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Antimicrobial stewardship rural

Lisa M Bebell, Joseph Ngonzi, Joel Bazira, Yarine Fajardo, Adeline A Boatin, Mark J Siedner, Ingrid V Bassett, Dan Nyehangane, Deborah Nanjebe, Yves Jacquemyn, Jean-Pierre van Geertruyden, Juliet Mwanga-Amumpaire, David R Bangsberg, Laura E Riley, Yap Boum
INTRODUCTION: Puerperal sepsis causes 10% of maternal deaths in Africa, but prospective studies on incidence, microbiology and antimicrobial resistance are lacking. METHODS: We performed a prospective cohort study of 4,231 Ugandan women presenting to a regional referral hospital for delivery or postpartum care, measured vital signs after delivery, performed structured physical exam, symptom questionnaire, and microbiologic evaluation of febrile and hypothermic women...
2017: PloS One
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
S E Bond, C S Boutlis, W W Yeo, W A B Pratt, M E Orr, S Miyakis
OBJECTIVE: Healthcare-associated Clostridium difficile infection (HCA-CDI) remains a major cause of morbidity and mortality in industrialized countries. However, few data exist on the burden of HCA-CDI in multi-site non-metropolitan settings. This study examined the introduction of an antimicrobial stewardship programme (ASP) in relation to HCA-CDI rates, and the effect of HCA-CDI on length of stay (LOS) and hospital costs. METHODS: A comparative before-and-after intervention study of patients aged ≥16 years with HCA-CDI from December 2010 to April 2016 across the nine hospitals of a non-metropolitan health district in New South Wales, Australia was undertaken...
April 2017: Journal of Hospital Infection
Adrian J Brink, Angeliki P Messina, Charles Feldman, Guy A Richards, Dena van den Bergh
Background: Few data exist on the implementation of process measures to facilitate adherence to peri-operative antibiotic prophylaxis (PAP) guidelines in Africa. Objectives: To implement an improvement model for PAP utilizing existing resources, in order to achieve a reduction in surgical site infections (SSIs) across a heterogeneous group of 34 urban and rural South African hospitals. Methods: A pharmacist-driven, prospective audit and feedback strategy involving change management and improvement principles was utilized...
April 1, 2017: Journal of Antimicrobial Chemotherapy
Kerry-Anne Hogan, Mohamed Gazarin, Julie Lapenskie
No abstract text is available yet for this article.
September 2016: Canadian Journal of Hospital Pharmacy
Robert T Pammett, Alicia Ridgewell
No abstract text is available yet for this article.
July 2016: Canadian Journal of Hospital Pharmacy
Adrian J Brink, Angeliki P Messina, Charles Feldman, Guy A Richards, Piet J Becker, Debra A Goff, Karri A Bauer, Dilip Nathwani, Dena van den Bergh
BACKGROUND: The available data on antimicrobial stewardship programmes in Africa are scarce. The aims of this study were to assess the implementation of an antimicrobial stewardship programme in a setting with limited infectious disease resources. METHODS: We implemented a pharmacist-driven, prospective audit and feedback strategy for antimicrobial stewardship on the basis of a range of improvement science and behavioural principles across a diverse group of urban and rural private hospitals in South Africa...
September 2016: Lancet Infectious Diseases
Kamini Walia, V C Ohri, Dilip Mathai
A survey was conducted to ascertain practice of antimicrobial stewardship programme (AMSP) in India for 2013. A total of 20 health care institutions (HCI) responded to a detailed questionnaire. All the institutions contacted were tertiary care HCI, of which 12 were funded by government (GHCI) and 8 were corporate/private HCI (PHCI). Further, all catered to both rural and urban populations and were spread across the country. Written documents were available with 40 per cent for AMSP, 75 per cent for hospital infection control (HIC) and HIC guidelines and 65 per cent for antimicrobial agents (AMA) prescription guidelines...
