Antimicrobial stewardship rural

Antimicrobial resistance (AMR) is a global health issue disproportionately affecting low- and middle-income countries. In Tanzania, multi-drug-resistant bacteria (MDR) are highly prevalent in clinical and community settings, inhibiting effective treatment and recovery from infection. The burden of AMR can be alleviated if antimicrobial stewardship (AMS) programs are coordinated and incorporate local knowledge and systemic factors. AMS includes the education of health providers to optimise antimicrobial use to improve patient outcomes while minimising AMR risks...

INTRODUCTION: Inappropriate antibiotic use contributes to antimicrobial resistance. High-income countries have high rates of antibiotic use, with a prevalence of health inequalities amongst populations. OBJECTIVES: To understand the influence of factors commonly known to be associated with health inequalities on antibiotic use in high-income countries. METHODS: Factors commonly known to be associated with health inequalities were defined as protected characteristics under UK's Equality Act (age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race/ethnicity, religion or belief, sex, sexual orientation), socioeconomic characteristics (income, insurance, employment status, deprivation, education), geography (urban versus rural, region) and vulnerable groups...

OBJECTIVES: This study aimed to explore trends and predictors for antibiotic prescriptions and referrals for patients seeking dental care at General Medical Practitioners (GMPs) over a 44-year period in Wales, UK. METHODS: This retrospective observational study analysed data from the nationwide Secure Anonymised Information Linkage Databank of visits to GMPs. Read codes associated with dental diagnoses were extracted from 1974-2017. Data were analysed using descriptive statistics, univariate and multivariable logistic regression...

INTRODUCTION: Few studies have reported antibiotic purchases from retail drug shops in relation to gender in low and middle-income countries (LMICs). Using a One Health approach, we aimed to examine gender dimensions of antibiotic purchases for humans and animals and use of prescriptions in retail drug shops in Bangladesh. METHODS: We conducted customer observations in 20 drug shops in one rural and one urban area. Customer gender, antibiotic purchases, and prescription use were recorded during a four-hour observation (2 sessions of 2 hours) in each shop...

BACKGROUND: Owing to pharmacokinetic variations in pediatric patients, many antibiotics require weight-based dosing to ensure medication safety and antimicrobial stewardship. Despite the need for weight-based dosing, prescribers are not legally required to include the weight or diagnosis code on pediatric prescriptions that are necessary components to verify appropriateness. Clinical decision support system (CDSS) can help clinicians improve dosing appropriateness, but little is known about CDSS in a community pharmacy setting...

The Antimicrobial Stewardship Collaborative of South Carolina created quarterly Comparative SAAR Analysis Reports based on standardized antimicrobial administration ratio (SAAR) data from the NHSN Antimicrobial Use (AU) Option. These reports provide SAAR histograms and site-specific feedback to participating facilities in South Carolina. They were created to improve antimicrobial use throughout the state, especially in rural regions.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has required healthcare systems and hospitals to rapidly modify standard practice, including antimicrobial stewardship services. Our study examines the impact of COVID-19 on the antimicrobial stewardship pharmacist. DESIGN: A survey was distributed nationally to all healthcare improvement company members. PARTICIPANTS: Pharmacist participants were mostly leaders of antimicrobial stewardship programs distributed evenly across the United States and representing urban, suburban, and rural health-system practice sites...

BACKGROUND: This study aims to investigate patterns of antibiotic prescribing and to determine patient-specific factors associated with the choice of antibiotics by the World Health Organization's Access-Watch-Reserve (WHO AWaRe) class for acute respiratory infections (ARIs) in rural primary care settings in northern Vietnam. METHODS: We retrospectively reviewed health records for outpatients who were registered with the Vietnamese Health Insurance Scheme, visited one of 112 commune health centres in 6 rural districts of Nam Dinh province, Vietnam during 2019, and were diagnosed with ARIs...

BACKGROUND: Although dog-to-dog bite wounds (DBW) are common, few studies worldwide have evaluated antimicrobial usage patterns or appropriateness of use. OBJECTIVES: Report frequency and results of DBW cultures, including antimicrobial susceptibility patterns. Determine the most commonly prescribed antimicrobials and their appropriateness for the treatment of DBW, and if antimicrobial importance is associated with wound severity, clinic type or year. ANIMALS: One thousand five hundred twenty-six dog bite events involving 1436 dogs presenting with DBW from 3 Australian university clinics from 1999 to 2019...

BACKGROUND: An irrational antibiotic use is a common problem in developing countries like Ethiopia, which makes empiric antibiotics use difficult. It is considered to be the greatest health problem in our time and future unless intervened. Therefore, this study aimed to assess the patterns of antibiotics use among hospitalized adult patients to pave the way for antimicrobial stewardship. METHODS: A hospital-based prospective observational study was conducted at Jimma Medical Center, southwestern Ethiopia, from 30 October 2020 to 29 January 2021 with 360 adult hospitalized patients participating...

