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Antibiotic/ antimicrobial stewardship

Emma J Woodmansey, Christopher D Roberts
Antimicrobial resistance is an ever-increasing global concern, with the era of untreatable infection becoming a reality. Wound care is no exception, with increasing issues of antibiotic-resistant infections across different wound types and care settings. Antibiotic resistance and stewardship have been the priority for most strategic interventions so far; however, in wound care, alternative or supplementary strategies using antiseptics should be considered. Antiseptics such as silver can provide effective cidal activity across a broad range of wound pathogens, assuming they are used at the correct level for an appropriate duration...
August 17, 2018: International Wound Journal
Vivian Alividza, Victor Mariano, Raheelah Ahmad, Esmita Charani, Timothy M Rawson, Alison H Holmes, Enrique Castro-Sánchez
BACKGROUND: Poverty increases the risk of contracting infectious diseases and therefore exposure to antibiotics. Yet there is lacking evidence on the relationship between income and non-income dimensions of poverty and antimicrobial resistance. Investigating such relationship would strengthen antimicrobial stewardship interventions. METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
August 17, 2018: Infectious Diseases of Poverty
Vaishali Gupte, Jaideep Gogtay, Raj Kumar Mani
Background: Antibiotic resistance is a serious problem being faced by physicians worldwide. This article was designed to study physician perceptions of antibiotic resistance and their prescribing patterns. Materials and Methods: A structured questionnaire was developed for reporting the prevalence of antibiotic resistance as perceived by physicians and recording their antibiotic preferences in specific contexts. A total of 539 intensivists across India participated in the study...
July 2018: Indian Journal of Critical Care Medicine
Ganga Maya Rizal, Jambay Gyeltshen, Kuenga Namgay
Alarming rate of emergence of antimicrobial resistance globally has urged Bhutan to take firm steps toward antibiotics stewardship through rational use in human, animal and agriculture. This paper specifically aims to investigate the status of use of three important antibiotics in animal feeds in Bhutan. A total of thirteen feed samples were selected randomly from the pool of feed samples. The samples were submitted by bidders for Annual Animal Feed Tender (fiscal year 2015-16) of the Department of Livestock, Bhutan...
August 10, 2018: Journal of Global Antimicrobial Resistance
David Y Graham, Maria Pina Dore, Hong Lu
Recent Helicobacter pylori treatment guidelines recommend the 4-drug combinations bismuth quadruple therapy and concomitant therapy. Areas covered: We review antimicrobial therapy for H. pylori in the context of antimicrobial therapy in general and specifically in relation to good antimicrobial stewardship (defined as optimal selection, dose, and duration of an antimicrobial that results in the best clinical outcome for the treatment of infection, with minimal toxicity to the patient and minimal impact on subsequent resistance)...
August 13, 2018: Expert Review of Anti-infective Therapy
Eva M Krockow, Andrew M Colman, Edmund Chattoe-Brown, David R Jenkins, Nelun Perera, Shaheen Mehtar, Carolyn Tarrant
BACKGROUND: Antimicrobial resistance is a global health threat, partly driven by inappropriate antibiotic prescriptions for acute medical patients in hospitals. AIM: To provide a systematic review of qualitative research on antibiotic prescribing decisions in hospitals worldwide including broad-spectrum antibiotic use. METHODS: A systematic search of qualitative research on antibiotic prescribing for adult hospital patients published between 2007 and 2017 was conducted...
August 9, 2018: Journal of Hospital Infection
Benjamin D Kulwicki, Kasey L Brandt, Lauren M Wolf, Andrew J Weise, Lisa E Dumkow
PURPOSE: It is critical to engage ED providers in antimicrobial stewardship programs (ASP). Emergency medicine pharmacists (EMPs) play an important role in ASP by working with providers to choose empiric antimicrobials. This study aimed to determine the impact of an EMP on appropriate empiric antibiotic prescribing for community-acquired pneumonia (CAP) and intra-abdominal infections (CA-IAI). METHODS: A retrospective cohort study was conducted evaluating adult patients admitted with CAP or CA-IAI...
