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https://www.readbyqxmd.com/read/28534213/impact-of-antimicrobial-stewardship-and-rapid-microarray-testing-on-patients-with-gram-negative-bacteremia
#1
K R Rivard, V Athans, S W Lam, S M Gordon, G W Procop, S S Richter, E Neuner
A rapid microarray assay, Nanosphere Verigene® Gram-negative blood culture test (BC-GN), detects four Gram-negative species, four Gram-negative genera, and six resistance genes directly from positive blood culture samples, shortening the time from Gram stain to pathogen and resistance-gene identification. The purpose of this study was to determine the impact of the BC-GN paired with an antimicrobial stewardship intervention on antimicrobial and clinical outcomes. Patients with Gram-negative bacteremia were compared before (n = 456) and after (n = 421) BC-GN implementation...
May 23, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28534037/otogenic-meningitis-a-comparison-of-diagnostic-performance-of-surgery-and-radiology
#2
Luca Bruschini, Simona Fortunato, Carlo Tascini, Annalisa Ciabotti, Alessandro Leonildi, Belinda Bini, Simone Giuliano, Arturo Abbruzzese, Stefano Berrettini, Francesco Menichetti
Development of intracranial complications from middle ear infections might be difficult to diagnose. We compared radiological and surgical findings of 26 patients affected by otogenic meningitis. Results of our analysis showed that surgery is more reliable than imaging in revealing bone defects. Therefore, suggest that surgery be performed for diagnosis and eventual management of all cases of suspected otogenic meningitis.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28532194/cost-effectiveness-of-ceftolozane-tazobactam-plus-metronidazole-compared-with-piperacillin-tazobactam-as-empiric-therapy-for-the-treatment-of-complicated-intra-abdominal-infections-based-on-the-in-vitro-surveillance-of-bacterial-isolates-in-the-uk
#3
Vimalanand Prabhu, Jason Foo, Harblas Ahir, Eric Sarpong, Sanjay Merchant
AIMS: An increase in the prevalence of antimicrobial resistance among gram-negative pathogens has been noted recently.[1] A challenge in empiric treatment of complicated intra-abdominal infection (cIAI) is identifying initial appropriate antibiotic therapy, which is associated with reduced length of stay and mortality compared with inappropriate therapy. The objective of this study was to assess the cost-effectiveness of ceftolozane/tazobactam+metronidazole compared with piperacillin/tazobactam (commonly used in this indication) in the treatment of patients with cIAI in United Kingdom (UK) hospitals...
May 22, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28526402/outpatient-antibiotic-stewardship-interventions-and-opportunities
#4
Erica L Dobson, Michael E Klepser, Jason M Pogue, Matthew J Labreche, Alex J Adams, Timothy P Gauthier, R Brigg Turner, Christy P Su, David M Jacobs, Katie J Suda
Improving the use of antibiotics across the continuum of care is a national priority. Data outlining the misuse of antibiotics in the outpatient setting justify the expansion of antibiotic stewardship programs (ASPs) into this health care setting; however, best practices for outpatient antibiotic stewardship (AS) are not yet defined. In a companion article, we focused on recommendations to overcome challenges related to the implementation of an outpatient ASP (e.g., building the AS team and defining program metrics)...
May 16, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#5
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
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...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28521796/effects-of-nurse-telesupport-on-transition-between-specialized-and-primary-care-in-diabetic-patients-study-protocol-for-a-randomized-controlled-trial
#8
Ana Marina Moreira, Roberta Marobin, Dimitris Varvaki Rados, Camila Bergonsi de Farias, Sabrina Coelli, Bárbara Luiza Bernardi, Lívia de Almeida Faller, Laura Ferraz Dos Santos, Ana Maria Matzenbacher, Natan Katz, Erno Harzheim, Sandra Pinho Silveiro
BACKGROUND: According to the Global Diabetes Plan, a unified health system with preventive and educational strategies is essential to proper diabetes care and primary settings should be the main site of care. In Brazil, there is limited access to outpatient hospital diabetes services, while primary-care diabetes support is underutilized. Telemedicine can be a useful adjunct to support discharge of stable patients with type 2 diabetes to the primary care setting. In this paper, we present a randomized controlled trial (RCT) protocol designed to evaluate the effects of telehealth support for stable type 2 diabetes patients discharged from hospital outpatient diabetes clinics...
