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Antimicrobial stewardship

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https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#1
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29149338/multiplex-respiratory-virus-testing-for-antimicrobial-stewardship-a-prospective-assessment-of-antimicrobial-use-and-clinical-outcomes-among-hospitalized-adults
#2
Makeda Semret, Ian Schiller, Barbara Ann Jardin, Charles Frenette, Vivian G Loo, Jesse Papenburg, Shelly A McNeil, Nandini Dendukuri
Background: Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults. Methods: Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada...
November 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29145934/economic-evaluations-on-antimicrobial-stewardship-programme-a-systematic-review
#3
Nor Haizan Ibrahim, Khalidah Maruan, Hasryn Azzuar Mohd Khairy, Yet Hoi Hong, Ahmad Fauzi Dali, Chin Fen Neoh
PURPOSE: To systematically review studies on cost-effectiveness of implementing Antimicrobial stewardship programmes (ASP) in the hospital setting. METHODS: A systematic literature search was performed using electronic databases, such as EMBASE, PubMed/Medline, CINAHL, NHS and CEA Registry from 2000 until 2017. The quality of each included study was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Economic Evaluations and Consolidated Health Economic Evaluation Reporting Standards Statement checklist...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29145465/hospital-associated-methicillin-resistant-staphylococcus-aureus-a-cross-sectional-analysis-of-risk-factors-in-south-african-tertiary-public-hospitals
#4
Liliwe L Shuping, Lazarus Kuonza, Alfred Musekiwa, Samantha Iyaloo, Olga Perovic
INTRODUCTION: Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. METHODS: We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture...
2017: PloS One
https://www.readbyqxmd.com/read/29141775/impact-of-interventions-by-an-antimicrobial-stewardship-program-team-on-appropriate-antimicrobial-therapy-in-patients-with-bacteremic-urinary-tract-infection
#5
Mitsuru Yanai, Maiko Ogasawara, Yuta Hayashi, Kiyozumi Suzuki, Hiromichi Takahashi, Atsushi Satomura
BACKGROUND: Inappropriate antimicrobial therapy often leads to poor outcomes. This study aimed to evaluate the impact of an antimicrobial stewardship program (ASP) team on appropriate therapy, in patients with bacteremic urinary tract infection (UTI). PATIENTS AND METHODS: We retrospectively reviewed the interventions by the ASP team in 807 patients with bacteremic UTI. Interventions were divided into 3 groups: group A (conventional report), group B (conventional report and written alert on the chart), and group C (conventional report and oral recommendation with/without written alert)...
November 12, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29138099/effect-of-an-antimicrobial-stewardship-programme-on-antimicrobial-utilisation-and-costs-in-patients-with-leukaemia-a-retrospective-interventional-controlled-study
#6
Miranda So, Muhammad Mamdani, Andrew Morris, Tim Lau, Raewyn Broady, Uday Deotare, Jennifer Grant, Dennis Dong Hwan Kim, Aaron D Schimmer, Andre Schuh, Salomeh Shajari, Marilyn Steinberg, Chaim M Bell, Shahid Husain
OBJECTIVES: To examine the effectiveness of an antimicrobial stewardship programme (ASPs) on utilisation and cost of antimicrobials in leukaemia patients in Canada. METHODS: We conducted a multisite, retrospective, observational time-series study from 2005 to 2013. We implemented academic detailing as the intervention of an ASP in leukaemia units at a hospital, piloted February-July 2010, then fully implemented December 2010-March 2013, with no intervention in August-November 2010...
November 11, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29136126/risk-of-subsequent-sepsis-within-90-days-of-a-previous-hospital-stay-by-type-of-antibiotic-exposure
#7
James Baggs, Johm A Jernigan, Alison Laufer Halpin, Lauren H Epstein, Kelly M Hatfield, L Clifford McDonald
Background: We examined the risk of sepsis within 90 days after discharge from a previous hospital stay by type of antibiotic received during the previous stay. Methods: We retrospectively identified a cohort of hospitalized patients from the Truven Health MarketScan Hospital Drug Database. We examined the association between the use of certain antibiotics, determined a priori, during the initial hospital stay and risk of post-discharge sepsis controlling for potential confounding factors in a multivariable logistic regression model...
