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Pneumonia and antimicrobial stewardship

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https://www.readbyqxmd.com/read/28629753/active-identification-of-patients-who-are-methicillin-resistant-staphylococcus-aureus-colonized-is-not-associated-with-longer-duration-of-vancomycin-therapy
#1
Carlos Acuna-Villaorduna, Westyn Branch-Elliman, Judith Strymish, Kalpana Gupta
BACKGROUND: Excessive prescribing of vancomycin among patients admitted to inpatient wards is a challenge for antimicrobial stewardship programs, especially in the setting of expanded screening programs for methicillin-resistant Staphylococcus aureus (MRSA). Studies examining factors associated with longer duration of vancomycin use are limited. METHODS: We conducted a retrospective cohort study to assess the impact of universal MRSA admission screening on duration of vancomycin use at the VA Boston Healthcare System during the period from January 2013-November 2015...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28628930/-rational-use-of-antibiotics-data-form-a-survey-from-2014-within-the-mrdo-network-compared-to-nationwide-data-from-2009
#2
Luba Lendowski, Peter Walger, Christoph Hoeser, Martin Exner, Claudia Roesing, Steffen Engelhart
Introduction To combat multi-resistant gram-negative bacteria as the cause of life-threatening infections, antibiotic stewardship activities are of great importance. Objective To detect weaknesses when prescribing antibiotics in hospitals and compare the situation between 2009 and 2014. Methods In 2014, a questionnaire was sent to all 380 physicians employed in 7 hospitals. Primary, secondary and tertiary care hospitals were included. Investigated were: demographic data, position, certified specialization, presence of antibiotic prescription rules and behavior to follow them...
June 19, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28626539/resistance-to-colistin-in-klebsiella-pneumoniae-a-4-0-strain
#3
REVIEW
Guido Granata, Nicola Petrosillo
The global rise of multidrug-resistant gram-negative bacteria represents an increasing threat to patient safety. From the first observation of a carbapenem-resistant gram-negative bacteria a global spread of extended-spectrum beta-lactamases and carbapenemases producing Klebsiella pneumoniae has been observed. Treatment options for multidrug-resistant K. pneumoniae are actually limited to combination therapy with some aminoglycosides, tigecycline and to older antimicrobial agents. Unfortunately, the prevalence of colistin-resistant and tigecycline-resistant K...
May 31, 2017: Infectious Disease Reports
https://www.readbyqxmd.com/read/28585611/knowledge-and-attitude-of-physicians-about-antimicrobial-resistance-and-their-prescribing-practices-in-services-hospital-lahore-pakistan
#4
Azib Shahid, Fatima Iftikhar, Mohammad Kamil Arshad, Zainub Javed, Muhammad Sufyan, Resham Sajjad Ghuman, Zenab Tarar
A cross sectional study was conducted in Services Hospital, Lahore using a self administered questionnaire to test the knowledge, attitude and prescribing practices of residents and attending physicians using non-probability convenience sampling. A total of 116 questionnaires were filled (Response rate=77.3%). Knowledge was below average (mean score of 3.66±1.1). Only 18 physicians (16%) could correctly estimate the rates of resistance of Klebsiella pneumoniae and pseudomonas aeruginosa to cephalosporin. Mostly physicians reviewed their decisions to prescribe an antibiotic by discussing with a senior colleague (n=93; 80%)...
June 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28555419/assessing-guideline-concordant-prescribing-for-community-acquired-pneumonia
#5
Kaci Thiessen, Ann E Lloyd, Michael J Miller, Juell Homco, Brooke Gildon, Katherine S O'Neal
Background Current reports of outpatient antimicrobial prescribing practices may overestimate guideline concordance since they address only drug selection. Appropriate stewardship should consider all prescribing criteria (i.e., dose, frequency, duration, and route of administration) to fully assess guideline concordance. Objective Using a community-acquired pneumonia (CAP) example, the aims of this pilot study were to estimate guideline concordance in adult patients 18 years or older when all prescribing criteria are considered, and provide recommendations to optimize treatment...