July 29, 2018: American Journal of Emergency Medicine
Giuseppe Magistro, Christian G Stief
Urinary tract infections (UTIs) are among the most common bacterial infections. Its management has become increasingly challenging due to antimicrobial resistance. The four mainstays to tackle this crisis rely on the development of new antibiotic agents, the introduction of preventive and alternative antimicrobial strategies, the concept of antimicrobial stewardship, and effective hygiene measures. One of the most effective approaches to prevent UTIs is the design of a potent vaccine. OM-89 is a lyophilised preparation of membrane proteins from 18 different uropathogenic Escherichia coli strains...
August 6, 2018: European Urology Focus
Nicholas K Goldner, Christopher Bulow, Kevin Cho, Meghan Wallace, Fong-Fu Hsu, Gary J Patti, C A Burnham, Paul Schlesinger, Gautam Dantas
Daptomycin, a last-line-of-defense antibiotic for treating Gram-positive infections, is experiencing clinical failure against important infectious agents, including Corynebacterium striatum The recent transition of daptomycin to generic status is projected to dramatically increase availability, use, and clinical failure. Here we confirm the genetic mechanism of high-level daptomycin resistance (HLDR; MIC = >256 µg/ml) in C. striatum , which evolved within a patient during daptomycin therapy, a phenotype recapitulated in vitro In all 8 independent cases tested, loss-of-function mutations in phosphatidylglycerol synthase ( pgsA2 ) were necessary and sufficient for high-level daptomycin resistance...
August 8, 2018: MSphere
Sean N Avedissian, Marc H Scheetz, Teresa R Zembower, Christina Silkaitis, Robert Maxwell, Charles Jenkins, Michael J Postelnick, Sarah H Sutton, Nathaniel J Rhodes
Objectives: To quantify the impact of varying the at-risk days definition on the overall report of at-risk days and on the calculated standardized consumption rates (SCRs) for piperacillin/tazobactam, amikacin, daptomycin and vancomycin. Methods: Data were evaluated for two system hospitals, an 894 bed academic centre and a 114 bed community hospital. Aggregate inpatient antibiotic administration and occupancy data were extracted from electronic databases at the facility-wide level...
August 6, 2018: Journal of Antimicrobial Chemotherapy
P Antonioli, A Formaglio, D Gamberoni, L Bertoni, P Perrone, A Stefanati, M Libanore, R Cultrera, G Gabutti
Introduction: The appropriate use of antibiotics is a global priority in order to avoid antibiotic resistance. Up to 50% of antibiotics usage in hospital is inappropriate (e.g. prolonged surgical prophylaxis, "defensive medicine" approach). In 2015, at the Ferrara University Hospital, an antimicrobial stewardship intervention to reduce antimicrobial prescription at the time of hospital discharge in patients at risk of surgical site infection was implemented. This programme included: update meetings for health professionals, focused meetings for critical wards, reviews of some surgical prophylaxis protocols, recommendations to reduce broad-spectrum antimicrobials use, and planning of an audit...
June 2018: Journal of Preventive Medicine and Hygiene
L Hayley Burgess, Karla Miller, Mandelin Cooper, Julia Moody, Jane Englebright, Edward Septimus
BACKGROUND: Antimicrobial stewardship is recommended as a crucial mechanism to reduce the emergence of antimicrobial resistance. The purpose of this article was to describe implementation of antimicrobial management programs (AMPs) across a large health system of community hospitals. METHODS: The initiative was structured in 4 phases. Although each phase was implemented sequentially, facilities could progress at their own pace. Phase goals needed to be met before moving to the next phase...
August 3, 2018: American Journal of Infection Control
Tommaso Cai
Empirical antibiotic treatment of urinary tract infections: from everyday clinical practice to EAU guidelines 2017 Recent epidemiological data confirm the increasing problem of antimicrobial resistance not only for hospitalized, healthcare-associated patients but also for outpatients. In particular, the progressive increase in resistance to broad-spectrum antibiotics, such as third-generation cephalosporins, fluoroquinolones, or carbapenems in Enterobacteriaceae, is an alarming situation for all urologists and general practitioners...
July 2018: Urologia
Michele Rizzo, Carlo Trombetta
Antibiotic prophylaxis in urological procedures Thousands of patients receive every day an antibiotic prophylaxis before diagnostic or therapeutic urological procedures. Aim of antibiotic prophylaxis is to reduce the risk of infective complications, unfortunately good quality evidences for the best choice of prophylaxis strategy are often lacking. Nowadays antimicrobial resistance is a major health problem caused primarily by overuse of antibiotics. It is the responsibility of all physicians to practice antibiotic stewardship avoiding the unnecessary use of this precious drugs...
