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Stewardship

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https://www.readbyqxmd.com/read/29351769/protocol-to-disseminate-a-hospital-site-controlled-intervention-using-audit-and-feedback-to-implement-guidelines-concerning-inappropriate-treatment-of-asymptomatic-bacteriuria
#1
Barbara W Trautner, Pooja Prasad, Larissa Grigoryan, Sylvia J Hysong, Jennifer R Kramer, Suja Rajan, Nancy J Petersen, Tracey Rosen, Dimitri M Drekonja, Christopher Graber, Payal Patel, Paola Lichtenberger, Timothy P Gauthier, Steve Wiseman, Makoto Jones, Anne Sales, Sarah Krein, Aanand Dinkar Naik
BACKGROUND: Antimicrobial stewardship to combat the spread of antibiotic-resistant bacteria has become a national priority. This project focuses on reducing inappropriate use of antimicrobials for asymptomatic bacteriuria (ASB), a very common condition that leads to antimicrobial overuse in acute and long-term care. We previously conducted a successful intervention, entitled "Kicking Catheter Associated Urinary Tract Infection (CAUTI): the No Knee-Jerk Antibiotics Campaign," to decrease guideline-discordant ordering of urine cultures and antibiotics for ASB...
January 19, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29351187/high-proportions-of-multidrug-resistant-acinetobacter-spp-isolates-in-a-district-in-western-india-a-four-year-antibiotic-susceptibility-study-of-clinical-isolates
#2
Ingvild Odsbu, Smita Khedkar, Uday Khedkar, Sandeep S Nerkar, Ashok J Tamhankar, Cecilia Stålsby Lundborg
The purpose of the study was to determine the proportions of multidrug-resistant (MDR) Acinetobacter spp. isolates from the district of Nashik in Western India during the period from 2011-2014. Antibacterial susceptibility testing of isolates from inpatients and outpatients was performed using Kirby-Bauer disc diffusion method to determine inhibitory zone diameters. Proportions of non-susceptible isolates were calculated from the antibacterial susceptibility data. MDR was defined as an isolate being non-susceptible to at least one antibacterial agent in at least three antibacterial categories...
January 19, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29346568/are-infection-specialists-recommending-short-antibiotic-treatment-durations-an-escmid-international-cross-sectional-survey
#3
Gabriel Macheda, Oliver J Dyar, Amandine Luc, Bojana Beovic, Guillaume Béraud, Bernard Castan, Rémy Gauzit, Philippe Lesprit, Pierre Tattevin, Nathalie Thilly, Céline Pulcini
Objectives: To evaluate the current practice and the willingness to shorten the duration of antibiotic therapy among infection specialists. Methods: Infection specialists giving at least weekly advice on antibiotic prescriptions were invited to participate in an online cross-sectional survey between September and December 2016. The questionnaire included 15 clinical vignettes corresponding to common clinical cases with favourable outcomes; part A asked about the antibiotic treatment duration they would usually advise to prescribers and part B asked about the shortest duration they were willing to recommend...
January 16, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29345611/accuracy-of-provider-selected-indications-for-antibiotic-orders
#4
Emily L Heil, Lisa Pineles, Poonam Mathur, Daniel J Morgan, Anthony D Harris, Arjun Srinivasan, Kerri A Thom
Documentation of antibiotic indication provides helpful information for antimicrobial stewardship, but accuracy is not understood. Review of 396 antibiotic orders in a pediatric ICU and adult medicine step-down unit found 90% agreement between provider-selected indication and independent review. Prompts to enter antibiotic indication during order entry provide largely accurate information. Infect Control Hosp Epidemiol 2018;39:111-113.
