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antibiótics stewardship

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https://www.readbyqxmd.com/read/28333409/missed-opportunities-for-antimicrobial-stewardship-in-pre-school-children-admitted-to-hospital-with-lower-respiratory-tract-infection
#1
Tony Walls, Erika Stark, Philip Pattemore, Lance Jennings
AIM: To describe the usage of multiplex polymerase chain reaction on nasopharyngeal swab (NPS) samples in pre-school children presenting with lower respiratory tract infection (LRTI) at Christchurch Hospital, and its impact on the use of antibiotics empirically and at discharge. METHODS: This retrospective cohort study included 237 children, ages 3 months to 5 years, admitted to hospital during the winter months of 2012-2015 with a diagnosis of community-acquired LRTI...
March 23, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28333297/effect-of-adding-a-mobile-health-intervention-to-a-multimodal-antimicrobial-stewardship-programme-across-three-teaching-hospitals-an-interrupted-time-series-study
#2
E Charani, M Gharbi, L S P Moore, E Castro-Sanchéz, W Lawson, M Gilchrist, A H Holmes
Objectives: To evaluate the impact of adding a mobile health (mHealth) decision support system for antibiotic prescribing to an established antimicrobial stewardship programme (ASP). Methods: In August 2011, the antimicrobial prescribing policy was converted into a mobile application (app). A segmented regression analysis of interrupted time series was used to assess the impact of the app on prescribing indicators, using data (2008-14) from a biannual point prevalence survey of medical and surgical wards...
February 28, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28333179/obtaining-antibiotics-online-from-within-the-uk-a-cross-sectional-study
#3
Sara Elizabeth Boyd, Luke Stephen Prockter Moore, Mark Gilchrist, Ceire Costelloe, Enrique Castro-Sánchez, Bryony Dean Franklin, Alison Helen Holmes
Background: Improved antibiotic stewardship (AS) and reduced prescribing in primary care, with a parallel increase in personal internet use, could lead citizens to obtain antibiotics from alternative sources online. Objectives: A cross-sectional analysis was performed to: (i) determine the quality and legality of online pharmacies selling antibiotics to the UK public; (ii) describe processes for obtaining antibiotics online from within the UK; and (iii) identify resulting AS and patient safety issues...
February 17, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28332344/impact-of-intervention-by-an-antimicrobial-stewardship-team-on-conversion-from-intravenous-to-oral-fluoroquinolones
#4
Soh Mee Park, Hyung Sook Kim, Young Mi Jeong, Jung Hwa Lee, Eunsook Lee, Euni Lee, Kyoung Ho Song, Hong Bin Kim, Eu Suk Kim
BACKGROUND: Early conversion from intravenous to oral antibiotics plays an important role in lowering the risk of catheter-associated infections, reducing the workload of nurses, decreasing direct and indirect costs, and shortening hospital stays. In August 2015, an antimicrobial stewardship program (ASP) was implemented to facilitate conversion from intravenous to oral administration of fluoroquinolones in our institute. This study evaluated the clinical and economic impact of the intervention...
March 13, 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/28329388/healthcare-claims-data-an-underutilized-tool-for-pediatric-outpatient-antimicrobial-stewardship
#5
Joshua R Watson, Ling Wang, Jennifer Klima, Melissa Moore-Clingenpeel, Sean Gleeson, Kelly Kelleher, Preeti Jaggi
Background: Healthcare claims are under-utilized to identify factors associated with high outpatient antibiotic use. Methods: We evaluated ambulatory encounter claims of Medicaid-insured children in 34 Ohio counties in 2014. 1) Rates of total antibiotic and azithromycin prescriptions dispensed were determined by county of patient residence. 2) Standardized treatment rates by county were estimated for uncomplicated upper respiratory tract encounters (acute otitis media, pharyngitis, sinusitis, presumed viral infection) after adjusting for patient age and encounter provider type...
March 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28318900/epidemiological-and-mycological-characteristics-of-candidemia-in-iran-a-systematic-review-and-meta-analysis
#6
REVIEW
A Vaezi, H Fakhim, S Khodavaisy, A Alizadeh, M Nazeri, A Soleimani, T Boekhout, H Badali
To date, there has been no comprehensive review of the epidemiology, risk factors, species distribution, and outcomes of candidemia in Iran. This study aimed to perform a systematic review and meta-analysis of all reported candidemia cases in Iran until December 2015. The review process occurred in three steps, namely a literature search, data extraction and statistical analyses. After a comprehensive literature search, we identified 55 cases. The mean age of patients was 46.80±24.30 years (range 1-81 years)...
