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Antimicrobial stewardship

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https://www.readbyqxmd.com/read/29332209/the-rapid-diagnosis-of-viral-respiratory-tract-infections-and-its-impact-on-antimicrobial-stewardship-programs
#1
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/29325870/the-impact-of-an-infectious-disease-specialist-on-antifungal-use-an-interrupted-time-series-analysis-in-a-tertiary-hospital-in-tokyo
#2
Daiichi Morii, Naoki Ichinose, Takayuki Yokozawa, Toshimi Oda
OBJECTIVES: To assess the efficacy and the limitations of antifungal antimicrobial stewardship programs. METHODS: A bundle to manage infectious diseases was implemented in our hospital in October 2010. Data regarding antimicrobial use density (AUD) from April 2006 to May 2016 were collected. Trends in AUD were assessed using an interrupted time-series model for three separate periods: the pre-bundle, the bundle implementation, and the long-term follow-up periods...
January 8, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#3
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29318696/an-underutilised-resource-for-antimicrobial-stewardship-a-snapshot-of-the-community-pharmacists-role-in-delayed-or-wait-and-see-antibiotic-prescribing
#4
Minyon L Avent, Jasmina Fejzic, Mieke L van Driel
OBJECTIVES: Various strategies have been implemented in primary care to address the inappropriate use of antibiotics, with varying degrees of success. One such intervention is delayed or 'wait and see' prescribing, where the prescriber indicates to wait a few days before dispensing the antibiotic. The aim of this study was to explore community pharmacists' perceptions and practice experiences with delayed antibiotic prescribing. METHODS: An online survey was advertised in two professional pharmacy organisations' e-newsletters for community and internship pharmacists in Queensland, Australia, from January to April 2016...
January 10, 2018: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29315295/the-role-of-vaccines-in-preventing-bacterial-antimicrobial-resistance
#5
REVIEW
Kathrin U Jansen, Charles Knirsch, Annaliesa S Anderson
Antimicrobial resistance (AMR) and the associated morbidity and mortality due to bacterial pathogens have been increasing globally to alarming levels. The World Health Organization (WHO) has called for global action on AMR, supported worldwide by governments, health ministries and health agencies. Many potential solutions to stem AMR are being discussed and implemented. These include increases in antimicrobial stewardship, investment in research and development to design new classes of antibiotics, and reduction of antibiotic use in rearing of livestock...
January 9, 2018: Nature Medicine
https://www.readbyqxmd.com/read/29309899/management-of-bloodstream-infections-by-infection-specialists-an-international-escmid-cross-sectional-survey
#6
Kévin Diallo, Nathalie Thilly, Amandine Luc, Guillaume Beraud, Önder Ergonul, Maddalena Giannella, Diamantis Kofteridis, Tomislav Kostyanev, José Ramón Paňo-Pardo, Pilar Retamar, Winfried Kern, Céline Pulcini
BACKGROUND: Bloodstream infections (BSI) are frequent, but international guidelines are available only for MRSA and candidaemia. OBJECTIVES: Our objective was to explore the management of BSI by infection specialists. METHODS: This international ESCMID cross-sectional survey was opened from December 2016 to February 2017. All infection specialists, senior or trainees, giving at least weekly advice on positive blood cultures could participate...
January 5, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29309813/optimization-of-the-blood-culture-pathway-a-template-for-improved-sepsis-management-and-diagnostic-antimicrobial-stewardship
#7
Weinbren Mj, Collins M, Heathcote R, Umar M, Nisar M, Ainger C, Masters P
Laboratory processing of blood cultures has remained static over the past 30 years despite increasing antibiotic resistance and advances in analyser design. By siting our blood culture analyser in the Blood Sciences laboratory and optimizing the pre-analytical and analytic phases of blood culture management we reduced the time taken to detect most blood culture isolates to <12 hours. 50% of positive blood cultures containing Escherichia coli were definitively reported with antibiotic susceptibilities in <24 hours...
January 5, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29309607/antimicrobial-usage-in-german-acute-care-hospitals-results-of-the-third-national-point-prevalence-survey-and-comparison-with-previous-national-point-prevalence-surveys
#8
Seven Johannes Sam Aghdassi, Petra Gastmeier, Brar Christian Piening, Michael Behnke, Luis Alberto Peña Diaz, Alexander Gropmann, Marie-Luise Rosenbusch, Tobias Siegfried Kramer, Sonja Hansen
Objectives: Previous point prevalence surveys (PPSs) revealed the potential for improving antimicrobial usage (AU) in German acute care hospitals. Data from the 2016 German national PPS on healthcare-associated infections and AU were used to evaluate efforts in antimicrobial stewardship (AMS). Methods: A national PPS in Germany was organized by the German National Reference Centre for Surveillance of Nosocomial Infections in 2016 as part of the European PPS initiated by the ECDC...
