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Stewardship antibiotic

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https://www.readbyqxmd.com/read/30517765/antimicrobial-stewardship-programs-in-long-term-care-settings-a-meta-analysis-and-systematic-review
#1
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
https://www.readbyqxmd.com/read/30517592/impact-of-a-prescriber-driven-antibiotic-time-out-on-antibiotic-use-in-hospitalized-patients
#2
Kerri A Thom, Pranita D Tamma, Anthony D Harris, Kathryn Dzintars, Daniel J Morgan, Shanshan Li, Lisa Pineles, Arjun Srinivasan, Edina Avdic, Sara E Cosgrove
A multicenter quasi-experimental study of a provider-driven antibiotic "time-out" in 3470 antibiotic courses showed no difference in antibiotic use before and after implementation, but did show a decrease in inappropriate therapy (45% vs 31%, P < .05). Single time-outs without input from antibiotic stewardship teams are insufficient to optimize prescribing.
December 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/30516118/one-day-point-prevalence-as-a-method-for-estimating-antibiotic-use-in-nursing-homes
#3
Grant R Barney, Christina B Felsen, Ghinwa K Dumyati
Antibiotic use tracking in nursing homes is necessary for stewardship and regulatory requirements but may be burdensome. We used pharmacy data to evaluate whether once-weekly sampling of antibiotic use can estimate total use; we found no significant differences in estimated and measured antibiotic use.
December 5, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/30508403/transurethral-resection-of-the-prostate-are-we-following-the-guidelines-outcomes-from-the-global-prevalence-of-infections-in-urology-gpiu-study
#4
Bela Köves, Peter Tenke, Zafer Tandogdu, Tommaso Cai, Florian Bogenhard, Björn Wullt, Kurt Naber, Riccardo Bartoletti, Mete Cek, Ekaterina Kulchavenya, Tamara Perepanova, Adrian Pilatz, Gernot Bonkat, Truls Erik Bjerklund Johansen, Florian Wagenlehner
Transurethral resection of the prostate (TURP) is one of the most common urological procedures. With the increasing rate of multiresistant infections including urosepsis, it is essential for all surgeons to adhere to the relevant international guidelines to prevent infectious complications. The aim of this prospective, multinational, multicentre study was to evaluate compliance with recommended infection control measures regarding TURP procedures. The study was performed as a side questionnaire to the annual Global Prevalence Study of Infections in Urology (GPIU) between 2006 and 2009...
December 3, 2018: Journal of Chemotherapy
https://www.readbyqxmd.com/read/30508107/antibiotic-resistance-of-enterobacteriaceae-causing-urinary-tract-infections-in-elderly-patients-living-in-the-community-and-in-the-nursing-home-a-retrospective-observational-study
#5
Céline Pulcini, Isabelle Clerc-Urmes, Cossi Angelo Attinsounon, Sébastien Fougnot, Nathalie Thilly
Objectives: Although nursing homes are thought to be significant reservoirs of antibiotic-resistant bacteria, very few large population-based studies comparing antibiotic resistance prevalence in nursing homes and in the community have adjusted for patient characteristics. Our objective was to compare the prevalence of antibiotic resistance of Enterobacteriaceae cultured from urine samples of nursing home residents with that of community-dwelling adults, all aged 65 years or older. Methods: This study analysed around 20 000 positive urine samples sent to a large laboratory in north-eastern France from 2014 to 2017, collected from individuals aged 65 years or older...
November 30, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/30506900/prevention-of-clostridium-difficile-infection-in-critically-ill-adults
#6
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
https://www.readbyqxmd.com/read/30502486/impact-of-bedside-diagnosis-of-influenza-in-the-paediatric-emergency-ward
#7
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
https://www.readbyqxmd.com/read/30497807/antibiotic-associated-adverse-drug-events-at-a-japanese-academic-hospital
#8
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
https://www.readbyqxmd.com/read/30496227/development-of-actionable-quality-indicators-and-an-action-implementation-toolbox-for-appropriate-antibiotic-use-at-intensive-care-units-a-modified-rand-delphi-study
#9
Marlot C Kallen, Marie-Jose Roos-Blom, Dave A Dongelmans, Jeroen A Schouten, Wouter T Gude, Evert de Jonge, Jan M Prins, Nicolette F de Keizer
INTRODUCTION: Extensive antibiotic use makes the intensive care unit (ICU) an important focus for antibiotic stewardship programs. The aim of this study was to develop a set of actionable quality indicators for appropriate antibiotic use at ICUs and an implementation toolbox, which can be used to assess and improve the appropriateness of antibiotic use in the treatment of adult patients at an ICU. METHODS: A four round modified-RAND Delphi procedure was used. Potential indicators were identified by a multidisciplinary panel of 15 Dutch experts, from international literature and guidelines...
