defined, pharmacists must be leaders in the implementation of these programs...
July 12, 2018: Journal of the American Pharmacists Association: JAPhA
Leanne Teoh, Kay Stewart, Rodrigo Marino, Michael McCullough
Antibiotic resistance is a well-established global public health crisis, with the use and misuse of antibiotics being the principal cause of bacterial resistance. Studies in both Australia and overseas have demonstrated that the dental prescribing of antibiotics is increasing, and that dentists tend to prescribe antibiotics unnecessarily and for incorrect clinical indications. Dental practitioners in Australia also prefer to prescribe moderate to broad spectrum antibacterial agents and make some inappropriate antibiotic prescribing choices...
July 14, 2018: Australian Dental Journal
Ingrid Torjesen
No abstract text is available yet for this article.
July 13, 2018: BMJ: British Medical Journal
E Junaid, L Jenkins, H Swanepoel, Z North, T Gould
Antimicrobial stewardship programmes have been introduced worldwide in response to the rise in antimicrobial resistance. The World Health Organization has mandated each Member State to produce a plan to address this problem. We report on the organic development of an antibiotic stewardship programme in a rural regional hospital in a resource-limited setting in South Africa. This has resulted in organisational change with increased awareness, participation, monitoring and education in antibiotic stewardship throughout the hospital...
June 26, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
(no author information available yet)
Doctors and the farming industry are often blamed for overuse of antibiotics that spurs the growing problem of antimicrobial resistance. Ingrid Torjesen reports from an expert discussion jointly hosted by Vet Record and The BMJ to identify ways to tackle it.
July 14, 2018: Veterinary Record
Liben Chen, Dong Jin Shin, Shuyu Zheng, Johan H Melendez, Charlotte Gaydos, Tza-Huei Wang
Multidrug-resistant gonorrhea has become an urgent issue for global public health. As the causative agent of gonorrhea ─ Neisseria gonorrhoeae ─ has been progressively developing resistance to nearly all prescribed antimicrobial drugs, monitoring its antimicrobial resistance on a broader scale has become a crucial agenda for effective antibiotic stewardship. Unfortunately, gold standard antimicrobial susceptibility testing (AST) relies on time and labor-intensive phenotypic assays, which lag behind the current diagnostic workflow for N...
July 12, 2018: ACS Infectious Diseases
Gowri Raman, Esther E Avendano, Jeffrey Chan, Sanjay Merchant, Laura Puzniak
Background: Identifying risk factors predicting acquisition of resistant Pseudomonas aeruginosa will aid surveillance and diagnostic initiatives and can be crucial in early and appropriate antibiotic therapy. We conducted a systematic review examining risk factors of acquisition of resistant P. aeruginosa among hospitalized patients. Methods: MEDLINE®, EMBASE®, and Cochrane Central were searched between 2000 and 2016 for studies examining independent risk factors associated with acquisition of resistant P...
2018: Antimicrobial Resistance and Infection Control
Uwe Koppe, Anja von Laer, Lars E Kroll, Ines Noll, Marcel Feig, Marc Schneider, Hermann Claus, Tim Eckmanns, Muna Abu Sin
Background: Carbapenem resistance in Klebsiella pneumoniae is of significant public health concern and recently spread across several countries. We investigated the extent of carbapenem non-susceptibility in K. pneumoniae isolates in Germany. Methods: We analysed 2011-2016 data from the German Antimicrobial Resistance Surveillance (ARS) System, which contains routine data of antimicrobial susceptibility testing from voluntarily participating German laboratories...
2018: Antimicrobial Resistance and Infection Control
Giorgia Montrucchio, Gabriele Sales, Silvia Corcione, Francesco G De Rosa, Luca Brazzi
More than two-thirds of critically ill patients receive an antimicrobial therapy with a percentage between 30 and 50% of all prescribed antibiotics reported to be unnecessary, inappropriate or misused. Since inappropriate prescription of antibiotic drugs concurs to dissemination of the multi-drug resistant organisms, a reasoned antibiotics use is crucial especially in Intensive Care Unit (ICU), where up to 60% of the admitted patients develops an infection during their ICU stay. Even if the concept of Antimicrobial Stewardship (AS) has been clearly described as a series of coordinated interventions designed to improve antimicrobial agents use, few studies are reporting about its effectiveness to improve outcomes, reduce adverse events and costs and decrease resistance rate spread...
July 9, 2018: Minerva Anestesiologica
Francesco M Labricciosa, Massimo Sartelli, Sofia Correia, Lilian M Abbo, Milton Severo, Luca Ansaloni, Federico Coccolini, Carlos Alves, Renato Bessa Melo, Gian Luca Baiocchi, José-Artur Paiva, Fausto Catena, Ana Azevedo
Background: Antibiotic resistance (AMR) is a growing public health problem worldwide, in part related to inadequate antibiotic use. A better knowledge of physicians' motivations, attitudes and practice about AMR and prescribing should enable the design and implementation of effective antibiotic stewardship programs (ASPs). The objective of the study was to assess attitudes and perceptions concerning AMR and use of antibiotics among surgeons who regularly perform emergency or trauma surgery...