January 4, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29309580/antimicrobial-resistance-and-the-environment-assessment-of-advances-gaps-and-recommendations-for-agriculture-aquaculture-and-pharmaceutical-manufacturing
#9
Edward Topp, Joakim Larsson, Daniel Miller, Christel Van den Eede, Marko Virta
A roundtable discussion held at the 4th international symposium on the Environmental Dimension of Antibiotic Resistance (EDAR4) considered key issues concerning the impact on the environment of antibiotic use in agriculture and aquaculture, and emissions from antibiotic manufacturing. The critical control points for reducing emissions of antibiotics from agriculture are antibiotic stewardship, and the pre-treatment of manure and sludge to abate antibiotic resistant bacteria. Antibiotics are sometimes added to fish and shellfish production sites via the feed, representing a direct route of contamination of the aquatic environment...
December 22, 2017: FEMS Microbiology Ecology
https://www.readbyqxmd.com/read/29305281/impact-of-real-time-notification-of-clostridium-difficile-test-results-and-early-initiation-of-effective-antimicrobial-therapy
#10
Christian B Polen, William R Judd, Patrick D Ratliff, Gregory S King
BACKGROUND: Clostridium difficile is a prominent nosocomial pathogen and is the most common causative organism of health care-associated diarrhea. To our knowledge, no studies have investigated the impact of real-time notification of culture results with rapid antimicrobial stewardship program (ASP) intervention in the setting of C difficile infection (CDI). The purpose of this study was to assess the impact of real-time notification of detection of toxigenic C difficile by DNA amplification results in patients with confirmed CDI...
January 3, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29305250/diagnosis-and-treatment-of-urinary-tract-infections-across-age-groups
#11
REVIEW
Christine M Chu, Jerry L Lowder
Urinary tract infections (UTI) are the most common outpatient infections, but predicting the probability of UTI through symptoms and test results can be complex. The most diagnostic symptoms of UTI include change in frequency, dysuria, urgency, and presence or absence of vaginal discharge, but UTIs may present differently in older women. Dipstick urinalysis is popular for its availability and usefulness, but results must be interpreted in context of the patient's pretest probability based on symptoms and characteristics...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29300965/an-evaluation-of-the-target-treat-antibiotics-responsibly-guidance-education-tools-antibiotics-toolkit-to-improve-antimicrobial-stewardship-in-primary-care-is-it-fit-for-purpose
#12
Leah Ffion Jones, Meredith K D Hawking, Rebecca Owens, Donna Lecky, Nick A Francis, Chris Butler, Micaela Gal, Cliodna A M McNulty
Background: The TARGET (Treat Antibiotics Responsibly; Guidance, Education, Tools) Antibiotics Toolkit aims to improve antimicrobial prescribing in primary care through guidance, interactive workshops with action planning, patient facing educational and audit materials. Objective: To explore GPs', nurses' and other stakeholders' views of TARGET. Design: Mixed methods. Method: In 2014, 40 UK GP staff and 13 stakeholders participated in interviews or focus groups...
December 28, 2017: Family Practice
https://www.readbyqxmd.com/read/29299000/roles-of-infectious-diseases-consultant-pharmacists-and-antimicrobial-stewardship-pharmacists-a-survey-of-canadian-tertiary-care-academic-hospitals
#13
Jessica E Beach, Tasha D Ramsey, Sean K Gorman, Tim T Y Lau
Background: Infectious diseases consultant (IDC) pharmacists work within an IDC service to care for inpatients with complex infections. With Accreditation Canada's new Required Organizational Practice promoting the establishment of antimicrobial stewardship (AMS) programs, AMS pharmacists are being employed in acute care hospitals. There is potential for overlap in responsibilities between IDC and AMS pharmacists, but there is no literature outlining the current duties for each group in Canada...
November 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29290744/antimicrobial-stewardship-program-using-plan-do-study-act-cycles-to-reduce-unjustified-antibiotic-prescribing-in-children-admitted-with-an-asthma-exacerbation
#14
Sasha E Dorzin, Claudia Halaby, Maria Lyn Quintos, Asif Noor, Gladys El-Chaar
OBJECTIVE: Antimicrobial stewardship programs (ASPs) ensure appropriate antibiotic use, reduce health care costs, and minimize antibiotic resistance. National asthma guidelines do not recommend antibiotics during an exacerbation unless the child has an infection or comorbidities. The American Academy of Pediatrics (AAP) established a benchmark for unjustified antibiotic use at 6.6%.9 A retrospective study at our institution showed that 7.8% of antibiotics were prescribed without justification in children admitted for asthma...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29288367/antimicrobial-resistance-and-antibiotic-stewardship-programs-in-the-icu-insistence-and-persistence-in-the-fight-against-resistance-a-position-statement-from-esicm-escmid-waaar-round-table-on-multi-drug-resistance
#15
Jan J De Waele, Murat Akova, Massimo Antonelli, Rafael Canton, Jean Carlet, Daniel De Backer, George Dimopoulos, José Garnacho-Montero, Jozef Kesecioglu, Jeffrey Lipman, Mervyn Mer, José-Artur Paiva, Mario Poljak, Jason A Roberts, Jesus Rodriguez Bano, Jean-François Timsit, Jean-Ralph Zahar, Matteo Bassetti
Antimicrobial resistance (AMR) is a clear and present danger to patients in any intensive care unit (ICU) around the world. Whereas AMR may affect any patient in the hospital, patients in the ICU are particularly at risk of acquiring AMR infections due to the intensity of the treatment, use of invasive devices, increased risk of transmission and exposure to antibiotics. AMR is present in every ICU, although prevalence is geographically different and AMR pathogens encountered are variable. Intensive care and infectious disease specialists from the European Society of Intensive Care Medicine, European Society of Microbiology and Infectious Diseases and World Alliance Against Antimicrobial Resistance, united in the ANTARCTICA (Antimicrobial Resistance in Critical Care) coalition, call for increased awareness and action among health care professionals to reduce AMR development in critically ill patients, to improve treatment of AMR infections and to coordinate scientific research in this high-risk patient population...
