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antibiótics stewardship

Ryian Mohamed, Josh Wall, Renuka Arumainathan, Douglas Fink, Taranveer Sandhu, Suchika Garg, Shabnamnaomi Spiers, Jonathan Hughes, Edward Burdett
BACKGROUND: Antibiotic prophylaxis is crucial in head and neck surgery to prevent infection from clean contaminated wounds. Scottish Intercollegiate Guidelines Network (SIGN) guidance, the gold standard of practice, recommends that administration of broad spectrum antibiotics is discontinued after 24 hours post-operation. A three-audit cycle quality improvement project was conducted to assess clinical practice against SIGN guidance at a large London teaching hospital. METHODS: Three change initiatives were implemented to improve antibiotic stewardship...
November 2, 2018: British Journal of Hospital Medicine
Maria Virginia Villegas, Sue Lyon
Antibiotic resistance was a major topic of interest for the nearly 13,000 physicians, microbiologists and scientists who attended European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) 2018. Much discussion centered round the potential benefits of novel antibiotics that are either already approved or under investigation in the treatment of infections caused by resistant Gram-negative pathogens. There was also general acceptance of the importance of ensuring that antibiotic stewardship is implemented in every ward throughout every hospital to ensure that these novel drugs are used appropriately and to combat the development of resistance...
October 2018: Future Science OA
Hicham Mansour, Mireille Feghali, Nadine Saleh, Mona Zeitouny
Objectives: Explore antibiotic use, assess conformity with evidence-practice guidelines, and describe knowledge and attitudinal factors among Lebanese dentists. Methods: National cross-sectional telephonic survey, using a standardized questionnaire addressing demographic, educational and professional data, usual antibiotics prophylactic and curative prescription pattern and influential factors, knowledge concerning antibiotics use in selected patient-populations, and attitude regarding antimicrobial resistance...
July 2018: Pharmacy Practice
Bo R Weber, Brie N Noble, David T Bearden, Christopher J Crnich, Katherine D Ellingson, Jessina C McGregor, Jon P Furuno
OBJECTIVE: To quantify the frequency and outcomes of receiving an antibiotic prescription upon discharge from the hospital to long-term care facilities (LTCFs). DESIGN: Retrospective cohort study. SETTING: A 576-bed, academic hospital in Portland, Oregon.PatientsAdult inpatients (≥18 years of age) discharged to an LTCF between January 1, 2012, and June 30, 2016. METHODS: Our primary outcome was receiving a systemic antibiotic prescription upon discharge to an LTCF...
November 9, 2018: Infection Control and Hospital Epidemiology
Rachel Yantzi, Gabriel van de Walle, Janet Lin
To identify factors precipitating antibiotic misuse and discuss how to promote safe antibiotics use and curb antibiotic resistance. Antibiotic misuse is a significant problem globally, leading to increased antibiotic resistance. Many socio-cultural factors facilitate antibiotic misuse: patient and provider beliefs about antibiotics, inadequate regulation, poor health literacy, inadequate healthcare provider training, and sub-optimal diagnostic capability. This study investigates the influence of such factors on antibiotic use and community health in rural Uganda...
November 8, 2018: Global Public Health
Diane Ashiru-Oredope, Anne Doble, Mary Richard Akpan, Sejal Hansraj, Nada Atef Shebl, Raheelah Ahmad, Susan Hopkins
The aim of this study was to assess antimicrobial stewardship activities in Community Healthcare Organisations (CHOs) with focus on the implementation of the two national antimicrobial stewardship toolkits, TARGET (Treat Antibiotics Responsibly, Guidance, Education, Tools) and SSTF (Start Smart, then Focus). The study utilised a web-based survey comprising 34 questions concerning antimicrobial policies and awareness and implementation of antimicrobial stewardship toolkits. This was distributed to pharmacy teams in all 26 CHOs in England...
November 7, 2018: Antibiotics
Pierre-Marie Roger, Eve Montera, Diane Lesselingue, Nathalie Troadec, Patrick Charlot, Agnès Simand, Agnès Rancezot, Olivier Pantaloni, Thomas Guichard, Véronique Dautezac, Cécile Landais, Frédéric Assi, Thierry Levent
Introduction: Assessment of antimicrobial use places an emphasis on therapeutic aspects of infected patients. Our aim was to determine the risk factors for unnecessary antibiotic therapy (UAT). Methods: This was a prospective, multicentre study evaluating all curative antibiotic therapies prescribed over two consecutive days through the same electronic medical records. Each item that could participate in the antibiotic prescriptions was collected from the computerized file: the reason for hospitalization, comorbid conditions, suspected or definitive diagnosis of infection, microbial analyses...