May 18, 2017: Trials
https://www.readbyqxmd.com/read/28520953/evolving-insights-into-the-epidemiology-and-control-of-clostridium-difficile-in-hospitals
#9
Daniel A Caroff, Deborah S Yokoe, Michael Klompas
Typing studies suggest most cases of hospital-onset Clostridium difficile infection are unrelated to other cases of active disease in the hospital. New cases may instead be due to transmissions from asymptomatic carriers or progression of latent C.difficile present-on-admission to active infection. Direct exposure to antibiotics remains the primary risk factor for C.difficile infection but ward-level antibiotic use, antibiotic exposure of the prior room occupant, and C.difficile status of the prior room occupant increase risk for C...
May 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28520865/impact-of-an-integrated-antibiotic-allergy-testing-program-on-antimicrobial-stewardship-a-multicenter-evaluation
#10
Jason A Trubiano, Karin A Thursky, Andrew J Stewardson, Karen Urbancic, Leon J Worth, Cheryl Jackson, Wendy Stevenson, Michael Sutherland, Monica A Slavin, M Lindsay Grayson, Elizabeth J Phillips
Background.: Despite the high prevalence of patient-reported antibiotic allergy (so-called antibiotic allergy labels [AALs]) and their impact on antibiotic prescribing, incorporation of antibiotic allergy testing (AAT) into antimicrobial stewardship (AMS) programs (AAT-AMS) is not widespread. We aimed to evaluate the impact of an AAT-AMS program on AAL prevalence, antibiotic usage, and appropriateness of prescribing. Methods.: AAT-AMS was implemented at two large Australian hospitals during a 14-month period beginning May 2015...
May 18, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28516820/blogging-in-infectious-diseases-and-clinical-microbiology-assessment-of-blogosphere-content
#11
Gabriel Birgand, Rachael Troughton, Luke S P Moore, Esmita Charani, Timothy M Rawson, Enrique Castro-Sánchez, Alison H Holmes
OBJECTIVE To analyze influential infectious diseases, antimicrobial stewardship, infection control, or medical microbiology blogs and bloggers SETTING World wide web DESIGN We conducted a systematic search for blogs in accordance with the PRISMA guidelines in September 2015. METHODS A snowball sampling approach was applied to identify blogs using various search engines. Blogs were eligible if they (1) focused on infectious diseases, antimicrobial stewardship, infection control, or medical microbiology; (2) were intended for health professionals; and (3) were written in English and (4) were updated regularly...
May 18, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28514013/antimicrobial-prescribing-in-dogs-and-cats-in-australia-results-of-the-australasian-infectious-disease-advisory-panel-survey
#12
L Y Hardefeldt, S Holloway, D J Trott, M Shipstone, V R Barrs, R Malik, M Burrows, S Armstrong, G F Browning, M Stevenson
BACKGROUND: Investigations of antimicrobial use in companion animals are limited. With the growing recognition of the need for improved antimicrobial stewardship, there is urgent need for more detailed understanding of the patterns of antimicrobial use in this sector. OBJECTIVES: To investigate antimicrobial use for medical and surgical conditions in dogs and cats by Australian veterinarians. METHODS: A cross-sectional study was performed over 4 months in 2011...
May 17, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28508086/revisiting-classical-design-in-engineering-from-a-perspective-of-frugality
#13
Balkrishna C Rao
The conservative nature of design in engineering has typically unleashed products fabricated with generous amounts of raw materials. This is epitomized by the factor of safety whose values higher than unity suggests various uncertainties of design that are tackled through material padding. This effort proposes a new factor of safety called the factor of frugality that could be used in ecodesign and which addresses both rigors of the classical design process and quantification of savings in materials going into a product...
May 2017: Heliyon
https://www.readbyqxmd.com/read/28504314/next-step-in-antibiotic-stewardship-pharmacist-provided-penicillin-allergy-testing
#14
Z Gugkaeva, J S Crago, M Yasnogorodsky
WHAT IS KNOWN: Penicillin allergy limits therapeutic options for patients but often disappears over time, leaving patients erroneously labelled allergic and leading to the utilization of broad-spectrum and more expensive antibiotics. Penicillin allergy can be effectively assessed via skin testing. OBJECTIVE: To improve patient access to penicillin allergy testing by implementing a pharmacist-provided service in a hospital setting. COMMENT: Beta-lactams remain a mainstream therapy for many infections due to their effectiveness, low side effects and affordability...