March 16, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28318891/lessons-from-a-national-audit-of-acute-pancreatitis-a-summary-of-the-ncepod-report-treat-the-cause
#7
REVIEW
D A O'Reilly, S J McPherson, M T Sinclair, N Smith
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is an independent organisation whose remit is to review the quality of medical and surgical care provided in the United Kingdom. We undertook a review into the care provided to patients treated for acute pancreatitis during a 6 month study period between 1st January and 30th June 2014. This included assessment of care at an organisational level, clinical level within hospitals and external peer review. From a random sample, 712 patients underwent hospital clinician review and 418 patients had external peer review...
February 17, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28303388/the-impact-of-antibiotic-stewardship-programs-in-combating-quinolone-resistance-a-systematic-review-and-recommendations-for-more-efficient-interventions
#8
REVIEW
Vasiliki Pitiriga, Georgia Vrioni, George Saroglou, Athanasios Tsakris
Quinolones are among the most commonly prescribed antibiotics worldwide. A clear relationship has been demonstrated between excessive quinolone use and the steady increase in the incidence of quinolone-resistant bacterial pathogens, both in hospital and community sites. In addition, exposure to quinolones has been associated with colonization and infection with healthcare-associated pathogens such as methicillin-resistant Staphylococcus aureus and Clostridium difficile in hospitalized patients. Therefore, the management of quinolone prescribing in hospitals through antibiotic stewardship programs is considered crucial...
March 16, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28302674/urine-culture-follow-up-and-antimicrobial-stewardship-in-a-pediatric-urgent-care-network
#9
Dipanwita Saha, Jimisha Patel, Don Buckingham, David Thornton, Terry Barber, Joshua R Watson
BACKGROUND AND OBJECTIVES: Empiric antibiotic therapy for presumed urinary tract infection (UTI) leads to unnecessary antibiotic exposure in many children whose urine culture results fail to confirm the diagnosis. The objective of this quality improvement study was to improve follow-up management of negative urine culture results in the off-campus urgent care network of Nationwide Children's Hospital to reduce inappropriate antibiotic exposure in children. METHODS: A multidisciplinary task force developed and implemented a protocol for routine nurse and clinician follow-up of urine culture results, discontinuation of unnecessary antibiotics, and documentation in the electronic medical record...
March 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28302376/emerging-trends-in-antibiotic-resistance-implications-for-emergency-medicine
#10
Ali Pourmand, Maryann Mazer-Amirshahi, Gregory Jasani, Larissa May
BACKGROUND: Many bacteria are demonstrating increasing levels of resistance to commonly used antibiotics. While this has implications for the healthcare system as a whole, many patients infected with these resistant organisms will initially present to the emergency department (ED). The purpose of this review is to provide a summary of current trends in infections caused by the most clinically relevant resistant organisms encountered in emergency medicine. METHODS: Bacteria were selected based on the Centers for Disease Control and Prevention's National Action Plan for Combating Antibiotic Resistant Bacteria, and PubMed database...
March 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28298480/antimicrobial-stewardship-programmes-bedside-rationing-by-another-name
#11
Simon Oczkowski
Antimicrobial therapy is a cornerstone of therapy in critically ill patients; however, the wide use of antibiotics has resulted in increased antimicrobial resistance and outbreaks of resistant disease. To counter this, many hospitals have instituted antimicrobial stewardship programmes as a way to reduce the inappropriate use of antibiotics. However, uptake of antimicrobial stewardship programmes has been variable, as many clinicians fear that they may put individual patients at risk of treatment failure. In this paper, I argue that antimicrobial stewardship programmes are indeed a form of bedside rationing, and explore the risks and benefits of such programmes for individual patients in the intensive care unit, and the critically ill population in general...
March 15, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28298366/antibiotics-for-acute-respiratory-tract-infections-a-mixed-methods-study-of-patient-experiences-of-non-medical-prescriber-management
#12
Molly Courtenay, Samantha Rowbotham, Rosemary Lim, Rhian Deslandes, Karen Hodson, Katie MacLure, Sarah Peters, Derek Stewart
OBJECTIVE: To (1) explore patients' expectations and experiences of nurse and pharmacist non-medical prescriber-led management of respiratory tract infections (RTIs), (2) examine whether patient expectations for antibiotics affect the likelihood of receiving them and (3) understand factors influencing patient satisfaction with RTI consultations. DESIGN: Mixed methods. SETTING: Primary care. PARTICIPANTS: Questionnaires from 120 patients and follow-up interviews with 22 patients and 16 nurse and pharmacist non-medical prescribers (NMPs)...
March 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28288838/routine-ertapenem-prophylaxis-for-transrectal-ultrasound-guided-prostate-biopsy-does-not-select-for-carbapenem-resistant-organisms-a-prospective-cohort-study
#13
Maxim G Bloomfield, Matthew J Page, Alice G McLachlan, Rodney C Studd, Timothy K Blackmore
PURPOSE: Post-transrectal ultrasound-guided prostate biopsy sepsis is an increasing problem in this era of rising antibiotic resistance. Ertapenem prophylaxis has proven very effective at our institution for reducing this, however has raised local and regional antimicrobial stewardship concerns. This study investigated the possible selective effect of single dose ertapenem prophylaxis on fecal colonization with carbapenem-resistant Enterobacteriaceae. MATERIALS AND METHODS: Patients had a rectal swab taken prior to receiving pre-biopsy ertapenem prophylaxis...