January 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29344355/impact-of-an-antifungal-stewardship-intervention-on-optimization-of-candidemia-management
#5
Hana Rac, Jamie L Wagner, S Travis King, Katie E Barber, Kayla R Stover
Background: Candidemia represents a leading cause of healthcare-associated bloodstream infections with significant morbidity and mortality. Previous studies have demonstrated that comprehensive care bundles improve candidemia management but are time-consuming. Objective: To determine the impact of a one-time targeted candidemia intervention on time to initiation of adequate therapy compared to standard of care. Methods: This Institutional Review Board (IRB)-approved, quasi-experiment evaluated a targeted candidemia intervention involving a single phone call to the primary team providing recommendations for care...
January 2018: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/29342478/design-and-implementation-of-a-visual-analytics-electronic-antibiogram-within-an-electronic-health-record-system-at-a-tertiary-pediatric-hospital
#6
Allan F Simpao, Luis M Ahumada, Beatriz Larru Martinez, Ana M Cardenas, Talene A Metjian, Kaede V Sullivan, Jorge A Gálvez, Bimal R Desai, Mohamed A Rehman, Jeffrey S Gerber
BACKGROUND:  Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually. OBJECTIVE:  We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29342469/the-2017-update-of-the-german-clinical-guideline-on-epidemiology-diagnostics-therapy-prevention-and-management-of-uncomplicated-urinary-tract-infections-in-adult-patients-part%C3%A2-1
#7
Jennifer Kranz, Stefanie Schmidt, Cordula Lebert, Laila Schneidewind, Falitsa Mandraka, Mirjam Kunze, Sina Helbig, Winfried Vahlensieck, Kurt Naber, Guido Schmiemann, Florian M Wagenlehner
OBJECTIVES: We aimed to update the 2010 evidence- and consensus-based national clinical guideline on the diagnosis and management of uncomplicated urinary tract infections (UTIs) in adult patients. MATERIALS AND METHODS: An interdisciplinary group consisting of 17 representatives of 12 medical societies and a patient representative was formed. Systematic literature searches were conducted in MEDLINE, -EMBASE, and the Cochrane Library to identify literature published in 2010-2015...
January 17, 2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29341550/health-stewardship-a-concept-for-best-health-outcomes
#8
Maria Donnelley
The concept of health stewardship and responsibility for self, marks a shift from adopting a paternalistic approach to care, with decision-making the main remit of healthcare practitioners, towards encouraging and empowering individuals to take increasing responsibility for their healthcare and outcomes. The main aim of nursing is to achieve optimal health outcomes for every patient. Exploring health stewardship as a path to wellness will assist healthcare practitioners to guide patients living with a chronic disease to be as healthy as possible...
January 17, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29340609/impact-of-antibiotic-stewardship-programmes-in-asia-a-systematic-review-and-meta-analysis
#9
Chun Fan Lee, Benjamin J Cowling, Shuo Feng, Hanae Aso, Peng Wu, Keiji Fukuda, Wing Hong Seto
Background: The use of antibiotic stewardship programmes (ASPs) is increasing in Asia, but their effectiveness in reducing antibiotic consumption and their impact on clinical outcomes is not known. Objectives: To determine the impact of ASPs conducted in Asia on the consumption of antibiotics and on patients' clinical outcomes. Methods: We systematically searched the Embase and Medline (PubMed) databases for studies that compared antibiotic consumption or clinical outcomes of patients in an Asian hospital or clinic with an ASP (intervention) with those in a similar setting without an ASP (control)...
January 11, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29340600/development-and-impact-of-a-massive-open-online-course-mooc-for-antimicrobial-stewardship
#10
Jacqueline Sneddon, Gavin Barlow, Sally Bradley, Adrian Brink, Sujith J Chandy, Dilip Nathwani
Background: The University of Dundee and the BSAC developed a massive open online course (MOOC) to address the global need for education to support antimicrobial stewardship in low- and middle-income countries. Methods: An interactive course, Antimicrobial Stewardship: Managing Antibiotic Resistance, was developed and delivered via the FutureLearn© platform. The course ran over four 6 week periods during 2015 and 2016 supported by educators and was evaluated via data on uptake and feedback from learners on impact on clinical practice...