May 29, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28526309/antimicrobial-stewardship-for-hospitalized-patients-with-viral-respiratory-tract-infections
#6
Christopher F Lowe, Michael Payne, David Puddicombe, Allison Mah, Davie Wong, Allison Kirkwood, Mark W Hull, Victor Leung
BACKGROUND: The purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection. METHODS: This was a quasi-experimental before and after audit and feedback intervention of adult inpatients with a positive polymerase chain reaction for a respiratory virus in 2 acute care hospitals in Vancouver, Canada. Audit and feedback was implemented based on 2 criteria: microbiology (no positive bacterial cultures) and chest imaging (absence of pneumonia or consolidation on radiology dictation)...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28524255/enablers-and-barriers-to-the-use-of-antibiotic-guidelines-in-the-assessment-and-treatment-of-community-acquired-pneumonia-a-qualitative-study-of-clinicians-perspectives
#7
Antoine Sedrak, Mahesan Anpalahan, Karen Luetsch
BACKGROUND: Community-acquired pneumonia (CAP) is a common condition and a number of guidelines have been developed for its assessment and treatment. Adherence to guidelines by clinicians varies and particularly the prescribing of antibiotics often remains suboptimal. OBJECTIVE: The aim of this study was to elucidate potential barriers and enablers to the adherence to antibiotic guidelines by clinicians treating CAP in an Australian hospital. METHODS: Semi-structured interviews were conducted with purposively recruited senior prescribers who regularly treat CAP in an Australian hospital...
June 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28503879/impact-of-an-antimicrobial-stewardship-intervention-on-appropriateness-of-prescribing-for-community-acquired-pneumonia-in-an-australian-regional-hospital
#8
Stuart E Bond, Craig S Boutlis, Wilfred W Yeo, Spiros Miyakis
Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP.
May 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28485087/impact-of-an-antimicrobial-stewardship-programme-on-antibiotic-usage-and-resistance-in-a-tertiary-hospital-in-china
#9
Z-G Zhang, F Chen, Y Ou
WHAT IS KNOWN AND OBJECTIVE: Antimicrobial misuse has been commonly observed in China. This phenomenon can cause antibiotic resistance. This study was designed to evaluate the impact of an antimicrobial stewardship programme implemented in a tertiary hospital in China from 2011 to 2014. METHODS: The antimicrobial stewardship programme began in 2011. Data on the consumption of antibiotics and antimicrobial resistance between 2011 and 2014 were collected. RESULTS: Comparison of the 2011 data with those of 2014 showed that antibiotic defined daily doses/per 100 patient-days decreased from 92...
May 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28480242/outcomes-associated-with-antimicrobial-de-escalation-of-treatment-for-pneumonia-within-the-veterans-healthcare-administration
#10
Jefferson G Bohan, Richard Remington, Makoto Jones, Matthew Samore, Karl Madaras-Kelly
De-escalation, an antimicrobial stewardship concept, involves narrowing broad-spectrum empiric antimicrobial therapy based on clinical data. Current health outcomes evidence is lacking to support de-escalation. Studying Veterans Healthcare Administration pneumonia patients, de-escalation was associated with improved length of stay without affecting 30-day readmission or 30-day Clostridium difficile infection rates.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28475792/clinical-and-molecular-epidemiology-of-carbapenem-resistant-enterobacteriaceae-among-adult-inpatients-in-singapore
#11
Kalisvar Marimuthu, Indumathi Venkatachalam, Wei Xin Khong, Tse Hsien Koh, Benjamin Pei Zhi Cherng, My Van La, Partha Pratim De, Prabha Unny Krishnan, Thean Yen Tan, Raymond Fong Kok Choon, Surinder Kaur Pada, Choong Weng Lam, Say Tat Ooi, Rama Narayana Deepak, Nares Smitasin, Eng Lee Tan, Jia Jun Lee, Asok Kurup, Barnaby Young, Nancy Tee Wen Sim, Koh Cheng Thoon, Dale Fisher, Moi Lin Ling, Brenda Ang Sze Peng, Yik-Ying Teo, Li Yang Hsu, Raymond Tzer Pin Lin, Rick Twee-Hee Ong, Jeanette Teo, Oon Tek Ng
Background: Since 2010, the incidence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing in Singapore. We analyzed the clinical and molecular epidemiology of CRE among adult inpatients in Singapore. Methods: Quarterly incidence of unique subjects (per 100000 patient-days) with positive clinical and surveillance cultures for CRE were estimated based on mandatory data submitted to the National Public Health Laboratory by public hospitals between 2010 and 2015...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28458799/the-use-of-bloodstream-infection-mortality-to-measure-the-impact-of-antimicrobial-stewardship-interventions-assessing-the-evidence
#12
REVIEW
Sonali Coulter, Jason A Roberts, Krispin Hajkowicz, Kate Halton
This review sets out to evaluate the current evidence on the impact of inappropriate therapy on bloodstream infections (BSI) and associated mortality. Based on the premise that better prescribing practices should result in better patient outcomes, BSI mortality may be a useful metric to evaluate antimicrobial stewardship (AMS) interventions. A systematic search was performed in key medical databases to identify papers published in English between 2005 and 2015 that examined the association between inappropriate prescribing and BSI mortality in adult patients...