July 2018: Urologia
Charles Feldman, Guy Richards
Lower respiratory tract infections are the leading cause of infectious disease deaths worldwide and are the fifth leading cause of death overall. This is despite conditions such as pneumococcal infections and influenza being largely preventable with the use of appropriate vaccines. The mainstay of treatment for the most important bacterial lower respiratory tract infections, namely acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and community-acquired pneumonia (CAP), is the use of antibiotics...
2018: F1000Research
Marco Falcone, Mical Paul, Dafna Yahav, Gabriella Orlando, Giusy Tiseo, Virginie Prendki, Robert Güerri-Fernández, Gaetan Gavazzi, Nico T Mutters, Barry Cookson, Marco Tinelli
BACKGROUND: Antimicrobials are amongst the most frequently prescribed drugs in long-term care facilities (LTCFs). Implementation of antimicrobial stewardship programs (ASPs) is often challenging, due to scarce data in this setting. OBJECTIVES: This narrative review aimed to provide data about antibiotic consumption in LTCFs and need, implementation and organization of antimicrobial stewardship programs (ASPs) in this setting. SOURCE: PubMed was searched for studies assessing antimicrobial consumption and implementation of ASPs in LTCFs...
August 1, 2018: Clinical Microbiology and Infection
Jenifer Barrie, Saurabh Jamdar, Neil Smith, Simon J McPherson, Ajith K Siriwardena, Derek A O'Reilly
BACKGROUND: International guidelines for the management of acute pancreatitis state that antibiotics should only be used to treat infectious complications. Antibiotic prophylaxis is not recommended. The aim of this study was to analyse antibiotic use, and its appropriateness, from a national review of acute pancreatitis. METHODS: Data were collected from The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) study into the management of acute pancreatitis...
May 24, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Tahmineh Khazaei, Jacob T Barlow, Nathan G Schoepp, Rustem F Ismagilov
Antimicrobial-resistant Neisseria gonorrhoeae is an urgent public-health threat, with continued worldwide incidents of infection and rising resistance to antimicrobials. Traditional culture-based methods for antibiotic susceptibility testing are unacceptably slow (1-2 days), resulting in the use of broad-spectrum antibiotics and the further development and spread of resistance. Critically needed is a rapid antibiotic susceptibility test (AST) that can guide treatment at the point-of-care. Rapid phenotypic approaches using quantification of DNA have been demonstrated for fast-growing organisms (e...
August 2, 2018: Scientific Reports
U Abubakar, S A Syed Sulaiman, A G Adesiyun
Background Audit of antibiotic prophylaxis is an important strategy used to identify areas where stewardship interventions are required. Objectives To evaluate compliance with surgical antibiotic prophylaxis in obstetrics and gynaecology surgeries and determine the Defined Daily Dose (DDD) of antibiotic. Settings Three public tertiary hospitals located in Northern Nigeria. Methods This prospective study included women who had obstetrics and gynaecology surgeries with no infection at the time of incision. Appropriateness of antibiotic prophylaxis was determined by a clinical pharmacist...
July 27, 2018: International Journal of Clinical Pharmacy
Giulia la Martire, Christine Robin, Nadia Oubaya, Raphaël Lepeule, Florence Beckerich, Mathieu Leclerc, Walid Barhoumi, Andréa Toma, Cécile Pautas, Sébastien Maury, Wiem Akrout, Catherine Cordonnier-Jourdin, Vincent Fihman, Mario Venditti, Catherine Cordonnier
Febrile neutropenia (FN) is the main reason for antibiotic prescription in hematology wards where, on the other hand, antibiotic stewardship (AS) is poorly explored. The objectives of the present study were to evaluate (1) the impact of an AS intervention on antibiotic consumption and (2) the applicability and acceptance rate of the intervention and its clinical impact. A persuasive AS intervention based on European Conference on Infection in Leukaemia (ECIL) guidelines for FN was implemented in a high-risk hematology ward in a tertiary referral public university hospital...
July 26, 2018: European Journal of Clinical Microbiology & Infectious Diseases
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