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Antibiotic/ antimicrobial stewardship

M L Ciofi Degli Atti, C D'Amore, C Gagliotti, C Zotti, E Ricchizzi, M L Moro, M Raponi
BACKGROUND: Antimicrobial stewardship programs and comprehensive infection control programs represent the main strategies to limit the emergence and transmission of multi-drug resistant bacteria in hospital settings. The purpose of this study was to describe strategies implemented in Italian children's hospitals for controlling antibiotic resistance. STUDY DESIGN: Cross sectional multicenter study. METHODS: Four tertiary care Italian children's hospitals were invited to participate in a survey aimed at collecting information on activities implemented as of December 2015 using a self-administered online questionnaire...
January 2019: Annali di Igiene: Medicina Preventiva e di Comunità
Wei Yee Chan, Manouchehr Khazandi, Elizabeth E Hickey, Stephen W Page, Darren J Trott, Peter B Hill
BACKGROUND: An antibiotic adjuvant is a chemical substance used to modify or augment the effectiveness of primary antimicrobial agents against drug-resistant micro-organisms. Its use provides an alternative approach to address the global issue of antimicrobial resistance and enhance antimicrobial stewardship. HYPOTHESIS/OBJECTIVES: To determine the antimicrobial activity of a panel of potential antimicrobial adjuvants against common pathogens associated with canine otitis externa (OE)...
December 13, 2018: Veterinary Dermatology
Zachary Willis, Annabelle de St Maurice
PURPOSE OF REVIEW: Neonates are at a high risk of infection and may have nonspecific signs of sepsis. Accordingly, they are heavily exposed to antimicrobials. Neonates are also uniquely at risk of both short-term and long-term complications from antibiotic exposure. This review discusses advances in antibiotic stewardship in the neonatal population. RECENT FINDINGS: Antimicrobial utilization is highly variable among NICUs in excess of case-mix variation. Rates of early-onset sepsis because of Group B Streptococcus have decreased substantially with the introduction of intrapartum antibiotic prophylaxis...
December 12, 2018: Current Opinion in Pediatrics
Harika Yalamanchili, Dima Dandachi, Pablo C Okhuysen
Acute diarrheal illness due to gastrointestinal infection is a significant cause of morbidity and mortality in the United States and around the world. Determining the causative organism in a timely manner assists with patient care, identifying outbreaks, providing infection control, and administering antimicrobial therapy when indicated. Traditional diagnostic modalities based on culture and immunoassays are limited by their low sensitivity and long turnaround time. Nucleic acid amplification tests (NAATs) for enteric pathogens allow for the syndromic testing of stool for multiple pathogens simultaneously and have higher sensitivity with a shorter turnaround time...
November 2018: Gastroenterology & Hepatology
Amanual Getnet Mersha
Background: Antibiotic resistance is a global burden and reduction of antimicrobial resistance requires change in antimicrobial prescribing behavior of health workers. The current study aimed to evaluate the attitude and perception of Ethiopian medical interns towards antimicrobials resistance. Methods: A multi center cross-sectional institutional based survey was conducted from August 2016 to October 2016 among medical interns in Ethiopia. Data entered and analyzed using Statistical Package for Social Sciences program (SPSS) software version 21...
2018: Antimicrobial Resistance and Infection Control
Joseph Y Ting, Vanessa Paquette, Karen Ng, Sarka Lisonkova, Valoria Hait, Sandesh Shivanada, Peter Tilley, Horacio Osiovich, Ashley Roberts
BACKGROUND: Our objective was to evaluate the appropriateness of antibiotic prescriptions in the neonatal intensive care unit using standardized criteria and determine the effects of an antimicrobial stewardship program (ASP) on patterns of antibiotic usage. METHODS: A retrospective audit of antibiotic use from July 2010 to June 2013 was conducted, focusing on prescriptions of vancomycin, cefotaxime, meropenem and linezolid for >3 calendar-days. We evaluated the appropriateness of each course of antibiotic treatment based on the Centers for Disease Control and Prevention 12-Step Guidelines to Prevent Antimicrobial Resistance (steps 4, 6 and 9)...
January 2019: Pediatric Infectious Disease Journal
Nick Lansdale, Samantha Fryer, Mairead Stockdale, James Bancroft, Jennifer Orr, Harriet Corbett, Simon Kenny
AIM: Despite evidence to suggest shorter durations of antibiotics are safe in complicated appendicitis, the practice has not been widely adopted in the UK. Our aim was to determine whether a clinical pathway that tailors antibiotics to clinical condition was safe and effective. METHODS: A new post-operative pathway (NewPath) was devised that reduced mandatory intravenous antibiotics for complicated appendicitis (perforated or gangrenous) from 5 to 3 days post-operatively, provided the child was apyrexial for >12 h and tolerating oral diet...