October 31, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Mark A Caudell, Colette Mair, Murugan Subbiah, Louise Matthews, Robert J Quinlan, Marsha B Quinlan, Ruth Zadoks, Julius Keyyu, Douglas R Call
BACKGOUND: Improved antimicrobial stewardship, sanitation, and hygiene are WHO-inspired priorities for restriction of the spread of antimicrobial resistance. Prioritisation among these objectives is essential, particularly in low-income and middle-income countries, but the factors contributing most to antimicrobial resistance are typically unknown and could vary substantially between and within countries. We aimed to identify the biological and socioeconomic risk factors associated with carriage of resistant Escherichia coli in three culturally diverse ethnic groups in northern Tanzania...
November 2018: Lancet. Planetary Health
Sarah Sungurlu, Robert A Balk
Biomarkers are used in the diagnosis, severity determination, and prognosis for patients with community-acquired pneumonia (CAP). Selected biomarkers may indicate a bacterial infection and need for antibiotic therapy (C-reactive protein, procalcitonin, soluble triggering receptor expressed on myeloid cells). Biomarkers can differentiate CAP patients who require hospital admission and severe CAP requiring intensive care unit admission. Biomarker-guided antibiotic therapy may limit antibiotic exposure without compromising outcome and thus improve antibiotic stewardship...
December 2018: Clinics in Chest Medicine
Di Zhang, Sasa Hu, Jinyao Sun, Lu Zhang, Haiyan Dong, Weiyi Feng, Jin'e Lei, Yalin Dong
PURPOSE: China launched a 3-year rectification scheme on the clinical use of antibiotics in 2011, and a specific scheme on carbapenem use in February 2017. This study investigated the trends in and correlations between antibiotic consumption and the prevalence of carbapenem-resistant Gram-negative bacteria (CRGN) at a tertiary hospital during these years, particularly in carbapenem consumption. METHODS: The data were collected calculated per quarter from 2011 to 2017...
October 29, 2018: Journal of Infection and Public Health
Freja Cecilie Barrett Mørk, Christina Gade, Marianne Thielsen, Marianne Sjølin Frederiksen, Magnus Arpi, Jesper Johannesen, Espen Jimenez-Solem, Helle Holst
INTRODUCTION: Antimicrobial stewardship programmes recommend use of narrow-spectrum antibiotics as first-line treatment of childhood pneumonia in secondary care. The primary aim of the present study was to assess whether current guidelines are followed. A secondary aim was to assess if tracheal aspiration is a useful tool in the diagnostic process of suspected childhood pneumonia. METHODS: This was a retrospective descriptive single-centre cohort study. Children between three months and 17 years with a pneumonia diagnosis were included...
November 2018: Danish Medical Journal
Aroa Tardáguila-García, José Luis Lázaro-Martínez, Irene Sanz-Corbalán, Yolanda García-Álvarez, Francisco Javier Álvaro-Afonso, Esther García-Morales
OBJECTIVE: To analyze the correlation between empirical antibiotic therapies prescribed in primary care centers by general practitioners and the microbiology results of bone culture in patients with diabetic foot-related osteomyelitis. METHODS: This observational study involved 80 patients with diabetic foot ulcers and clinically suspected osteomyelitis. The patients were taking antibiotics prescribed by general practitioners to treat diabetic foot infections. Bone samples were taken from every patient for microbiology analysis in a specialized diabetic foot unit...
October 30, 2018: Advances in Skin & Wound Care
Masifa George, Jacob Stanley Iramiot, Rita Muhindo, Peter Olupot-Olupot, Ann Nanteza
Background: Post-operative wound sepsis remains a surgical challenge of public health concern constituting approximately 20% of the health care-associated nosocomial infections. This study aimed at determining the prevalence and antimicrobial resistance patterns of bacterial pathogens isolated from post-operative wound infections at Mbale Regional Referral Hospital. Materials and Methods: This was a descriptive cross-sectional study conducted from June to October 2015...