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29134582/long-term-efficacy-of-comprehensive-multidisciplinary-antibiotic-stewardship-programs-centered-on-weekly-prospective-audit-and-feedback
#8
Takeshi Kimura, Atsushi Uda, Tomoyuki Sakaue, Kazuhiko Yamashita, Tatsuya Nishioka, Sho Nishimura, Kei Ebisawa, Manabu Nagata, Goh Ohji, Tatsuya Nakamura, Chihiro Koike, Mari Kusuki, Takeshi Ioroi, Akira Mukai, Yasuhisa Abe, Hiroyuki Yoshida, Midori Hirai, Soichi Arakawa, Ikuko Yano, Kentaro Iwata, Issei Tokimatsu
OBJECTIVE: To evaluate the long-term effects of comprehensive antibiotic stewardship programs (ASPs) on antibiotic use, antimicrobial-resistant bacteria, and clinical outcomes. DESIGN: Before-after study. SETTING: National university hospital with 934 beds. INTERVENTION: Implementation in March 2010 of a comprehensive ASPs including, among other strategies, weekly prospective audit and feedback with multidisciplinary collaboration...
November 13, 2017: Infection
https://www.readbyqxmd.com/read/29133158/cmi-policy-on-antimicrobial-stewardship-research
#9
EDITORIAL
Céline Pulcini, Angela Huttner
No abstract text is available yet for this article.
November 10, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29132695/thai-clinicians-attitudes-toward-antimicrobial-stewardship-programs
#10
Nantanit Sutthiruk, Julie Considine, Ana Hutchinson, Andrea Driscoll, Kumthorn Malathum, Mari Botti
BACKGROUND: Effective hospital-wide antimicrobial stewardship (AMS) programs need multidisciplinary engagement; however, clinicians' attitudes have not been investigated in Thailand where AMS is in early development. The aim of this study was to explore Thai clinicians' (doctors, nurses, and pharmacists) perceptions and attitudes toward AMS. METHODS: A paper-based survey was distributed in a 1,000-bed university hospital in Bangkok, Thailand, between November 9, 2015, and December 21, 2015...
November 10, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29122393/how-do-professional-relationships-influence-surgical-antibiotic-prophylaxis-decision-making-a-qualitative-study
#11
Jennifer K Broom, Alex F Broom, Emma R Kirby, Jeffrey J Post
BACKGROUND: Surgical antibiotic prophylaxis (SAP) is a critical area to optimize to reduce the escalation of antimicrobial resistance. This article explores the ways by which interpersonal relationships influence SAP decision making. METHODS: Twenty surgeons and anesthetists participated in in-depth semistructured interviews on SAP prescribing. Results were analyzed using the framework approach. RESULTS: Analysis revealed 3 ways by which interpersonal relationships influence SAP: relationship dynamics between the surgeon and the anesthetist determine appropriateness of SAP, particularly operative risk ownership; perceived hierarchies within, and between, surgical and anesthetist specialties influence antibiotic prescribing decisions; and surgical distance from the antimicrobial stewardship team, which influences use of antimicrobial stewardship principles...
November 7, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29121202/adaptive-designs-for-clinical-trials-application-to-healthcare-epidemiology-research
#12
W Charles Huskins, Vance G Fowler, Scott Evans
Clinical trials with adaptive designs use data that accumulates during the course of the study to modify study elements in a pre-specified manner. The goal is to provide flexibility such that a trial can serve as a definitive test of its primary hypothesis, preferably in a shorter time period, involving fewer human subjects, and at lower cost. Elements that may be modified include the sample size, endpoints, eligible population, randomization ratio, and interventions. Accumulating data used to drive these modifications include the outcomes, subject enrollment (including factors associated with the outcomes), and information about the application of the interventions...
November 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29120282/surgical-infection-society-we-endorse-antimicrobial-stewardship-we-stand-by-our-international-colleagues-and-societies-in-the-fight-for-proper-antimicrobial-therapy
#13
Kamal M F Itani, Addison K May
No abstract text is available yet for this article.
November 2017: Surgical Infections
https://www.readbyqxmd.com/read/29118939/escherichia-coli-pathotypes-and-shigella-sero-groups-in-diarrheic-children-in-nairobi-city-kenya
#14
Peter Lokamar Nyanga, Jackson Onyuka, Mark Kilongosi Webale, Tom Were, Valentine Budambula
Aim: In the present study, we investigated the prevalence of E. coli pathotypes and Shigella sero-groups and their antimicrobial profiles among diarrheic children in Nairobi city, Kenya. Background: Although diarrheagenic E. coli pathotypes and Shigella sero-groups are leading causes of diarrhea in children under five years in developing countries, their distribution and antimicrobial resistance vary from place to place and over time in a given region. Methods: In a cross-sectional study, we enrolled diarrheic children (n=354) under five years seeking treatment at Mbagathi Hospital, Nairobi city, Kenya,...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/29105600/microbiology-in-burns-patients-with-blood-stream-infections-trends-over-time-and-during-the-course-of-hospitalization
#15
Dolores Sousa, Alejandra Ceniceros, Rita Galeiras, Sonia Pértega-Díaz, José-María Gutiérrez-Urbón, María Rodríguez-Mayo, Eugenia López-Suso, Mónica Mourelo-Fariña, Pedro Llinares
BACKGROUND: Bloodstream infections (BSI) are a major cause of mortality in burns patients. Knowledge of the microbiology is crucial to direct empirical therapy. We sought to determine the causative microorganisms and antibiotic resistance in burns patients with BSI. METHODS: All consecutive BSI episodes in a tertiary hospital burns unit from 2000 to 2014 were included. The following three subperiods were compared: 2000-2004, 2005-2009 and 2010-2014. Changes in BSI occurring during early and late hospitalization periods were evaluated...