November 7, 2018: Journal of Pediatric Surgery
David M Krpata
BACKGROUND: The management of incisions and decisions on closure techniques for surgical wounds are driven by expected incisional morbidity and the severity of the potential morbidity for the patient. METHODS: This article reviews current literature on the potential strategies to be considered in closing the skin and fascia of incisions. RESULTS: The review of the literature indicates that low-risk wounds for infection should be closed primarily with subcuticular suture, and adjunctive local measures should be avoided...
December 11, 2018: Surgical Infections
Julie Hui-Chih Wu, Bradley J Langford, Nick Daneman, Jan O Friedrich, Gary Garber
BACKGROUND: Antimicrobial stewardship programs have been established in hospitals, but less studied in long-term care facilities (LTCFs), a setting with unique challenges related to patient populations and available resources. This systematic review sought to provide a comprehensive assessment of antimicrobial stewardship interventions implemented in LTCFs, using meta-analysis to examine their impact on overall antimicrobial use. METHODS: Electronic searches of MEDLINE, Embase, and CINAHL (1990 to July 2018) identified any antimicrobial stewardship interventions in LTCFs, with no restriction on patient population, study design, or outcomes...
December 5, 2018: Journal of the American Geriatrics Society
David D Leedahl, Heather A Personett, Avish Nagpal, Erin F Barreto
The incidence and severity of Clostridium difficile infection (CDI) remain high across intensive care units in the United States despite national efforts to decrease this escalating health care burden. Most published literature and guidelines address treatment rather than prevention, yet this approach may be too downstream to limit morbidity and mortality from the disease and its complications. Mechanisms to successfully prevent CDI include reducing modifiable risk factors and minimizing horizontal transmission of C...
December 3, 2018: Pharmacotherapy
Aymeric Cantais, Olivier Mory, Aurélie Plat, Aurélie Bourmaud, Antoine Giraud, Marion Costille, Bruno Pozzetto, Sylvie Pillet
OBJECTIVES: This prospective study performed in the paediatric emergency department of the University Hospital of Saint-Etienne aimed to measure the impact of the 24/7 bedside use of the Veritor™ System (Becton Dickinson) on the reduction of supplementary investigations, hospital stay and antimicrobial use. METHODS: Influenzavirus A and B antigens were detected with a rapid influenza digital immunoassay (DIA) on nasopharyngeal aspirates (NPA) sampled from the children consulting at the paediatric emergency department between January and March 2016 for influenza-like illness...
November 28, 2018: Clinical Microbiology and Infection
Ryohei Kokado, Hideharu Hagiya, Toshihiro Koyama, Eiko Matsui, Hideo Okuno, Daiichi Morii, Shigeto Hamaguchi, Hisao Yoshida, Yoshihiro Miwa, Kazunori Tomono
INTRODUCTION: To promote antimicrobial stewardship activity, an understanding of the incidence of antibiotic-associated adverse drug events (ADEs) is essential. In this study, we aimed to describe the occurrence of antibiotic-associated ADEs at our hospital. METHODS: We retrospectively searched the ADE registration system in Osaka University Hospital between 2010 and 2017. Registrations of ADEs were dependent on the patients' drug history and clinical course after hospitalization...
November 26, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Fangning Liu, Satyender Hansra, Gordon Crockford, Wolfgang Köster, Brenda J Allan, Joseph M Blondeau, Chantal Lainesse, Aaron P White
Central venous access devices (CVADs) are an essential component of modern health care. However, their prolonged use commonly results in microbial colonization, which carries the potential risk of hospital-acquired bloodstream infections. These infections complicate the treatment of already sick individuals and cost the existing health care systems around the world millions of dollars. The microbes that colonize CVADs typically form multicellular biofilms that are difficult to dislodge and are resistant to antimicrobial treatments...
November 28, 2018: MSphere
Stephanie J Tang, Renuka Gupta, Jennifer I Lee, Adrian M Majid, Parimal Patel, Leigh Efird, Angela Loo, Shawn Mazur, David P Calfee, Alexi Archambault, Deanna Jannat-Khah, Savira Kochhar Dargar, Matthew S Simon
BACKGROUND: Approximately 20%-50% of antimicrobial use in hospitals is inappropriate. Limited data exist on the effect of frontline provider engagement on antimicrobial stewardship outcomes. METHODS: A three-arm pre-post quality improvement study was conducted on three adult internal medicine teaching services at an urban academic hospital. Data from September through December 2016 were compared to historic data from corresponding months in 2015. Intervention arms were (1) Educational bundle (Ed-only); (2) Educational bundle plus antimicrobial stewardship rounds twice weekly with an infectious disease-trained clinical pharmacist (Ed+IDPharmDx2); and (3) Educational bundle plus internal medicine-trained clinical pharmacist embedded into daily attending rounds (Ed+IMPharmDx5)...