2018: PloS One
https://www.readbyqxmd.com/read/30487154/tetrasodium-edta-is-effective-at-eradicating-biofilms-formed-by-clinically-relevant-microorganisms-from-patients-central-venous-catheters
#10
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
https://www.readbyqxmd.com/read/30482662/impact-of-hospitalist-led-interdisciplinary-antimicrobial-stewardship-interventions-at-an-academic-medical-center
#11
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
https://www.readbyqxmd.com/read/30481920/-further-understanding-of-infection-of-carbapenems-resistant-klebsiella-pneumoniae-among-burn-patients-and-the-related-strategies-for-antimicrobial-treatment
#12
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
https://www.readbyqxmd.com/read/30481058/antimicrobial-resistance-in-fecal-escherichia-coli-and-salmonella-enterica-from-dairy-calves-a-systematic-review
#13
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
https://www.readbyqxmd.com/read/30478815/how-to-measure-quantitative-antibiotic-use-in-order-to-support-antimicrobial-stewardship-in-acute-care-hospitals-a-retrospective-observational-study
#14
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
https://www.readbyqxmd.com/read/30478167/patients-at-risk-for-aortic-rupture-often-exposed-to-fluoroquinolones-during-hospitalization
#15
William C Frankel, Barbara W Trautner, Andrew Spiegelman, Larissa Grigoryan, Scott A LeMaire
Several studies have indicated that fluoroquinolone use may be associated with an increased risk of aortic aneurysm or dissection (AAD). Because patients with AAD or Marfan syndrome are at increased risk for aortic rupture, we performed a retrospective cohort study to determine the prevalence of systemic fluoroquinolone exposure and predictors of fluoroquinolone use in these patients. Data were obtained from the Advisory Board billing and administrative database, which contained information on 22 million adult hospitalizations in the United States for the study period (2009-2015)...
November 26, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/30475200/characterization-of-a-colistin-resistant-avian-pathogenic-escherichia-coli-st69-isolate-recovered-from-a-broiler-chicken-in-germany
#16
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
https://www.readbyqxmd.com/read/30473786/antibiotic-consumption-and-antimicrobial-resistance-in-poland-findings-and-implications
#17
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
https://www.readbyqxmd.com/read/30472426/the-quality-of-studies-evaluating-antimicrobial-stewardship-interventions-a-systematic-review
#18
REVIEW
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
https://www.readbyqxmd.com/read/30471970/knowledge-attitudes-and-practices-of-bedside-nursing-staff-regarding-antibiotic-stewardship-a-cross-sectional-study
#19
Salma Abbas, Kimberly Lee, Amy Pakyz, Daniel Markley, Kaila Cooper, Ginger Vanhoozer, Michelle Doll, Gonzalo Bearman, Michael P Stevens
BACKGROUND: Nursing engagement in antibiotic stewardship programs (ASPs) remains suboptimal. The purpose of this study was to determine the knowledge, attitudes, and practices of nursing staff members regarding ASPs and identify barriers to their participation in such programs. METHODS: This cross-sectional study was conducted at Virginia Commonwealth University Health System, an 860-bed tertiary care academic center located in Richmond, Virginia, where a well-resourced ASP has been in place for 2 decades...
November 21, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/30465860/inpatient-beta-lactam-test-dose-protocol-promotes-antimicrobial-stewardship-in-patients-with-history-of-penicillin-allergy
#20
Keith A Sacco, Benjamin P Cochran, Kevin Epps, Mark Parkulo, Alexei Gonzalez-Estrada
BACKGROUND: Penicillin allergy is the most commonly reported drug allergy in hospitalized patients, resulting in increased second-line antibiotic use, nosocomial infections, and healthcare utilization. Given that the vast majority of patients are not truly allergic, a safe strategy that empowers the admitting physician is needed. OBJECTIVE: To assess the impact on antibiotic prescribing practices for hospitalized patients with penicillin allergy using a validated intervention...
November 19, 2018: Annals of Allergy, Asthma & Immunology
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