November 6, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/29105102/impact-of-penicillin-allergy-on-empirical-carbapenem-use-in-gram-negative-bloodstream-infections-an-antimicrobial-stewardship-opportunity
#16
Majdi N Al-Hasan, Emily C Acker, Joseph E Kohn, P Brandon Bookstaver, Julie Ann Justo
OBJECTIVES: Retrospective matched cohort study evaluating association between penicillin allergy and empirical carbapenem use in gram-negative bloodstream infections (BSI) and utility of antimicrobial stewardship interventions in reducing carbapenem utilization. METHODS: Hospitalized adults with community-onset gram-negative BSI from January 1, 2010 to June 30, 2015 at two large community hospitals in Columbia, SC were identified. Antimicrobial stewardship interventions targeting penicillin allergy and carbapenem utilization were fully implemented in January 1, 2014...
November 3, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29102353/effect-of-a-training-and-educational-intervention-for-physicians-and-caregivers-on-antibiotic-prescribing-for-upper-respiratory-tract-infections-in-children-at-primary-care-facilities-in-rural-china-a-cluster-randomised-controlled-trial
#17
Xiaolin Wei, Zhitong Zhang, John D Walley, Joseph P Hicks, Jun Zeng, Simin Deng, Yu Zhou, Jia Yin, James N Newell, Qiang Sun, Guanyang Zou, Yan Guo, Ross E G Upshur, Mei Lin
BACKGROUND: Inappropriate antibiotic prescribing contributes to the generation of drug resistance worldwide, and is particularly common in China. We assessed the effectiveness of an antimicrobial stewardship programme aiming to reduce inappropriate antibiotic prescribing in paediatric outpatients by targeting providers and caregivers in primary care hospitals in rural China. METHODS: We did a pragmatic, cluster-randomised controlled trial with a 6-month intervention period...
December 2017: Lancet Global Health
https://www.readbyqxmd.com/read/29102325/surveillance-for-control-of-antimicrobial-resistance
#18
REVIEW
Evelina Tacconelli, Frangiscos Sifakis, Stephan Harbarth, Remco Schrijver, Maaike van Mourik, Andreas Voss, Mike Sharland, Nithya Babu Rajendran, Jesús Rodríguez-Baño
Antimicrobial resistance poses a growing threat to public health and the provision of health care. Its surveillance should provide up-to-date and relevant information to monitor the appropriateness of therapy guidelines, antibiotic formulary, antibiotic stewardship programmes, public health interventions, infection control policies, and antimicrobial development. In Europe, although the European Antimicrobial Resistance Surveillance Network provides annual reports on monitored resistant bacteria, national surveillance efforts are still fragmented and heterogeneous, and have substantial structural problems and issues with laboratory data...
October 25, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29102103/frequency-antimicrobial-susceptibility-and-clonal-distribution-of-methicillin-resistant-staphylococcus-pseudintermedius-in-canine-clinical-samples-submitted-to-a-veterinary-diagnostic-laboratory-in-italy-a-3-year-retrospective-investigation
#19
G Ventrella, A Moodley, E Grandolfo, A Parisi, M Corrente, D Buonavoglia, L Guardabassi
In the last decade there has been a rapid global spread of methicillin-resistant Staphylococcus pseudintermedius (MRSP) clones displaying multidrug resistance in dogs. We investigated prevalence, antimicrobial susceptibility and clonal distribution of MRSP isolated from clinical canine samples between during 2011-2014. Following species identification by nuc PCR, MRSP were confirmed by the presence of mecA and characterized by antimicrobial susceptibility testing, Pulsed Field Gel Electrophoresis (PFGE), SCCmec typing, and Multi-Locus Sequence Typing (MLST) of a few isolates having distinct PFGE profiles...
November 2017: Veterinary Microbiology
https://www.readbyqxmd.com/read/29096027/impact-of-an-antimicrobial-stewardship-policy-to-restrict-palivizumab-use
#20
Torsten Joerger, Shannon Chan, Sanjeev K Swami, Lori K Handy
No abstract text is available yet for this article.
October 31, 2017: Journal of the Pediatric Infectious Diseases Society
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