March 30, 2017: Infectious Disease Reports
https://www.readbyqxmd.com/read/28431848/epidemiology-of-device-associated-infections-in-an-intensive-care-unit-of-a-teaching-hospital-in-nepal-a-prospective-surveillance-study-from-a-developing-country
#13
Narayan Prasad Parajuli, Subhash Prasad Acharya, Santosh Dahal, Jaya Prasad Singh, Shyam Kumar Mishra, Hari Prasad Kattel, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Device-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs. METHODS: A prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28385463/clinical-and-social-barriers-to-antimicrobial-stewardship-in-pulmonary-medicine-a-qualitative-study
#14
Jennifer K Broom, Alex F Broom, Emma R Kirby, Alexandra F Gibson, Jeffrey J Post
BACKGROUND: The treatment of pulmonary infections is one of the largest indications for antibiotics in human health care, offering significant potential for antibiotic optimization internationally. This study explores the perspectives of pulmonary clinicians on antibiotic use in hospital pulmonary infections. METHODS: Twenty-eight pulmonary doctors and nurses from 2 hospitals participated in semi-structured interviews focusing on their experiences of antibiotic use...
April 3, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28384858/antimicrobial-resistance-surveillance-among-intensive-care-units-of-a-tertiary-care-hospital-in-southern-india
#15
Kailash Moolchandani, Apurba Sankar Sastry, R Deepashree, Sujatha Sistla, B N Harish, Jharna Mandal
INTRODUCTION: Hospital Acquired Infections (HAIs) are the rising threat in the health care facilities across the globe. As most Intesive Care Unit (ICU) patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. AIM: To study the occurrence of different types of HAIs in patients admitted to various ICUs of JIPMER and the AMR pattern of the bacterial pathogens isolated from them...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28345481/cost-effectiveness-analysis-of-implementing-an-antimicrobial-stewardship-program-in-critical-care-units
#16
Jesus Ruiz-Ramos, Juan Frasquet, Eva Romá, Jose Luis Poveda-Andres, Miguel Salavert-Leti, Alvaro Castellanos, Paula Ramirez
AIMS: To evaluate the cost-effectiveness of antimicrobial stewardship (AS) program implementation focused on critical care units based on assumptions for the Spanish setting. MATERIALS AND METHODS: A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed...
April 13, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28339675/high-reported-rates-of-antimicrobial-resistance-in-indian-neonatal-and-pediatric-blood-stream-infections
#17
Dhanya Dharmapalan, Anita Shet, Vijay Yewale, Mike Sharland
Background.: There is real shortage of national data on antimicrobial resistance rates in Indian neonates and children. A descriptive review was conducted to determine the patterns of antimicrobial resistance in isolates of blood stream infection among hospitalized children in India. Methods.: Published and gray literature on antibiotic resistance in children was searched using "Google Scholar", "Scopus", and "PubMed" databases between January 2000 and July 2015...
February 18, 2017: Journal of the Pediatric Infectious Diseases Society
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
#18
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
#19
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...
April 2017: Pediatrics
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#20
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
May 2017: Current Opinion in Pulmonary Medicine
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