January 10, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29340593/the-clinical-utility-of-methicillin-resistant-staphylococcus-aureus-mrsa-nasal-screening-to-rule-out-mrsa-pneumonia-a-diagnostic-meta-analysis-with-antimicrobial-stewardship-implications
#11
Diane M Parente, Cheston B Cunha, Eleftherios Mylonakis, Tristan T Timbrook
Background: Recent literature has highlighted MRSA nasal screening as a possible antimicrobial stewardship program (ASP) tool for avoiding unnecessary empiric MRSA therapy for pneumonia, yet current guidelines recommend MRSA therapy based on risk factors. The objective of this meta-analysis was to evaluate the diagnostic value of MRSA nasal screening in MRSA pneumonia. Methods: Pubmed and EMBASE were searched from inception to November 2016 for English studies evaluating MRSA nasal screening and development of MRSA pneumonia...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29339385/effectiveness-of-an-antimicrobial-stewardship-program-in-critical-care-a-before-and-after-study
#12
Francisco Álvarez-Lerma, Santiago Grau Cerrato, Daniel Echeverría Esnal, Montserrat Martínez-Alonso, Maria Pilar Gracia Arnillas, Juan Pablo Horcajada, Juan Ramón Masclans
We evaluated the use of antimicrobials expressed as defined daily doses (DDDs) per 1,000 patient days and days of therapy (DOT) per 100 occupied bed-days in a intensive care unit (UCI) of a general hospital in Barcelona, Spain, before and after implementation of an antimicrobial stewardship (AMS) program (2007-2010 versus 2011-2015). The quarterly costs of antimicrobials used in the ICU and its weight in the overall hospital costs of antimicrobials were calculated. The effect of the applied AMS program on DDDs and DOT time series data was analyzed by means of intervention time series analysis...
January 16, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29339298/implementation-and-impact-of-an-audit-and-feedback-antimicrobial-stewardship-intervention-in-the-orthopaedics-department-of-a-tertiary-care-hospital-a-controlled-interrupted-time-series-study
#13
Margarida Tavares, Ana Cláudia Carvalho, José Pedro Almeida, Paulo Andrade, Ricardo São Simão, Pedro Soares, Carlos Alves, Rui Pinto, Arnaud Fontanet, Laurence Watier
A prospective audit and feedback antimicrobial stewardship intervention conducted in the Orthopaedics Department of a University Hospital in Portugal was evaluated by comparing an interrupted time series in an intervention group and a non-intervention (control) group. Monthly antibiotic use (except cefazolin) was measured as World Health Organization- and Anatomical Therapeutic Chemical-defined daily doses (DDD) from January 2012 to September 2016, excluding the 6-month phase of intervention implementation starting on January 1, 2015...
January 12, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29339297/the-experiences-and-perspectives-of-implementing-antimicrobial-stewardship-in-five-french-hospitals-a-qualitative-study
#14
Anne Perozziello, Christelle Routelous, Esmita Charani, Alice Truel, Gabriel Birgand, Yazdan Yazdanpanah, François-Xavier Lescure, Jean-Christophe Lucet
OBJECTIVE: To describe current antimicrobial stewardship program (ASP) in France, both at policy level and at local implementation level, and to assess how ASP leaders (ASPL) worked and prioritised their activities. METHODS: We conducted a qualitative study based on face-to-face semi-structured interviews with healthcare professionals responsible for ASP across five French hospitals. Five infectious disease specialists and one microbiologist were interviewed between April and June 2016...
