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Antibiotics and prescribing

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https://www.readbyqxmd.com/read/27913975/clinical-impact-of-an-antibiotic-stewardship-program-at-a-children-s-hospital
#1
Brian R Lee, Jennifer L Goldman, Diana Yu, Angela L Myers, Leslie M Stach, Erin Hedican, Mary Anne Jackson, Jason G Newland
INTRODUCTION: Antibiotic stewardship programs (ASP) improve appropriate antibiotic use. Data are limited on the clinical benefit of ASPs in children's hospitals. This study's objective was to determine the impact of an ASP on length of stay (LOS) and readmission rate among patients admitted to children's hospitals. METHODS: Data from a prospective-audit-with-feedback ASP were used to examine the ASP review characteristics, including antibiotic(s) prescribed, clinical indication, recommendations made by the ASP, and agreement with recommendations...
December 2, 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27909252/nurses-as-antibiotic-brokers-institutionalized-praxis-in-the-hospital
#2
Alex Broom, Jennifer Broom, Emma Kirby, Graham Scambler
We are likely moving rapidly toward a post-antibiotic era, as a result of escalating antimicrobial resistance, rapidly declining antibiotic production and profligate overuse. Hitherto research has almost exclusively focused on doctors' prescribing, with nurses' roles in antibiotic use remaining virtually invisible. Drawing on interviews with 30 nurses, we focus on nurses as brokers of doctors' antibiotic decisions, nursing capacity to challenge doctors' decisions, and, "back stage" strategies for circumnavigating organizational constraints...
November 30, 2016: Qualitative Health Research
https://www.readbyqxmd.com/read/27908336/appropriate-antibiotic-therapy
#3
REVIEW
Michael G Allison, Emily L Heil, Bryan D Hayes
Prescribing antibiotics is an essential component of initial therapy in sepsis. Early antibiotics are an important component of therapy, but speed of administration should not overshadow the patient-specific characteristics that determine the optimal breadth of antimicrobial therapy. Cultures should be drawn before antibiotic therapy if it does not significantly delay administration. Combination antibiotic therapy against gram-negative infections is not routinely required, and combination therapy involving vancomycin and piperacillin/tazobactam is associated with an increase in acute kidney injury...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27905262/should-the-patients-colonized-with-extended-spectrum-beta-lactamase-producing-gram-negative-bacilli-e-gnb-coming-to-hospital-from-the-community-with-pneumonia-get-anti-e-gnb-active-empirical-treatment
#4
Lara Peterlin, Mateja Žagar, Tatjana Lejko Zupanc, Marija Paladin, Bojana Beović
Extended-spectrum beta-lactamases are responsible for resistance of Gram-negative bacilli to several beta-lactam antibiotics, including those prescribed for treatment pneumonia. To evaluate the importance of colonization with E-GNB for the choice of empirical treatment we performed a retrospective case-control study including 156 patients, hospitalized for treatment of pneumonia from 2009 through 2013. Empirical treatment success and in-hospital survival were significantly lower in patients colonized with E-GNB compared to non-colonized (p = 0...
December 1, 2016: Journal of Chemotherapy
https://www.readbyqxmd.com/read/27904748/patterns-of-medication-use-and-factors-associated-with-antibiotic-use-among-adult-fever-patients-at-singapore-primary-care-clinics
#5
Zaw Myo Tun, Mahesh Moorthy, Martin Linster, Yvonne C F Su, Richard James Coker, Eng Eong Ooi, Jenny Guek-Hong Low, Gavin J D Smith, Clarence C Tam
BACKGROUND: Antimicrobial resistance is a public health problem of global importance. In Singapore, much focus has been given to antibiotic usage patterns in hospital settings. Data on antibiotic use in primary care is lacking. We describe antibiotic usage patterns and assess factors contributing to antibiotic usage among adults presenting with acute febrile illness (AFI) in primary care settings in Singapore. METHODS: We analyzed data from the Early Dengue infection and outcome study...
2016: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/27898626/dental-trauma-in-a-pediatric-emergency-department-referral-center
#6
Emily Hall, Patricia Hickey, Thuy Nguyen-Tran, Jeff Louie
OBJECTIVE: The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS: We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27895014/ceftazidime-avibactam-as-salvage-therapy-for-infections-caused-by-carbapenem-resistant-organisms-a-case-series-from-the-compassionate-use-program
#7
Elizabeth Temkin, Julian Torre-Cisneros, Bojana Beovic, Natividad Benito, Maddalena Giannella, Raúl Gilarranz, Cameron Jeremiah, Belén Loeches, Isabel Machuca, María José Jiménez-Martín, José Antonio Martínez, Marta Mora-Rillo, Enrique Navas, Michael Osthoff, Juan Carlos Pozo, Juan Carlos Ramos Ramos, Marina Rodriguez, Miguel Sánchez García, Pierluigi Viale, Michel Wolff, Yehuda Carmeli
Ceftazidime-avibactam (CAZ-AVI) is a recently approved β-lactam β-lactamase inhibitor combination with the potential to treat serious infections caused by carbapenem-resistant organisms. Few patients with such infections were included in the CAZ-AVI clinical trials, and clinical experience is lacking. We present a case series of patients with infections caused by carbapenem-resistant Enterobacteriaceae (CRE) or Pseudomonas aeruginosa (CRPa) who were treated with CAZ-AVI salvage therapy on a compassionate-use basis...