December 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29281974/development-of-an-intervention-to-reduce-antibiotic-use-for-childhood-coughs-in-uk-primary-care-using-critical-synthesis-of-multi-method-research
#16
Patricia J Lucas, Jenny Ingram, Niamh M Redmond, Christie Cabral, Sophie L Turnbull, Alastair D Hay
BACKGROUND: Overuse of antibiotics contributes to the global threat of antimicrobial resistance. Antibiotic stewardship interventions address this threat by reducing the use of antibiotics in occasions or doses unlikely to be effective. We aimed to develop an evidence-based, theory-informed, intervention to reduce antibiotic prescriptions in primary care for childhood respiratory tract infections (RTI). This paper describes our methods for doing so. METHODS: Green and Krueter's Precede/Proceed logic model was used as a framework to integrate findings from a programme of research including 5 systematic reviews, 3 qualitative studies, and 1 cohort study...
December 28, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29281716/trends-and-patterns-of-antibiotic-consumption-in-china-s-tertiary-hospitals-based-on-a-5-year-surveillance-with-sales-records-2011-2015
#17
Haishaerjiang Wushouer, Ye Tian, Xiao-Dong Guan, Sheng Han, Lu-Wen Shi
The consumption of antibiotics is a major driver in the development of antimicrobial resistance. This study aims to identify the trends and patterns of the total antibiotic consumption in China's tertiary hospitals from 2011 to 2015 by retrospectively analyzing aggregated monthly surveillance data on antibiotic sales made to 468 hospitals from 28 provinces. Antibiotic consumption was expressed in DDD per 1,000 inhabitants per day (DID). We compared population weighted antibiotic consumption patterns in China with European countries using indicators from the European Surveillance of Antimicrobial Consumption (ESAC)...
2017: PloS One
https://www.readbyqxmd.com/read/29277727/antimicrobial-resistance-in-urine-and-skin-isolates-in-timor-leste
#18
Ian Marr, Nevio Sarmento, Matt O'Brien, Karl Lee, Celia Gusmao, Gloria de Castro, Sonja Janson, Steven Y C Tong, Rob W Baird, Joshua R Francis
OBJECTIVES: High rates of antimicrobial resistance are seen throughout Southeast Asia. Limited antimicrobial resistance data exists for Timor-Leste, which is situated on the south-eastern portion of the Malay Archipelago. The purpose of this study was to identify antimicrobial resistance in bacteria isolated from urine and skin swabs from patients in Dili, Timor-Leste. METHODS: Urine and skin swabs were collected from symptomatic patients and processed for bacterial culture in Timor-Leste...
December 22, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29277527/high-excess-costs-of-infections-caused-by-carbapenem-resistant-gram-negative-bacilli-in-an-endemic-region
#19
Carlos Andrés Vargas-Alzate, Luis Felipe Higuita-Gutiérrez, Lucelly López López, Astrid Vanessa Cienfuegos Gallet, Judy Natalia Jiménez Quiceno
BACKGROUND: The financial burden of antibiotic resistance is a serious concern worldwide. The aim of this study is to describe the excess costs associated with pneumonia, bacteremia, surgical site infections and intra-abdominal infections caused by carbapenem-resistant gram-negative bacilli in Medellín, Colombia, an endemic region for carbapenem resistance. METHODS: A cohort study was conducted in a third level hospital from 2014 to 2015. All patients with carbapenem-resistant and carbapenem-susceptible gram-negative bacteria infections were included...
December 22, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29276300/multilayer-model-of-pharmacy-participation-in-the-antimicrobial-stewardship-program-at-a-large-academic-medical-center
#20
Yanina Dubrovskaya, Marco R Scipione, Justin Siegfried, Shin-Pung Jen, Vinh Pham, John Papadopoulos, Arnold Decano, Tyler Lewis, Arash Dabestani
Purpose: Leveraging pharmacy personnel resources for the purpose of antimicrobial stewardship program (ASP) operations presents a challenging task. We describe our experience integrating all pharmacists into an ASP, and evaluate the impact on ASP interventions, antimicrobial utilization, rate of selected hospital-onset infections and readmission. Summary: During a study period (January 1 to December 31, 2015), a total of 14 552 ASP-related pharmacy interventions were performed (ASP clinical pharmacotherapy specialists [CPS] n = 4025; non-ASP CPS n = 4888; hospital pharmacists n = 5639)...
October 2017: Hospital Pharmacy
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