January 12, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29337664/containment-studies-of-transgenic-mosquitoes-in-disease-endemic-countries-the-broad-concept-of-facilities-readiness
#15
M Megan Quinlan, Josephine Birungi, Mamadou B Coulibaly, Abdoulaye Diabaté, Luca Facchinelli, Wolfgang Richard Mukabana, James Mutuku Mutunga, Tony Nolan, Peter Raymond, Sékou F Traoré
Genetic strategies for large scale pest or vector control using modified insects are not yet operational in Africa, and currently rely on import of the modified strains to begin preliminary, contained studies. Early involvement of research teams from participating countries is crucial to evaluate candidate field interventions. Following the recommended phased approach for novel strategies, evaluation should begin with studies in containment facilities. Experiences to prepare facilities and build international teams for research on transgenic mosquitoes revealed some important organizing themes underlying the concept of "facilities readiness," or the point at which studies in containment may proceed, in sub-Saharan African settings...
January 2018: Vector Borne and Zoonotic Diseases
https://www.readbyqxmd.com/read/29336894/preoperative-surveillance-rectal-swab-is-associated-with-an-increased-risk-of-infectious-complications-in-pancreaticoduodenectomy-and-directs-antimicrobial-prophylaxis-an-antibiotic-stewardship-strategy
#16
Matteo De Pastena, Salvatore Paiella, Anna M Azzini, Giovanni Marchegiani, Giuseppe Malleo, Debora Ciprani, Annarita Mazzariol, Erica Secchettin, Deborah Bonamini, Clizia Gasparini, Ercole Concia, Claudio Bassi, Roberto Salvia
BACKGROUND: Despite improvements in the perioperative care, the morbidity rate after pancreaticoduodenectomy (PD) is still higher than 50%. The aim of this study was twofold: first, to assess the correlation between preoperative rectal swab (RS) and intraoperative bile cultures; to examine the impact of RS isolates on postoperative course after PD. METHODS: An observational study was conducted analyzing all consecutive PD performed from January 2015 to July 2016...
January 11, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29334865/-i-never-would-have-caught-that-before-pharmacist-perceptions-of-using-clinical-decision-support-for-antimicrobial-stewardship-in-the-united-states
#17
Christopher A Giuliano, Juliann Binienda, Pramodini B Kale-Pradhan, Mohamad G Fakih
To systematically improve the appropriateness of antibiotic prescribing, antimicrobial stewardship programs have been developed. There is a paucity of literature examining how pharmacists perform antimicrobial stewardship using a clinical decision support system in a hospital setting. The purpose of this qualitative study was to develop a model exploring how pharmacists perform antimicrobial stewardship to identify areas for programmatic improvement. Semistructured interviews were conducted across a health care system until saturation of themes was reached...
January 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29333498/impact-of-pharmacist-led-antibiotic-stewardship-program-in-a-picu-of-low-middle-income-country
#18
Anwarul Haque, Kashif Hussain, Romesa Ibrahim, Qalab Abbas, Shah Ali Ahmed, Humaira Jurair, Syed Asad Ali
No abstract text is available yet for this article.
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29332209/the-rapid-diagnosis-of-viral-respiratory-tract-infections-and-its-impact-on-antimicrobial-stewardship-programs
#19
Şiran Keske, Önder Ergönül, Faik Tutucu, Doruk Karaaslan, Erhan Palaoğlu, Füsun Can
We aimed to describe the potential benefit of new rapid molecular respiratory tests (MRT) in decreasing inappropriate antibiotic use among the inpatients presenting with influenza-like illness (ILI). We included patients from inpatient and outpatient departments who had ILI and performed MRT between 1 January 2015 and 31 December 2016 in a 265-bed private hospital in Istanbul. At the end of 2015, we implemented antimicrobial stewardship including systematic use of MRT. Then, we compared our observations between the year 2015 and the year 2016...
January 13, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29331159/diagnostic-stewardship-for-healthcare-associated-infections-opportunities-and-challenges-to-safely-reduce-test-use
#20
Gregory R Madden, Robert A Weinstein, Costi D Sifri
No abstract text is available yet for this article.
January 14, 2018: Infection Control and Hospital Epidemiology
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