November 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27891373/retrospective-comparison-of-clinical-characteristics-and-in-hospital-outcomes-among-diabetic-and-non-diabetic-adults-with-acute-pyelonephritis
#8
Shailesh C Trivedi, Sanjeev R Phatak, Renu S Trivedi
INTRODUCTION: Acute Pyelonephritis (APN) is a common infection in community. Diabetes Mellitus (DM) may have different effect on clinical characteristics and outcomes of APN compared to non-diabetic individuals. AIM: To compare clinical characteristics and assess outcomes of APN patients with and without DM. MATERIALS AND METHODS: A retrospective analysis of 122 patients with DM (n=61) and without DM (n=61) was conducted at a single, private, urban set-up from Gujarat, India...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890038/an-evaluation-of-antibiotic-prescribing-practices-upon-hospital-discharge
#9
Sarah J Scarpato, Daniel R Timko, Valerie C Cluzet, Jillian P Dougherty, Jonathan J Nunez, Neil O Fishman, Keith W Hamilton
We conducted a retrospective study of the appropriateness of antimicrobial agents prescribed on discharge from an acute care hospital. Seventy percent of discharge antibiotics were inappropriate in antibiotic drug choice, dose, or duration. Our findings suggest there is a significant need for antimicrobial stewardship at transitions in care. Infect Control Hosp Epidemiol 2016;1-3.
November 28, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27889248/comprehensive-study-to-investigate-the-role-of-various-aminoglycoside-resistance-mechanisms-in-clinical-isolates-of-acinetobacter-baumannii
#10
Vajihe Sheikhalizadeh, Alka Hasani, Mohammad Ahangarzadeh Rezaee, Mohammad Rahmati-Yamchi, Akbar Hasani, Reza Ghotaslou, Hamid Reza Goli
Therapeutic resistance towards most of the current treatment regime by Acinetobacter baumannii has reduced the prescribing antibiotic pattern and option is being re-shifted towards more toxic agents including aminoglycosides. The present investigation aimed at to study various mechanisms towards aminoglycoside non-susceptibility in clinical isolates of A. baumannii. The bacteria were subjected to genetic basis assessment for the presence of aminoglycoside modifying enzymes (AME), 16S rRNA methylase encoding genes and relative expression of AdeABC and AbeM efflux pumps in relation to their susceptibility to five aminoglycosides...
November 23, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27887585/reduction-in-antibiotic-prescribing-for-respiratory-tract-infections-in-swedish-primary-care-a-retrospective-study-of-electronic-patient-records
#11
Mia Tyrstrup, Anders Beckman, Sigvard Mölstad, Sven Engström, Christina Lannering, Eva Melander, Katarina Hedin
BACKGROUND: Swedish studies on antibiotic use in primary care have been based on one-week registrations of infections. In order to study adherence to guidelines, analyses based on large databases that provide information on diagnosis linked prescriptions, are needed. This study describes trends in management of infections in Swedish primary care particularly with regards to antibiotic prescribing and adherence to national guidelines. METHODS: A descriptive study of Sweden's largest database regarding diagnosis linked antibiotic prescription data, the Primary care Record of Infections in Sweden (PRIS), for the years 2008, 2010 and 2013...
November 25, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27886368/written-information-for-patients-or-parents-of-child-patients-to-reduce-the-use-of-antibiotics-for-acute-upper-respiratory-tract-infections-in-primary-care
#12
REVIEW
Jack W O'Sullivan, Robert T Harvey, Paul P Glasziou, Amanda McCullough
BACKGROUND: Acute upper respiratory tract infections (URTIs) are frequently managed in primary care settings. Although many are viral, and there is an increasing problem with antibiotic resistance, antibiotics continue to be prescribed for URTIs. Written patient information may be a simple way to reduce antibiotic use for acute URTIs. OBJECTIVES: To assess if written information for patients (or parents of child patients) reduces the use of antibiotics for acute URTIs in primary care...
November 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27883161/-is-it-necessary-to-prescribe-antibiotics-in-impacted-third-molar-surgical-removal-comparative-study-between-prescribing-patterns
#13
I Izuzquiza, K A Jamtøy, N P Fossland, I Martínez-Padilla, F Falahat, L Alou, J Prieto, M L Gómez-Lus
OBJECTIVE: To assess whether there is a significant difference in infection rate after surgery tooth extraction in two different hospitals from Norway and Spain where different surgical antimicrobial prophylaxis protocols are applied. METHODS: An analytical observational study was conducted, retrospective cohorts type, analyzing healthy patients with no risk factors, who were third molar tooth operated in maxillofacial services of two different hospitals: St. Olav in Trondheim (Norway) and Clínico San Carlos in Madrid (Spain)...
