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Antimicrobial stewardship

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https://www.readbyqxmd.com/read/28646964/global-advocacy-needed-for-sepsis-in-children
#1
Sagar Dugani, Niranjan Kissoon
Sepsis in children is a complex syndrome that develops from various infections and results in 15-30% mortality in high-income countries and up to 50% or higher in low-income countries. Worldwide, this represents an annual burden of 30 million cases resulting in 8 million deaths. Not surprisingly, there is a significantly higher burden in low-income countries with children there being 18 times more likely to die before the age of 5 years compared to high-income countries. Factors such as commercial air travel, climate change, and unchecked population growth have contributed to the growing burden of infectious diseases and ensuing sepsis...
June 2017: Journal of Infection
https://www.readbyqxmd.com/read/28642146/is-antimicrobial-stewardship-cost-effective-a-narrative-review-of-the-evidence
#2
REVIEW
Nichola R Naylor, Nina Zhu, Marlies Hulscher, Alison Holmes, Raheelah Ahmad, Julie V Robotham
AIMS: This narrative review aimed to collate recent evidence on the cost-effectiveness and cost-benefit of antimicrobial stewardship (AMS) programmes, to address the question "is AMS cost-effective?", whilst providing resources and guidance for future research in this area. SOURCES: PubMed was searched for studies assessing the cost-effectiveness, cost-utility or cost-benefit of AMS interventions in humans, published from January 2000 to March 2017, with no setting inclusion/exclusion criteria specified...
June 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28637912/parallel-evaluation-of-the-maldi-sepsityper-and-verigene-bc-gn-assays-for-rapid-identification-of-gram-negative-bacilli-from-positive-blood-cultures
#3
Miguel A Arroyo, Gerald A Denys
Rapid identification of microorganisms from positive blood cultures has improved clinical management and antimicrobial stewardship. The advent of the matrix-assisted laser desorption time-of-flight Mass Spectrometry (MALDI-TOF MS) has reduced the time to identification of cultured isolates and is now often the definitive method used in the clinical microbiology laboratory. The commercial in vitro diagnostic MALDI Sepsityper (Sepsityper) kit has the potential for standardization and clinical routine use for the rapid identification of a broad range of bacteria from positive blood cultures...
June 21, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28637307/sparing-carbapenem-usage
#4
A Peter R Wilson
Background: Carbapenem resistance in Gram-negative bacteria is increasing in many countries and use of carbapenems and antibiotics to which resistance is linked should be reduced to slow its emergence. There are no directly equivalent antibiotics and the alternatives are less well supported by clinical trials. The few new agents are expensive. Objectives: To provide guidance on strategies to reduce carbapenem usage. Methods: A literature review was performed as described in the BSAC/HIS/BIA/IPS Joint Working Party on Multiresistant Gram-negative Infection Report...
June 15, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28631121/-prudent-use-of-antimicrobial-prophylaxis-prevention-of-increasing-antibiotic-resistance
#5
REVIEW
C Hein, A Pilatz, F M E Wagenlehner
BACKGROUND: The use of peri-operative antimicrobial prophylaxis during urological procedures to prevent postoperative complications is very common. OBJECTIVES: What kind of recommendations for reasonable use of peri-operative antimicrobial prophylaxis during urological procedures to prevent increasing antibiotic resistance and postoperative complications exist? METHODS: Review of evidence-based recommendations from literature and current Guidelines of the EAU...
June 19, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28630187/cumulative-effect-of-an-antimicrobial-stewardship-and-rapid-diagnostic-testing-bundle-on-early-streamlining-of-antimicrobial-therapy-in-gram-negative-bloodstream-infections
#6
P B Bookstaver, E B Nimmich, T J Smith, J A Justo, J Kohn, K L Hammer, C Troficanto, H A Albrecht, M N Al-Hasan
OBJECTIVES: The use of rapid diagnostic tests (RDT) enhances antimicrobial stewardship programs (ASP) interventions in optimization of antimicrobial therapy. This quasi-experimental cohort study evaluates the combined impact of an ASP/RDT bundle on appropriateness of empirical antimicrobial therapy (EAT) and time to de-escalation of broad-spectrum agents (BSAA) in gram-negative bloodstream infections (GNBSI). METHODS: ASP/RDT bundle consisted of a system-wide GNBSI treatment guidelines, prospective stewardship monitoring, and sequential introduction of two RDTs, Matrix Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) and FilmArray® Blood Culture Identification (BCID) panel...
