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https://www.readbyqxmd.com/read/29168673/the-role-of-dalbavancin-in-the-multi-disciplinary-management-of-wound-infections-in-orthopaedic-surgery
#1
Fabio Arena, Emilio Romanini, Elia Rosi, Carlo Salomone, Gabriele Tucci, Ciro Pempinello, Massimo Fantoni
Antimicrobial resistance is continuously increasing among bacterial clinical isolates (especially methicillin resistance in Staphylococcus aureus, MRSA), negatively impacting on outcomes of patients with Surgical Site Infections (SSIs). A multi-disciplinary team work is essential for SSIs prevention and for the choice of antibiotic therapy of orthopaedic SSIs. In particular, an Antibiotic Stewardship (AS) approach is recommended for preserving the activity of old and new antimicrobials. Dalbavancin is a novel antimicrobial agent, belonging to the lipoglycopeptides family, recently approved by FDA for the treatment of ABSSSIs (Acute Bacterial Skin and Skin Structure Infections) and can be considered as a candidate for the treatment of orthopaedic superficial SSIs...
November 23, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/29167291/candida-auris-an-emerging-fungal-pathogen
#2
Emily S Spivak, Kimberly E Hanson
Candida auris has emerged globally as a multidrug resistant, healthcare-associated fungal pathogen. Recent reports highlight ongoing challenges due to organism misidentification, high rates of antifungal drug resistance and significant patient mortality. The predilection for intra and inter-healthcare facility transmission possibly promoted by virulence factors that facilitate skin colonization and environmental persistence is unique among Candida species. This minireview details the global emergence of C. auris and discusses issues relevant to clinical microbiology laboratories, hospital infection control and antimicrobial stewardship efforts...
November 22, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29165636/reducing-redundant-anaerobic-therapy-through-spaced-education-and-antimicrobial-stewardship-interventions
#3
Kelly B Flett, Athos Bousvaros, Jane Carpenter, Carly E Millrinen, Patricia Martin, Thomas J Sandora
Background: Decreasing the use of redundant anaerobic therapy is a key target for antimicrobial stewardship. Education techniques that optimize knowledge retention could be an important component of reducing these regimens. Methods: We implemented a quality improvement project that incorporated spaced education to reduce the use of redundant anaerobic therapy. The initial interventions (November through December 2015) included education in a hospital-wide newsletter and review of redundant anaerobic regimens by the antimicrobial stewardship program...
November 20, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29165505/-evolutionary-interactions-as-a-possible-mechanism-of-drug-interactions-an-approach-to-the-control-of-antibiotic-resistant-bacteria
#4
Héctor Holguín, Pedro Amariles, William Ospina
In the 21st century, the world is facing a post-antibiotic era, in which the appearance of infections with a minor or no therapeutic alternative is common. In this context, it is essential to implement measures that optimize the available therapeutic tool, thus generating new strategies that strengthen the fight against growing bacterial resistance. The evolutionary interactions suggest that the development of sensitivity or resistance of a microorganism to an antimicrobial will have an inverse effect (collateral sensitivity) or similar (cross resistance) in a second antimicrobial that is involved in this system...
August 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/29164489/antimicrobial-stewardship-opportunities-in-critically-ill-patients-with-gram-negative-lower-respiratory-tract-infections-a-multicenter-cross-sectional-analysis
#5
Kimberly C Claeys, Evan J Zasowski, Trang D Trinh, Abdalhamid M Lagnf, Susan L Davis, Michael J Rybak
INTRODUCTION: Lower respiratory tract infections (LRTIs) are a major cause of morbidity and death. Because of changes in how LRTIs are defined coupled with the increasing prevalence of drug resistance, there is a gap in knowledge regarding the current burden of antimicrobial use for Centers for Disease Control and Prevention (CDC)-defined LRTIs. We describe the infection characteristics, antibiotic consumption, and clinical and economic outcomes of patients with Gram-negative (GN) LRTIs treated in intensive care units (ICUs)...
November 21, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29164361/bacteraemia-in-emergency-departments-effective-antibiotic-reassessment-is-associated-with-a-better-outcome
#6
Charlotte Aillet, Didier Jammes, Agnès Fribourg, Sophie Léotard, Olivier Pellat, Patricia Etienne, Dominique Néri, Djamel Lameche, Olivier Pantaloni, Serge Tournoud, Pierre-Marie Roger
Patients with bacteraemia constitute an useful population for an audit of antibiotic treatments. Empirical antibiotic therapy (EAT) and its reassessment must take into account clinical data and microbiological results. Our aim was to determine the impact of these sequential steps of the therapy on survival. This was a retrospective multicentre study which included patients admitted to emergency departments (ED) for whom blood cultures were positive over a 4-month period. Microbial results were compiled from the database of the laboratories...