2018: Microbiology research journal international
Karin E Steinmann, Dirk Lehnick, Michael Buettcher, Katharina Schwendener-Scholl, Karin Daetwyler, Matteo Fontana, Davide Morgillo, Katja Ganassi, Kathrin O'Neill, Petra Genet, Susanne Burth, Patrizia Savoia, Ulrich Terheggen, Christoph Berger, Martin Stocker
Background: Antimicrobial stewardship (AMS) is an important strategy of quality improvement for every hospital. Leadership is an important factor for implementation of quality improvement and AMS programs. Recent publications show successful AMS programs in children's hospitals, but successful implementation is often difficult to achieve and literature of AMS in neonatal and pediatric intensive care units (NICU/PICU) is scarce. Lack of resources and prescriber opposition are reported barriers. A leadership style focusing on empowering frontline staff to take responsibility is one approach to implement changes in health care institutions...
2018: Frontiers in Pediatrics
Wen Han, Yun Cao
Antibiotics are commonly used in the neonatal intensive care unit (NICU), but unnecessary or long-time exposure to antibiotics early after birth can increase the risk of poor prognosis of neonates. Antibiotic treatment in the NICU often begins with empiric therapy, but no uniform standards have been established for the initiation and course of empiric therapy. In neonates with negative bacterial culture results and stable clinical manifestations, empiric antibiotic therapy should be terminated in a timely manner...
October 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
J F García-Rodríguez, B Bardán-García, M F Peña-Rodríguez, H Álvarez-Díaz, A Mariño-Callejo
There are few prospective studies with sufficient duration in time to evaluate clinical and antibiotic resistance impact of antibiotic stewardship programs (ASP). This is a descriptive study between January 2012 and December 2017, pre-post intervention. A meropenem ASP was initiated in January 2015; in patients who started treatment with meropenem, an infectious disease physician performed treatment recommendations to prescribers. Prospective information was collected to evaluate adequacy of meropenem prescription to local guidelines and to compare results between cases with accepted or rejected intervention...
October 26, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Inayat Ur Rehman, Malik Muhammad Asad, Allah Bukhsh, Zahid Ali, Humera Ata, Juman Abdulelah Dujaili, Ali Qais Blebil, Tahir Mehmood Khan
Background: The irrational use, "over the counter supply", and unregulated supply chains of antimicrobials are contributing toward antimicrobial resistance. Antimicrobial stewardship programs regulate antimicrobials usage to prevent resistance and reduce health care burden. Objective: To assess the knowledge and practice of pharmacists' working in various healthcare settings toward antimicrobial stewardship in Pakistan. Method: A cross-sectional study was conducted among pharmacists working in different sectors between March to June 2017...
October 23, 2018: Pharmacy (Basel, Switzerland)
Maria Gabriella Matera, Paola Rogliani, Josuel Ora, Mario Cazzola
Antibiotics are frequently prescribed to children in the community and in nosocomial settings, mainly because of lower respiratory tract infections(LRTIs), which include influenza, bronchitis, bronchiolitis, pneumonia, and tuberculosis, in addition to bronchiectasis and cystic fibrosis lung disease. It is important to note, however, that more than 50% of these prescriptions are unnecessary or inappropriate. Areas covered: The current choice of antimicrobial therapy for etiological agents of LRTIs is examined and discussed considering each type of LRTI...
October 25, 2018: Expert Opinion on Pharmacotherapy
Johan Karp, Jon Edman-Wallér, Michael Toepfer, Anders Lundqvist, Gunnar Jacobsson
Background: Antibiotic treatment is a well-known risk factor for healthcare facility-associated Clostridioides (Clostridium) difficile infection (HCF-CDI). Antibiotic stewardship programmes (ASPs) targeting high-risk antibiotics have been shown to decrease HCF-CDI incidence. HCF-CDI incidence is high in Nordic countries despite relatively low antibiotic use in hospital. Objectives: To determine if HCF-CDI incidence was modified by a hospital ASP that restricted cephalosporin use...
October 25, 2018: Journal of Antimicrobial Chemotherapy
Claus Klingenberg, René F Kornelisse, Giuseppe Buonocore, Rolf F Maier, Martin Stocker
Sepsis is a leading cause of mortality and morbidity in neonates. Presenting clinical symptoms are unspecific. Sensitivity and positive predictive value of biomarkers at onset of symptoms are suboptimal. Clinical suspicion therefore frequently leads to empirical antibiotic therapy in uninfected infants. The incidence of culture confirmed early-onset sepsis is rather low, around 0.4-0.8/1000 term infants in high-income countries. Six to 16 times more infants receive therapy for culture-negative sepsis in the absence of a positive blood culture...
2018: Frontiers in Pediatrics
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