June 19, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28629754/improving-compliance-with-surgical-antibiotic-prophylaxis-guidelines-a-multicenter-evaluation
#7
Cristiane Schmitt, Rubia Aparecida Lacerda, Ruth Natalia Teresa Turrini, Maria Clara Padoveze
BACKGROUND: Improving surgical antibiotic prophylaxis (SAP) use is an important element in the control of antimicrobial resistance. However, compliance with SAP guidelines is unsatisfactory. This study investigated the level of compliance with SAP guidelines in neurosurgery, and institutional characteristics associated with compliance. METHODS: This study assessed surgeries in 9 Brazilian hospitals. Medical record reviews and a structured questionnaire were used to assess compliance and to describe institutional characteristics...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28629753/active-identification-of-patients-who-are-methicillin-resistant-staphylococcus-aureus-colonized-is-not-associated-with-longer-duration-of-vancomycin-therapy
#8
Carlos Acuna-Villaorduna, Westyn Branch-Elliman, Judith Strymish, Kalpana Gupta
BACKGROUND: Excessive prescribing of vancomycin among patients admitted to inpatient wards is a challenge for antimicrobial stewardship programs, especially in the setting of expanded screening programs for methicillin-resistant Staphylococcus aureus (MRSA). Studies examining factors associated with longer duration of vancomycin use are limited. METHODS: We conducted a retrospective cohort study to assess the impact of universal MRSA admission screening on duration of vancomycin use at the VA Boston Healthcare System during the period from January 2013-November 2015...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28628930/-rational-use-of-antibiotics-data-form-a-survey-from-2014-within-the-mrdo-network-compared-to-nationwide-data-from-2009
#9
Luba Lendowski, Peter Walger, Christoph Hoeser, Martin Exner, Claudia Roesing, Steffen Engelhart
Introduction To combat multi-resistant gram-negative bacteria as the cause of life-threatening infections, antibiotic stewardship activities are of great importance. Objective To detect weaknesses when prescribing antibiotics in hospitals and compare the situation between 2009 and 2014. Methods In 2014, a questionnaire was sent to all 380 physicians employed in 7 hospitals. Primary, secondary and tertiary care hospitals were included. Investigated were: demographic data, position, certified specialization, presence of antibiotic prescription rules and behavior to follow them...
June 19, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28626539/resistance-to-colistin-in-klebsiella-pneumoniae-a-4-0-strain
#10
REVIEW
Guido Granata, Nicola Petrosillo
The global rise of multidrug-resistant gram-negative bacteria represents an increasing threat to patient safety. From the first observation of a carbapenem-resistant gram-negative bacteria a global spread of extended-spectrum beta-lactamases and carbapenemases producing Klebsiella pneumoniae has been observed. Treatment options for multidrug-resistant K. pneumoniae are actually limited to combination therapy with some aminoglycosides, tigecycline and to older antimicrobial agents. Unfortunately, the prevalence of colistin-resistant and tigecycline-resistant K...
May 31, 2017: Infectious Disease Reports
https://www.readbyqxmd.com/read/28625717/clinical-impact-of-non-antibiotic-recommendations-by-a-multi-disciplinary-antimicrobial-stewardship-team
#11
Tat Ming Ng, Vanessa Y Phang, Barnaby Young, Sock Hoon Tan, Hui Lin Tay, Michelle W Tan, Li Min Ling, Brenda S Ang, Christine B Teng, David C Lye
INTRODUCTION: The multi-disciplinary antimicrobial stewardship team at the study hospital conducts prospective review and feedback on all inpatient orders of piperacillin-tazobactam and carbapenems. In addition, the team provides non-antibiotic recommendations (i.e. additional investigations and infectious disease reviews). This study aimed to describe the impact of these recommendations on patient outcomes. METHODS: Patients on carbapenem and piperacillin-tazobactam who received at least one non-antibiotic recommendation between January 2012 and August 2014 were included in this study...
June 15, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28622980/how-do-hospital-respiratory-clinicians-perceive-antimicrobial-stewardship-ams-a-qualitative-study-highlighting-barriers-to-ams-in-respiratory-medicine
#12
J Broom, A Broom, E Kirby, A F Gibson, J J Post
BACKGROUND: Suboptimal antibiotic use in respiratory infections is widespread in hospital medicine and primary care. Antimicrobial stewardship (AMS) teams within hospitals, commonly led by infectious diseases physicians, are frequently charged with optimizing the use of respiratory antibiotics, but there is limited information on what drives antibiotic use in this area of clinical medicine, or on how AMS is perceived. AIM: To explore the perceptions of hospital respiratory clinicians on AMS in respiratory medicine...
May 5, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28622340/antibiotic-prophylaxis-for-surgical-site-infections-as-a-risk-factor-for-infection-with-clostridium-difficile
#13
Aubrey Balch, Aaron M Wendelboe, Sara K Vesely, Dale W Bratzler
OBJECTIVE: We aimed to measure the association between 2013 guideline concordant prophylactic antibiotic use prior to surgery and infection with Clostridium difficile. DESIGN: We conducted a retrospective case-control study by selecting patients who underwent a surgical procedure between January 1, 2012 and December 31, 2013. SETTING: Large urban community hospital. PATIENTS: Cases and controls were patients age 18+ years who underwent an eligible surgery (i...
2017: PloS One
https://www.readbyqxmd.com/read/28615344/advancing-infection-prevention-and-antimicrobial-stewardship-through-improvement-science
#14
EDITORIAL
Jerome A Leis
No abstract text is available yet for this article.