November 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29164170/impact-of-procalcitonin-guided-antibiotic-management-on-antibiotic-exposure-and-outcomes-real-world-evidence
#7
Michael R Broyles
Background: Delayed pathogen identification and nonspecific clinical findings make definitive decisions regarding antibiotics challenging. The stimuli of bacterial toxins and inflammation make procalcitonin (PCT) unique in its ability to differentiate bacterial infection from other causes of inflammation, and thus it is useful for antibiotic management. The objective of our study was to evaluate the impact of a PCT algorithm (PCT-A) on current practice. Methods: A single-center, retrospective cohort study was conducted to evaluate the impact of adding PCT-A to stewardship practices...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29163414/control-of-antimicrobial-resistance-requires-an-ethical-approach
#8
REVIEW
Ben Parsonage, Philip K Hagglund, Lloyd Keogh, Nick Wheelhouse, Richard E Brown, Stephanie J Dancer
Ethical behavior encompasses actions that benefit both self and society. This means that tackling antimicrobial resistance (AMR) becomes an ethical obligation, because the prospect of declining anti-infectives affects everyone. Without preventive action, loss of drugs that have saved lives over the past century, will condemn ourselves, people we know, and people we don't know, to unacceptable risk of untreatable infection. Policies aimed at extending antimicrobial life should be considered within an ethical framework, in order to balance the choice, range, and quality of drugs against stewardship activities...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29163151/ongoing-initiatives-to-improve-the-quality-and-efficiency-of-medicine-use-within-the-public-healthcare-system-in-south-africa-a-preliminary-study
#9
Johanna C Meyer, Natalie Schellack, Jacobus Stokes, Ruth Lancaster, Helecine Zeeman, Douglas Defty, Brian Godman, Gavin Steel
Introduction: South Africa has an appreciable burden of both communicable and non-communicable diseases as well as high maternal, neonatal, and child morbidity. In recent years there have been significant strides with improving the public health system, and addressing current inequalities, with the right to health a constitutional provision in South Africa. Initiatives include the introduction of National Health Insurance, programmes to enhance access to medicines for patients with chronic diseases, as well as activities to improve care in hospitals, including improving pharmacovigilance...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29162405/identification-of-target-risk-groups-for-population-based-clostridium-difficile-infection-prevention-strategies-using-a-population-attributable-risk-approach
#10
Sung-Hee Oh, Hye-Young Kang
OBJECTIVES: We aimed to determine risk factors associated with Clostridium difficile infection (CDI) and assess the contributions of these factors on CDI burden. METHODS: We conducted a 1:4 matched case-control study using a national claims dataset. Cases were incident CDI without a history of CDI in the previous 84 days, and were age- and sex-matched with control patients. We ascertained exposure, defined as a history of morbidities and drug use within 90 days...
November 18, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29157244/antimicrobial-stewardship-a-qualitative-study-of-the-development-of-national-guidelines-for-antibiotic-use-in-hospitals
#11
Eli Feiring, Anne Berit Walter
BACKGROUND: As effective antibiotics are becoming a scarce resource, governmental regulation is needed to promote responsible use. Implementation of antibiotic stewardship and practice guidelines in health care facilities seems to be crucial to this effort. Empirical studies suggest, however, that guidelines have limited influence on health professionals' behavior and practice. Barriers and facilitators to guideline implementability are much studied, but little attention has been given to health professionals' perceptions of normative acceptability of guidelines as a condition for compliance...
November 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29156865/antibacterial-resistance-patterns-and-incidence-of-hospital-acquired-staphylococcus-aureus-bacteremia-in-a-tertiary-care-educational-hospital-in-turkey-a-perspective-from-2001-to-2013
#12
Oğuz Reşat Sipahi, Serhat Uysal, Sabire Şöhret Aydemir, Hüsnü Pullukçu, Meltem Taşbakan, Alper Tünger, Fatma Feriha Çilli, Tansu Yamazhan, Bilgin Arda, Hilal Sipahi, Sercan Ulusoy
Background/aim: Staphylococcus aureus is an important nosocomial pathogen and a successful antimicrobial-resistance developer. In this study we retrospectively evaluated the resistance patterns and incidence of microbiologically confirmed nosocomial bacteremia (MCNB) related S. aureus strains between 2001 and 2013. Materials and methods: Any patient in whom S. aureus was isolated in at least one set of blood cultures (sent to the bacteriology laboratory 72 h after hospital admission) was considered to have MCNB...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29155990/a-systematic-review-of-interventions-and-performance-measures-for-antifungal-stewardship-programmes
#13
A L Bienvenu, L Argaud, F Aubrun, J L Fellahi, C Guerin, E Javouhey, V Piriou, T Rimmele, C Chidiac, G Leboucher
Objectives: Antifungal resistance is a significant and emerging threat. Stewardship programmes (SPs) have been proposed as an opportunity to optimize antifungal use. While examples of antifungal SP implementation have been recently described, there is yet to be an overview of interventions and their impacts on performance measures. Methods: We systematically reviewed published articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses check-list 2009...