2018: World Journal of Emergency Surgery: WJES
George Sakoulas, Matthew Geriak, Victor Nizet
The majority of patients with reported penicillin allergy are not allergic when tested or challenged. Penicillin allergy testing has been shown to significantly reduce future annual healthcare expenditures. Data have emerged showing beta-lactams to be multi-dimensional antibacterial effects in vivo, far beyond what is appreciated in standard bacteriological susceptibility testing media. These include enhancing bacterial killing by the innate immune system. Supporting the clinical relevance of these secondary underappreciated effects are recent clinical and pharmaco-economic analyses that show worse outcomes in patients with reported penicillin allergies who receive non-beta lactam antibiotics when compared to their non-penicillin allergic counterparts...
July 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Xiang-Sheng Chen, Yue-Ping Yin, Xin-Yu Li
Gonococcal antimicrobial resistance (AMR) has become a global threat significantly hampering the control of gonorrhea. Many socio-economic, biological, behavioral, and programmatic factors have played an important role in driving the emergence, transmission and spread of gonococcal AMR. However, research to address these scientific and programmatic questions is limited in China. Here we propose a ROADMAP (resistance surveillance, outcomes due to AMR, antibiotic stewardship and application, diagnostic tools, mechanisms of AMR, antimicrobial assessment, and population pharmacokinetics and pharmacodynamics) plan for expanding interdisciplinary collaborations to address the research needs in China...
July 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Ella J Ariza-Heredia, Roy F Chemaly
Therapies in oncology have evolved rapidly over the last years. At the same pace, supportive care for patients receiving cancer therapy has also evolved, allowing patients to safely receive the newest advances in treatment in both an inpatient and outpatient basis. The recognition of the role of infection control and prevention (ICP) in the outcomes of patients living with cancer has been such that it is now a requirement for hospitals and involves multidisciplinary groups. Some unique aspects of ICP for patients with cancer that have gained momentum over the past few decades include catheter-related infections, multidrug-resistant organisms, community-acquired viral infections, and the impact of the health care environment on the horizontal transmission of organisms...
July 9, 2018: CA: a Cancer Journal for Clinicians
Tanaya Bhowmick, Thomas J Kirn, Frances Hetherington, Shandurai Takavarasha, Sarbjit S Sandhu, Shveta Gandhi, Navaneeth Narayanan, Melvin P Weinstein
BACKGROUND: Rapid identification of Gram-positive cocci in clusters (GPCC) in positive blood cultures (pBC) may limit exposure to unnecessary or inappropriate antibiotics. METHODS: Inpatients with pBC showing GPCC between October 2013 and December 2017 were included. In the baseline period (BL), final ID and susceptibility results were reported in the electronic medical record (EMR) within 48 h of telephoned Gram stain report. The laboratory introduced rapid phenotypic identification and direct susceptibility testing (INT1), later replaced by PCR (INT2)...
May 29, 2018: Diagnostic Microbiology and Infectious Disease
Patrick J Lindsay, Sagar Rohailla, Linda R Taggart, David Lightfoot, Thomas Havey, Nick Daneman, Christopher Lowe, Matthew P Muller
Background: Antimicrobial stewardship programs (ASP) using audit and feedback in the intensive care unit setting (ICU) can reduce harms related to inappropriate antibiotic use. However, inappropriate discontinuation or narrowing of antibiotic treatment could increase infection-related mortality in this population. Individual ASP studies are underpowered to detect mortality differences. Methods: We conducted a systematic review and meta-analysis of audit and feedback in the ICU setting using mortality as our outcome...
June 30, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Antonio Morales, Manuel Campos, José M Juárez, Bernardo Cánovas-Segura, Francisco Palacios, Roque Marín
BACKGROUND: Local cumulative antibiograms are useful tools with which to select appropriate empiric or directed therapies when treating infectious diseases at a hospital. However, data represented in traditional antibiograms are static, incomplete and not well adapted to decision-making. METHODS: We propose a decision support method for empiric antibiotic therapy based on the Number Needed to Fail (NNF) measure. NNF indicates the number of patients that would need to be treated with a specific antibiotic for one to be inadequately treated...
July 5, 2018: Journal of Biomedical Informatics
Rehema Marando, Jeremiah Seni, Mariam M Mirambo, Linda Falgenhauer, Nyambura Moremi, Martha F Mushi, Neema Kayange, Festo Manyama, Can Imirzalioglu, Trinad Chakraborty, Stephen E Mshana
The study was conducted to establish predictors of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) neonatal sepsis and mortality in a tertiary hospital, Tanzania. Between July and December 2016, blood culture was performed in neonates with clinical features of sepsis and neonates/mothers/guardians were screened for ESBL colonization. Selected isolates underwent whole genome sequencing to investigate relatedness. Logistic regression analysis was performed to determine predictors for ESBL-PE associated neonatal sepsis and mortality...
July 2, 2018: International Journal of Medical Microbiology: IJMM
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