November 22, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27880718/contribution-of-jac-to-antimicrobial-stewardship
#14
REVIEW
Alan P Johnson
Antimicrobial stewardship programmes are increasingly being used to improve the quality of antimicrobial prescribing, with the dual aim of optimizing clinical outcomes and minimizing the emergence and spread of antimicrobial resistance. The Journal of Antimicrobial Chemotherapy (JAC) is celebrating its 40th anniversary and, as part of activities to commemorate this event, this article highlights the contribution of JAC to antimicrobial stewardship. Papers published in JAC have contributed to the evidence base for stewardship, have highlighted educational and behavioural change initiatives aimed at improving antibiotic prescribing practice, and have actively sought to foster the practice of antimicrobial stewardship amongst its readers...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27879178/-minocycline-induced-hyperpigmentation-not-uncommon-but-nonetheless-important-to-recognise
#15
P J G M Voets, D Blommaert, R R M C Keijsers, H A C Alkemade
BACKGROUND: Minocycline, a broad-spectrum antibiotic from the group of tetracyclins, is frequently prescribed for acne vulgaris and rosacea. Hyperpigmentation is a relatively common side effect of this drug and can lead to multiple unsightly skin lesions, which are not always reversible. It can take a long period, from a few months to several years, before the lesions have completely vanished. CASE DESCRIPTION: A 24-year-old male was seen in our outpatient clinic because of slowly progressive pigmented lesions on his shins...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879042/high-antibiotic-resistance-of-helicobacter-pylori-and-its-effect-on-tailored-and-empiric-eradication-of-the-organism-in-lower-silesia-poland
#16
Stanisław Ferenc, Jan Gnus, Magdalena Kościelna, Małgorzata Kinda, Andriy Yarka, Luke Stewart, Wojciech Witkiewicz
BACKGROUND: At present, the resistance to antibiotics is considered the most important reason for Helicobacter pylori (HP) eradication failure. The aim of this study was to estimate the prevalence of antimicrobial resistance of HP strains and to evaluate tailored and empiric therapeutic regimens in patients with peptic ulcer disease associated with infection of this microorganism. MATERIALS AND METHODS: Between May 2011 and February 2013, 185 consecutive Polish patients with at least one positive Helicobacter pylori test (urease test, histopathologic examination, and/or culture) underwent eradication therapy...
November 23, 2016: Helicobacter
https://www.readbyqxmd.com/read/27876477/current-prescribing-practices-for-skin-and-soft-tissue-infections-in-nursing-homes
#17
Diana Feldstein, Philip D Sloane, David Weber, Kimberly Ward, David Reed, Sheryl Zimmerman
OBJECTIVES: Antibiotic stewardship has been called for across all sites of health care, including nursing homes (NHs). Skin and soft tissue infections (SSTIs) are the third most common indication for antibiotics in the NH, and so should be a focus of stewardship. This study audited medical records to identify signs and symptoms of SSTIs treated with antibiotics in relation to the McGeer criteria for surveillance, the Loeb minimum criteria for antibiotic initiation, and prescribing recommendations of the Infectious Disease Society of America...
November 18, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27874151/a-stepwise-introduction-of-a-successful-antimicrobial-stewardship-program-experience-from-a-tertiary-care-university-hospital-in-western-saudi-arabia
#18
Maha M Alawi, Bayan M Darwesh
OBJECTIVES: To analyze and evaluate the safety and cost-effectiveness of a gradually-implemented antimicrobial stewardship programs (ASP) in a tertiary care center. METHODS: Prospective data were collected from an ASP that was gradually introduced between April 2012 and December 2013 in 6 hospital departments, over successive periods of 3 months each. A multidisciplinary team supervised antibiotic use and regulated pharmacy dispensations of a list of restricted antimicrobials (RAs)...
December 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27874095/longitudinal-metagenomic-profiling-of-bovine-milk-to-assess-the-impact-of-intramammary-treatment-using-a-third-generation-cephalosporin
#19
Erika K Ganda, Rafael S Bisinotto, Svetlana F Lima, Kristina Kronauer, Dean H Decter, Georgios Oikonomou, Ynte H Schukken, Rodrigo C Bicalho
Antimicrobial usage in food animals has a direct impact on human health, and approximately 80% of the antibiotics prescribed in the dairy industry are used to treat bovine mastitis. Here we provide a longitudinal description of the changes in the microbiome of milk that are associated with mastitis and antimicrobial therapy. Next-generation sequencing, 16 S rRNA gene quantitative real-time PCR, and aerobic culturing were applied to assess the effect of disease and antibiotic therapy on the milk microbiome...
November 22, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27869374/state-of-the-art-systemic-rosacea-management
#20
M Schaller, H Schöfer, B Homey, U Gieler, P Lehmann, T A Luger, T Ruzicka, M Steinhoff
Based on numerous trials, oral tetracyclines and most commonly their second-generation derivative doxycycline have become the main pillar in systemic rosacea treatment. However, the only preparation that has been approved so far in this setting is 40 mg doxycycline in an anti-inflammatory dosage and with a modified release formulation. With the introduction of this once-daily, non-antibiotic dosing of doxycycline, oral therapy is more commonly prescribed as first-line treatment in moderate to severe papulopustular rosacea...
December 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
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