November 16, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29155536/antimicrobial-resistance-and-antibiotic-prescribing-in-dental-practice
#14
Nikolaus O A Palmer
The purpose of this paper is to review the principles of antibiotic prescribing in light of the increasing worldwide problem of antimicrobial resistance and the evidence of inappropriate use of antibiotics in dentistry. Guidance on the management of dental infections and antibiotic prophylaxis based on a review of the scientific evidence will be given to ensure good patient care. Clinical relevance: To discuss the relevance of legislation around antimicrobial prescribing and antimicrobial stewardship for dentists...
December 2016: Dental Update
https://www.readbyqxmd.com/read/29154024/global-antimicrobial-resistance-in-gram-negative-pathogens-and-clinical-need
#15
REVIEW
Ursula Theuretzbacher
Resistance in Gram-negative bacteria has become a serious problem in many regions of the world as it may reduce the treatment options substantially. Carbapenem-resistance is a good marker for such situations and is most prevalent in Acinetobacter, Pseudomonas but also increasingly in Enterobacteriaceae, especially Klebsiella. This review gives a rough global picture highlighting the epicentres of resistance. The medical need for novel treatment options globally is undeniable even if many countries with good stewardship and infection control conditions are not highly affected...
November 15, 2017: Current Opinion in Microbiology
https://www.readbyqxmd.com/read/29153470/impact-of-a-pharmacist-driven-care-package-on-staphylococcus-aureus-bacteremia-management-in-a-large-community-healthcare-network-a-propensity-score-matched-quasi-experimental-study
#16
Jordan R Smith, Jeremy J Frens, Cynthia B Snider, Kimberly C Claeys
OBJECTIVES: Staphylococcus aureus bacteremia (SAB) is an important cause of morbidity and mortality. Suboptimal treatment has been associated with poor patient outcomes. Our antimicrobial stewardship program (ASP) evaluated SAB management based on predefined performance measures both prior to and after instituting a "care package" intervention led by clinical pharmacists and infectious diseases physicians. The primary outcome included a 4-point "optimal care score" (OCS) consisting of targeted antibiotic therapy within 24hours, repeating blood cultures, antibiotic duration assessment, and appropriate duration of therapy...
October 7, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29153252/antimicrobial-stewardship-in-pediatric-post-acute-care-facilities
#17
Candace L Johnson, Meaghan Jain, Lisa Saiman, Natalie Neu
Providers in pediatric post-acute care facilities were surveyed about knowledge of and resources for antimicrobial stewardship. All agreed that antibiotics were overused in such pediatric facilities, but 60% had not implemented stewardship strategies. Lack of treatment guidelines (47%) was identified as the most common barrier to antimicrobial stewardship.
November 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29152678/first-year-results-of-an-antibiotic-stewardship-program-in-a-greek-tertiary-care-hospital
#18
K Chrysou, O Zarkotou, S Kalofolia, P Papagiannakopoulou, G Chrysos, K Themeli-Digalaki, A Tsakris, S Pournaras
The aim of this study was to investigate the effect of the implementation of an antibiotic stewardship program (ASP) on antibiotic consumption in our 428-bed hospital. The Infection Control Committee implemented an ASP beginning in January 2016, aiming to reduce inappropriate antibiotic use through improved prescribing practices. The ASP included both pre-authorization and prospective audit and feedback strategies. We collected pharmacy and hospital data for the years 2015 (pre-intervention) and 2016 (post-intervention)...
November 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29151013/decreasing-the-incidence-of-surgical-site-infections-following-joint-replacement-surgery
#19
Lorraine Hutzler, Jarrett Williams
OBJECTIVE: Despite the generalized use of prophylactic antibiotics in orthopaedic surgery, Surgical Site Infections (SSIs) are still a major source of morbidity, mortality, and hospital cost. This is due in part to the increasing prevalence of antibiotic resistant organisms. METHODS: A review of local epidemiology, the importance of an antibiotic stewardship program, patient optimization, and risk stratification options to reduce SSIs. RESULTS: The proportion of revisions due to infection is projected to rise rapidly over the next 25 years...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#20
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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