BACKGROUND: Infectious diseases (ID) and antimicrobial stewardship (AS) improve Staphylococcus aureus bacteremia (SAB) outcomes. However, many small community hospitals (SCHs) lack on-site access to these services, and it is not known if ID telehealth (IDt) offers the same benefit for SAB. We evaluated the impact of an integrated IDt service on SAB outcomes in 16 SCHs. METHODS: An IDt service offering IDt physician consultation plus IDt pharmacist surveillance was implemented in October 2016...

Antimicrobial resistance is a major public health concern globally. The most serious antimicrobial resistance problem among pathogenic bacteria is multidrug resistance (MDR). The objectives of this study were to investigate the risk factors of MDR infections and to develop a risk assessment tool for MDR Gram-negative bacteria (MDR-GNB) infections at a community hospital in rural Thailand. The study revealed 30.77% MDR-GNB among GNB strains. The most common MDR-GNB strains were 63.02% for Escherichia coli and 11...

BACKGROUND: Antimicrobial resistance is a serious threat to the global achievements in child health thus far. Previous studies have found high use of antibiotics in children in Northern Tanzania, but the experiences of the primary care-givers, who play a key role in accessing and administering antibiotics for the sick child, have remained largely unknown. Therefore, the aim of this study was to understand mothers' conceptions of antibiotic use in their children, which is of importance when forming strategies to improve antibiotic use in the community...

BACKGROUND: Urinary tract infections (UTIs) are a common indication for antibiotic prescriptions in the outpatient setting. With rising antimicrobial resistance, eliminating unnecessary antibiotics is critical. Previous research has shown that pharmacist-led antimicrobial stewardship in the emergency department (ED) setting can reduce the number of unnecessary antibiotics and increase appropriate antibiotic prescribing. By expanding the scope of ED pharmacists to include antimicrobial stewardship initiatives, rural EDs can better justify pharmacy involvement in the ED...

BACKGROUND: Antimicrobial resistance is a global problem driven by the overuse of antibiotics. Dentists are responsible for about 10% of antibiotics usage across healthcare worldwide. Factors influencing dental antibiotic prescribing are numerous, with some differences in low- and middle-income countries compared with high-income countries. This study aimed to explore the antibiotic prescribing behaviour and knowledge of teams treating dental patients in two Ghanaian hospitals. METHODS: Qualitative interviews were undertaken with dentists, pharmacists, and other healthcare team members at two hospitals in urban and rural locations...

In 2017, the Myanmar National Action Plan for Containment of Antimicrobial Resistance (AMR) (2017-2022) was endorsed by the Ministry of Health and Sports, Myanmar; one of its objectives was to increase public awareness of AMR to accelerate appropriate antibiotic use. This survey aimed to assess the public knowledge, practices and awareness concerning antibiotics and AMR awareness among adults in Myanmar. We conducted a nationwide cross-sectional mobile phone panel survey in January and February 2020. Participants were randomly selected from the mobile phone panel in each of three groups stratified by gender, age group, and residential area urbanity; they were interviewed using a structured questionnaire...

Background: Quantitative surveillance of antimicrobial use is a valuable tool used to support antimicrobial stewardship, identify overprescribing, monitor unexpected changes in usage, and assess the impact of interventions to improve prescribing. Smaller, more remote hospitals face many challenges in conducting effective antimicrobial surveillance. Aim: To investigate the impact of expired stock on reported antimicrobial usage rates in smaller, more remote hospitals...

PURPOSE: A systematic review was performed to determine if remote stewardship (telestewardship) provides clinical and fiscal benefit and is a feasible alternative to local stewardship programs. SUMMARY: Antibiotic resistance is an increasingly important national and global threat. US regulators have made antimicrobial stewardship programs a condition of participation in federally funded healthcare programs, and stewardship programs are surveyed during accreditation visits...

Inappropriate antibiotic use may lead to antibiotic resistance, which has become a serious global crisis. Addressing suboptimal antibiotic use in the general population can play a significant role in the fight against antimicrobial resistance. This study aims to describe antibiotic use and sources of acquisition, and to identify factors influencing antibiotic access among rural community residents in Eastern China. A cross-sectional survey was conducted from July to August 2020, and 1494 participants from two villages in Eastern China were enrolled...

BACKGROUND: In low- and middle-income countries, the prevalence of antimicrobial resistance (AMR) is increasing. To control AMR, WHO recommends monitoring antibiotic use, in particular Watch antibiotics. These are critically important antibiotics, with restricted use because at risk of becoming ineffective due to increasing AMR. We investigated pre-hospital antibiotic use in rural Burkina Faso. METHODS: During 2016-2017, we collected data from patients aged > 3 months presenting with severe acute fever to the rural hospital of Nanoro Health District, Burkina Faso, including antibiotic use in the two weeks prior to consultation or hospitalization...