June 14, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28614043/antibiotics-vs-appendectomy-for-acute-uncomplicated-appendicitis-in-adults-review-of-the-evidence-and-future-directions
#15
Jared M Huston, Lillian S Kao, Phillip K Chang, James M Sanders, Sara Buckman, Charles A Adams, Christine S Cocanour, Sarah E Parli, Julia Grabowski, Jose Diaz, Jeffrey M Tessier, Therese M Duane
BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency in the United States, with a lifetime risk of 7%-8%. The treatment paradigm for complicated appendicitis has evolved over the past decade, and many cases now are managed by broad-spectrum antibiotics. We determined the role of non-operative and operative management in adult patients with uncomplicated appendicitis. METHODS: Several meta-analyses have attempted to clarify the debate. Arguably the most influential is the Appendicitis Acuta (APPAC) Trial...
June 14, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28608289/-antibiotic-stewardship-a%C3%A2-programmatic-approach-to-improved-antimicrobial-management
#16
REVIEW
Martin Müller, Patrick Lehmann, Christian Willy
Due to the increasing selection and prevalence of multidrug-resistant gram-negative bacteria and the insufficient development of novel antibiotics, the responsible and prudent use of the available antimicrobial drugs is of major importance. In Germany the rational use of anti-infectives considering the local antimicrobial resistance situation is defined in the infection protection act of 2011. An important tool to follow legal regulations and to improve the treatment of bacterial infections is the antimicrobial stewardship (AMS) concept...
June 12, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28605452/optimizing-preoperative-prophylaxis-in-patients-with-reported-%C3%AE-lactam-allergy-a-novel-extension-of-antimicrobial-stewardship
#17
Alon Vaisman, Janine McCready, Sandy Hicks, Jeff Powis
Background: Use of alternative second-line antibiotics is associated with adverse events in patients reporting β-lactam allergy. In the perioperative setting, we hypothesized that structured allergy histories, without the use of skin testing, can reduce alternative prophylactic antibiotic use. Objectives: Assess the impact of structured allergy histories on patients with self-reported β-lactam allergy (SRBA) undergoing elective surgical procedures. Methods: Structured allergy histories were performed by a pharmacist and reviewed with an infectious diseases physician...
June 10, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28603609/antimicrobial-susceptibility-of-clostridium-difficile-isolated-in-thailand
#18
Papanin Putsathit, Monthira Maneerattanaporn, Pipat Piewngam, Daniel R Knight, Pattarachai Kiratisin, Thomas V Riley
BACKGROUND: Exposure to antimicrobials is the major risk factor associated with Clostridium difficile infection (CDI). Paradoxically, treatment of CDI with antimicrobials remains the preferred option. To date, only three studies have investigated the antimicrobial susceptibility of C. difficile from Thailand, two of which were published in the 1990s. This study aimed to investigate the contemporary antibiotic susceptibility of C. difficile isolated from patients in Thailand. METHODS: A collection of 105 C...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28601833/targeted-simplification-versus-antipseudomonal-broad-spectrum-beta-lactams-in-patients-with-bloodstream-infections-due-to-enterobacteriaceae-simplify-a-study-protocol-for-a-multicentre-open-label-phase-iii-randomised-controlled-non-inferiority-clinical-trial
#19
Luis Eduardo López-Cortés, Clara Rosso-Fernández, María Núñez-Núñez, Lucía Lavín-Alconero, José Bravo-Ferrer, Ángel Barriga, Mercedes Delgado, Carmen Lupión, Pilar Retamar, Jesús Rodríguez-Baño
INTRODUCTION: Within the context of antimicrobial stewardship programmes, de-escalation of antimicrobial therapy is one of the proposed strategies for reducing the unnecessary use of broad-spectrum antibiotics (BSA). The empirical treatment of nosocomial and some healthcare-associated bloodstream infections (BSI) frequently includes a beta-lactam with antipseudomonal activity as monotherapy or in combination with other drugs, so there is a great opportunity to optimise the empirical therapy based on microbiological data...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28597623/-impact-of-a-stewardship-program-on-bacteraemia-in-adult-inpatients
#20
E Merino, E Caro, J R Ramos, V Boix, A Gimeno, J C Rodríguez, G Riera, P Más-Serrano, J Sanchéz-Paya, S Reus, D Torrús, J Portilla
OBJECTIVE: Bloodstream infections (BSIs) are associated with considerable morbidity and mortality among inpatients. The aim of this study was to evaluate the impact of a stewardship program on clinical and antimicrobial therapy-related outcomes in patients with bacteraemia. METHODS: Single-centre, before-and-after quasi-experimental study in adult inpatients. Over 1 January 2013 to 31 June 2013 all patients aged 18 years or older with a bacteraemia (interven-tion group, N=200) were compared to a historical cohort (1 Janu-ary 2012 to 31 December 2012) (control group, N=200)...
June 8, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
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