March 10, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28285740/fight-antibiotic-resistance-it-s-in-your-hands-to-improve-antibiotic-stewardship
#14
EDITORIAL
A Bashir, J Gray
No abstract text is available yet for this article.
March 9, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28285605/using-clinical-scenarios-to-understand-preventability-of-clostridium-difficile-infections-by-inpatient-antibiotic-stewardship-programs
#15
Jessica Seidelman, Kristen V Dicks, Michael J Durkin, Arthur W Baker, Rebekah W Moehring, Deverick J Anderson, Daniel J Sexton, Luke F Chen, Sarah S Lewis
No abstract text is available yet for this article.
March 13, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28284685/identifying-priorities-to-improve-paediatric-in-hospital-antimicrobial-use-by-cross-sectional-evaluation-of-prevalence-and-appropriateness-of-prescription
#16
Walter Alfredo Goycochea-Valdivia, Francisco Moreno-Ramos, José Ramón Paño-Pardo, Francisco Javier Aracil-Santos, Fernando Baquero-Artigao, Teresa Del Rosal-Rabes, María José Mellado-Peña, Luis Escosa-García
INTRODUCTION: Information about paediatric in-hospital antimicrobial usage and prescribing patterns to guide improvement strategies is scant. We aim to use an evaluation of the prevalence and appropriateness of antimicrobial prescription to identify antimicrobial stewardship priorities in children. METHODS: A cross-sectional point study was performed on hospitalised paediatric patients in a Spanish tertiary hospital, assessing the prevalence of antimicrobial prescription (PAP) and appropriateness of antimicrobial prescription (AAP)...
March 8, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28270546/variability-in-antibiotic-prescribing-for-community-acquired-pneumonia
#17
Lori K Handy, Matthew Bryan, Jeffrey S Gerber, Theoklis Zaoutis, Kristen A Feemster
BACKGROUND AND OBJECTIVES: Published guidelines recommend amoxicillin for most children with community-acquired pneumonia (CAP), yet macrolides and broad-spectrum antibiotics are more commonly prescribed. We aimed to determine the patient and clinician characteristics associated with the prescription of amoxicillin versus macrolide or broad-spectrum antibiotics for CAP. METHODS: Retrospective cohort study in an outpatient pediatric primary care network from July 1, 2009 to June 30, 2013...
March 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/28270268/antibiotic-stewardship-new-frontier-familiar-journey
#18
Caren McHenry Martin
Recent changes in regulations by the Centers for Medicare & Medicaid Services require long-term care facilities to meet specific requirements on antibiotic stewardship, promoting the appropriate use of antibiotics and antimicrobials. The goal is to improve patient outcomes and decrease the spread of infections caused by multi-drug-resistant organisms. Consultant pharmacists can help facility personnel implement policies and procedures for effective antibiotic stewardship, assist prescribers and facility staff in understanding how to use the facility's antibiogram, find appropriate resources, and provide facility personnel with feedback on their antimicrobial stewardship efforts...
March 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28267992/clostridium-difficile-disease-diagnosis-pathogenesis-and-treatment-update
#19
REVIEW
Lena M Napolitano, Charles E Edmiston
Clostridium difficile infections are the leading cause of health care-associated infectious diarrhea, posing a significant risk for both medical and surgical patients. Because of the significant morbidity and mortality associated with C difficile infections, knowledge of the epidemiology of C difficile in combination with a high index of suspicion and susceptible patient populations (including surgical, postcolectomy, and inflammatory bowel disease patients) is warranted. C difficile infections present with a wide spectrum of disease, ranging from mild diarrhea to fulminant colitis or small bowel enteritis and recurrent C difficile infections...
March 3, 2017: Surgery
https://www.readbyqxmd.com/read/28267763/molecular-characterization-of-vancomycin-resistant-enterococcus-faecium-isolates-from-bermuda
#20
Patrick Eberechi Akpaka, Shivnarine Kissoon, Clyde Wilson, Padman Jayaratne, Ashley Smith, George R Golding
Molecular characteristics of vancomycin resistant enterococci isolates from Bermuda Island is currently unknown. This study was conducted to investigate phenotypic and genotypic characteristics of VRE isolates from Bermuda Island using the chromogenic agar, E-tests, polymerase chain reaction (PCR), pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Eighteen E. faecium isolates were completely analyzed and were all resistant to vancomycin, susceptible to linezolid and quinupristin/dalfopristin, positive for vanA and esp genes...
2017: PloS One
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