August 2015: Indian Journal of Medical Research
Shandra R Day, Dennis Smith, Karen Harris, Heather L Cox, Amy J Mathers
The importance of antimicrobial stewardship is increasingly recognized, yet data from community hospitals are limited. Despite an initially low acceptance rate, an Infectious Diseases physician-led program at a 70-bed rural hospital was associated with a 42% decrease in anti-infective expenditures and susceptibility improvement in Pseudomonas aeruginosa over 3 years.
April 2015: Open Forum Infectious Diseases
Rodney James, Susan Luu, Minyon Avent, Caroline Marshall, Karin Thursky, Kirsty Buising
OBJECTIVES: The Australian Commission on Safety and Quality in Health Care released recommendations for antimicrobial stewardship programmes to be established within all Australian healthcare facilities. However, implementation practices are not well defined. The aim of this study was to gain an understanding of factors affecting implementation of antimicrobial stewardship programmes within Australian regional and rural hospitals. METHODS: This study was designed whereby a preliminary quantitative process was used to contribute to a principally qualitative study...
September 2015: Journal of Antimicrobial Chemotherapy
Sara M Reese, Heather Gilmartin, Karen L Rich, Connie S Price
BACKGROUND: The purpose of our study was to conduct a needs assessment for infection prevention programs in both rural and urban hospitals in Colorado. METHODS: Infection control professionals (ICPs) from Colorado hospitals participated in an online survey on training, personnel, and experience; ICP time allocation; and types of surveillance. Responses were evaluated and compared based on hospital status (rural or urban). Additionally, rural ICPs participated in an interview about resources and training...
June 2014: American Journal of Infection Control
Brandon J Bloomgren, Brad R Laible
PURPOSE: To evaluate the discordance between Vitek 2 and Etest vancomycin minimum inhibitory concentration (MIC) testing methods in methicillin-resistant Staphylococcus aureus (MRSA) isolates. METHODS: Inclusion criteria consisted of MRSA isolates with blood, respiratory, or wound origin of culture, inpatient or emergency department location at time of culture and isolates with a Vitek 2 MIC reported. Isolates were subjected to Etest and the resulting MICs were compared to the corresponding Vitek 2 MICs, and both the rate and degree of discordance were evaluated...
August 2013: Journal of Pharmacy Practice
Kavita K Trivedi, Jon Rosenberg
OBJECTIVE: To assess antimicrobial stewardship programs (ASPs) and strategies in California general acute care hospitals and to describe the effect of state legislation (Senate Bill 739) requiring hospitals to develop processes for evaluating the judicious use of antimicrobials. DESIGN: Web-based survey of general acute care hospitals. PARTICIPANTS: All 422 general acute care hospital campuses in California were invited to participate. RESULTS: Responses from 223 (53%) of California's general acute care hospital campuses were included and were statistically representative of all acute care hospital campuses by region but not bed size or rurality...
April 2013: Infection Control and Hospital Epidemiology
Peggy Yam, Dalari Fales, John Jemison, Michael Gillum, Michael Bernstein
PURPOSE: The implementation of a pharmacy-directed antimicrobial stewardship (AMS) program involving the use of telemedicine technology is described. SUMMARY: Pursuant to a gap analysis of AMS services at a rural hospital where physician specialists in infectious diseases (ID) or pharmacists with advanced ID training were not available, a multidisciplinary team was formed to implement a stewardship program targeting six antimicrobials with a high potential for misuse...
July 1, 2012: American Journal of Health-system Pharmacy: AJHP
Christopher A Ohl, Elizabeth S Dodds Ashley
By controlling and changing how antimicrobial agents are selected and administered, antimicrobial stewardship programs (ASPs) aim to prevent or slow the emergence of antimicrobial resistance; optimize the selection, dosing, and duration of antimicrobial therapy; reduce the incidence of drug-related adverse events; and lower rates of morbidity and mortality, length of hospitalization, and costs. There is an abundant and growing body of evidence demonstrating that ASPs change the quantity and quality of antimicrobial prescriptions; however, measuring whether, when, and how ASPs improve patient outcomes and change patterns of antimicrobial resistance--which is the ultimate goals of ASPs--has been difficult, but the totality of evidence indicates that ASPs are capable of achieving these goals...
August 2011: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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