May 14, 2017: Journal of Clinical Pharmacy and Therapeutics
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
#15
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/28501668/response-adjusted-for-days-of-antibiotic-risk-radar-evaluation-of-a-novel-method-to-compare-strategies-to-optimise-antibiotic-use
#16
Valentijn A Schweitzer, Maarten van Smeden, Douwe F Postma, Jan Jelrik Oosterheert, Marc J M Bonten, Cornelis H van Werkhoven
OBJECTIVES: The Response Adjusted for Days of Antibiotic Risk (RADAR)-statistic was proposed to improve efficiency of trials comparing antibiotic stewardship strategies to optimize antibiotic use. We studied the behaviour of RADAR in a non-inferiority trial in which a beta-lactam monotherapy strategy (BL, n=656) was non-inferior to fluoroquinolone monotherapy (FQL, n=888) for moderately-severe community-acquired pneumonia (CAP) patients. METHODS: Patients were ranked according to clinical outcome, using five or eight categories, and antibiotic use...
May 10, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28499717/a-call-to-action-for-outpatient-antibiotic-stewardship
#17
Michael E Klepser, Erica L Dobson, Jason M Pogue, Matthew J Labreche, Alex J Adams, Timothy P Gauthier, R Brigg Turner, Christy P Su, David M Jacobs, Katie J Suda
OBJECTIVES: To address the public health threat of antibiotic resistance, there has been an enhanced call for antibiotic stewardship programs throughout the health care continuum. SUMMARY: While antibiotic stewardship programs have been well described in the inpatient setting, data on effectiveness and guidance on implementing outpatient programs is scarce. Establishing stewardship practices in the outpatient setting is necessary because more than 60% of human antibiotic use occurs in this setting...
May 9, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28499421/patterns-of-use-and-appropriateness-of-antibiotics-prescribed-to-patients-receiving-haemodialysis-an-observational-study
#18
Katrina Hui, Michelle Nalder, Kirsty Buising, Aspasia Pefanis, Khai Y Ooi, Eugenie Pedagogos, Craig Nelson, Carl M J Kirkpatrick, David C M Kong
BACKGROUND: There are limited published data on the types and appropriateness of oral and intravenous (IV) antibiotics prescribed to patients receiving haemodialysis. This information is critical to optimise antibiotic prescribing. Therefore this study aims to describe the patterns of use and the appropriateness of oral and IV antibiotics prescribed to patients receiving haemodialysis. METHODS: This was a prospective, observational study across four community and two hospital inpatient haemodialysis units in Melbourne, Australia...
May 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28492525/neonatal-sepsis-in-rural-india-timing-microbiology-and-antibiotic-resistance-in-a-population-based-prospective-study-in-the-community-setting
#19
P Panigrahi, D S Chandel, N I Hansen, N Sharma, S Kandefer, S Parida, R Satpathy, L Pradhan, A Mohapatra, S S Mohapatra, P R Misra, N Banaji, J A Johnson, J G Morris, I H Gewolb, R Chaudhry
OBJECTIVE: To examine the timing and microbiology of neonatal sepsis in a population-based surveillance in the Indian community setting. STUDY DESIGN: All live born infants in 223 villages of Odisha state were followed at home for 60 days. Suspect sepsis cases were referred to study hospitals for further evaluation including blood culture. RESULTS: Of 12 622 births, 842 were admitted with suspected sepsis of whom 95% were 4 to 60 days old...
May 11, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28492121/south-african-medical-students-perceptions-and-knowledge-about-antibiotic-resistance-and-appropriate-prescribing-are-we-providing-adequate-training-to-future-prescribers
#20
Sean Wasserman, Samantha Potgieter, Evan Shoul, Deborah Constant, Annemie Stewart, Marc Mendelson, Tom H Boyles
BACKGROUND: Education of medical students has been identified by the World Health Organization as an important aspect of antibiotic resistance (ABR) containment. Surveys from high-income countries consistently reveal that medical students recognise the importance of antibiotic prescribing knowledge, but feel inadequately prepared and require more education on how to make antibiotic choices. The attitudes and knowledge of South African (SA) medical students regarding ABR and antibiotic prescribing have never been evaluated...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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