October 25, 2018: Joint Commission Journal on Quality and Patient Safety
J Xiang, J N Huan
The prevalence of carbapenems-resistant Klebsiella pneumoniae (CRKP ) in burn wards has become one of the most troublesome issues in current management of bacterial infections. It is necessary for us to reconsider the epidemiology, risk factors and clinical characteristics of CRKP infection as well as therapeutic options. Formulating the principles of antimicrobial therapy of CRKP infection and combined antibiotics therapy and implementing appropriate dosage regimens designed by pharmacokinetic and pharmacodynamic profiles will be of importance...
November 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Hayley R Springer, Thomas N Denagamage, Ginger D Fenton, Bradd J Haley, Jo Ann S VanKessel, Ernest P Hovingh
The discovery of antibiotics brought with it many advances in the health and well-being of humans and animals; however, in recent years development of antimicrobial resistance (AMR) has increasingly become a concern. Much of the antibiotic use on dairy farms is for disease management in mature cattle, and AMR in fecal organisms is relatively rare in this group. However, young dairy calves often carry high levels of AMR in their fecal Escherichia coli and Salmonella enterica, which could provide a potential reservoir of AMR genes on dairy farms...
November 27, 2018: Foodborne Pathogens and Disease
Marlot C Kallen, S Natsch, B C Opmeer, M E J L Hulscher, J A Schouten, J M Prins, Paul van der Linden
A cornerstone of antimicrobial stewardship programs (ASPs) is monitoring quantitative antibiotic use. Frequently used metrics are defined daily dose (DDD) and days of therapy (DOT). The purpose of this study was (1) to explore for the hospital setting the possibilities of quantitative data retrieval on the level of medical specialty and (2) to describe factors affecting the usability and interpretation of these quantitative metrics. We performed a retrospective observational study, measuring overall systemic antibiotic use at specialty level over a 1-year period, from December 1st 2014 to December 1st 2015, in one university and 13 non-university hospitals in the Netherlands...
November 26, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Michael Hornsey, Jonathan W Betts, Jai W Mehat, David W Wareham, Arnoud H M van Vliet, Martin J Woodward, Roberto M La Ragione
In recent years, several plasmids harbouring genes encoding phosphoethanolamine transferases conferring colistin resistance have been described in multiple Enterobacteriaceae species. Avian Pathogenic E. coli (APEC) causes colibacillosis and is responsible for a considerable proportion of the disease burden in commercial poultry flocks, and may be linked to zoonotic infections in humans. Here, we describe the genotypic and phenotypic characteristics of a multidrug-resistant APEC ST69 isolate (APECA2), recovered in 2016 from a diseased broiler at post-mortem examination in Germany...
November 26, 2018: Journal of Medical Microbiology
Jadwiga Wojkowska-Mach, Brian Godman, Amanda Glassman, Amanj Kurdi, Andrzej Pilc, Anna Rozanska, Szymon Skoczyński, Marta Wałaszek, Tomasz Bochenek
Background: The problem of inappropriate use of antibiotics and the resulting growth in antimicrobial resistance (AMR) has implications for Poland and the world. The objective of this paper was to compare and contrast antibiotic resistance and antibiotic utilisation in Poland in recent years versus other European countries, including agreed quality indicators, alongside current AMR patterns and ongoing policies and initiatives in Poland to influence and improve antibiotic prescribing...
2018: Antimicrobial Resistance and Infection Control
Valentijn A Schweitzer, Inger van Heijl, Cornelis H van Werkhoven, Jasmin Islam, Kelly D Hendriks-Spoor, Julia Bielicki, Marc J M Bonte, A Sarah Walker, Martin J Llewelyn
BACKGROUND: Antimicrobial stewardship aims to optimise antibiotic use and minimise selection of antimicrobial resistance. The methodological quality of published studies in this field is unknown. OBJECTIVES: Our objective was to perform a comprehensive systematic review of antimicrobial stewardship research design and identify features which limit validity and translation of research findings into clinical practice. DATA SOURCES: The following online database was searched: PubMed...
November 22, 2018: Clinical Microbiology and Infection
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