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Antimicrobial stewardship

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https://www.readbyqxmd.com/read/28444166/the-effect-of-a-piperacillin-tazobactam-shortage-on-antimicrobial-prescribing-and-clostridium-difficile-risk-in-88-u-s-medical-centers
#1
Alan E Gross, Richard S Johannes, Vikas Gupta, Ying P Tabak, Arjun Srinivasan, Susan C Bleasdale
Background: Anti-infective shortages are a pervasive problem in the U.S. The objective of this study was to identify any associations between changes in antibiotic prescribing during a piperacillin/tazobactam (PIP/TAZO) shortage and hospital-onset Clostridium difficile infection (HO-CDI) risk in 88 U.S medical centers. Methods: We analyzed electronically captured microbiology and antibiotic use data from a network of U.S. hospitals from July 2014 through June 2015...
April 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28443360/overview-of-procalcitonin-assays-and-procalcitonin-guided-protocols-for-the-management-of-patients-with-infections-and-sepsis
#2
Philipp Schuetz, Celine Bretscher, Luca Bernasconi, Beat Mueller
Procalcitonin is a surrogate infection blood marker whose levels help estimate the likelihood of bacterial infections and correlate with their resolution. Recent trials have revealed the benefits of inclusion of procalcitonin in antibiotic stewardship protocols for initiation and discontinuation of antimicrobial therapy. Areas covered: Procalcitonin-guided antibiotic stewardship protocols have shown appreciable reductions in antibiotic use and duration of therapy in respiratory infections, sepsis, and other infections, with positive effects on clinical outcomes...
April 26, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28433726/managing-responsible-antimicrobial-use-perspectives-across-the-healthcare-system
#3
REVIEW
Oliver J Dyar, Gianpiero Tebano, Céline Pulcini
BACKGROUND: Healthcare systems consist of building blocks. Shaping how these building blocks function and interact can promote responsible antimicrobial use, and this represents an important opportunity for managers at different points within healthcare systems to act upon. AIMS: To review real-world examples of how healthcare systems can promote responsible antimicrobial use, focusing on the role of governance and managers. SOURCES: We searched and reviewed existing literature and official documents, which mostly focused on antibiotics...
April 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28432607/impact-of-the-medical-specialty-on-knowledge-regarding-multidrug-resistant-organisms-and-strategies-toward-antimicrobial-stewardship
#4
Steffen Lebentrau, Christian Gilfrich, Malte W Vetterlein, Harald Schumacher, Philipp J Spachmann, Sabine D Brookman-May, Hans M Fritsche, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Matthias May
PURPOSE: Evidence is scarce on subject-specific knowledge of multidrug-resistant organisms and rational use of antibiotics. We aimed at evaluating attitude, perception, and knowledge about multidrug-resistant organisms (MDRO) and antibiotic prescribing among urologists versus other medical specialties. METHODS: Within the MR2-study (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria), a questionnaire was conducted targeting general surgeons, internists, gynecologists, and urologists in 18 German hospitals...
April 21, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28431848/epidemiology-of-device-associated-infections-in-an-intensive-care-unit-of-a-teaching-hospital-in-nepal-a-prospective-surveillance-study-from-a-developing-country
#5
Narayan Prasad Parajuli, Subhash Prasad Acharya, Santosh Dahal, Jaya Prasad Singh, Shyam Kumar Mishra, Hari Prasad Kattel, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Device-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs. METHODS: A prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28431847/guideline-compliance-and-clinical-outcomes-among-patients-with-staphylococcus-aureus-bacteremia-with-infectious-diseases-consultation-in-addition-to-antimicrobial-stewardship-directed-review
#6
Kevin Buehrle, Jennifer Pisano, Zhe Han, Natasha N Pettit
OBJECTIVE: Previous studies have shown infectious diseases consultation (IDC) for Staphylococcus aureus bacteremia (SAB) improves management and outcomes. The influence of IDC on outcomes for SAB in addition to an antimicrobial stewardship program (ASP) review for adult inpatients with SAB has not been evaluated. The purpose of this study was to investigate the effect of IDC on SAB management with concomitant ASP review and resulting outcomes. METHODS: Adult inpatients with SAB admitted December 2012-October 2014 were included...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28421979/applying-the-horizontal-and-vertical-paradigm-to-antimicrobial-stewardship
#7
Payal K Patel
No abstract text is available yet for this article.
May 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28417331/use-of-high-dose-oral-valacyclovir-during-an-intravenous-acyclovir-shortage-a-retrospective-analysis-of-tolerability-and-drug-shortage-management
#8
Milena M McLaughlin, Sarah H Sutton, Ashley O Jensen, John S Esterly
INTRODUCTION: In late 2011, a shortage of IV acyclovir led to the need to empirically substitute high-dose oral valacyclovir (HDVA) to conserve IV acyclovir for patients with confirmed herpes simplex virus (HSV) meningitis or encephalitis. This report describes the management of the most recent national IV acyclovir shortage by the Antimicrobial Stewardship Program (ASP) at Northwestern Memorial Hospital (NMH), Chicago, IL, USA, and the use of HDVA. Secondarily, we assessed the safety and tolerability of HDVA as an alternate to IV acyclovir during this shortage...
April 17, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28411959/implementation-and-outcomes-of-an-antimicrobial-stewardship-program-effectiveness-of-education
#9
Yea-Yuan Chang, Hsin-Pai Chen, Chia-Wei Lin, Jen-Jen Tang, Ti-Ying Hsu, Yueh-Chun Weng, Yuan-Ming Lee, Wei-Shu Wang, Su-Shun Lo
BACKGROUND: Unnecessary use of antibiotics is a common occurrence in hospitals. Implementation of antibiotic stewardship programs (ASPs) has been shown to reduce both unnecessary antibiotic use and drug-resistant bacteria. Education is a fundamental component of an ASP. However, the effectiveness of proper uses of antibiotics education has not been clearly analyzed. METHODS: In a 520-bed university hospital located in northeastern Taiwan, a significantly increasing prescription of carbapenems, specifically imipenem and meropenem, was observed...
April 12, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28407067/evaluation-of-a-second-sign-process-for-antimicrobial-prior-authorization
#10
Aimee M Dassner, Jennifer E Girotto
Background.: A second-sign prospective restriction of select broad-spectrum antimicrobials was fully implemented in January 2015 as a pediatric antimicrobial stewardship program (ASP) initiative to help ensure the most appropriate empiric use of ceftaroline, cefepime, fidaxomicin, linezolid, and vancomycin (intravenous). The objective of this evaluation is to assess the effectiveness of a forced second-sign process in the electronic medical record as a pediatric ASP strategy. We anticipated that the second-sign process for antibiotics would increase the appropriateness of empiric antibiotic use, as defined by preapproved criteria, clinical pathways, national guidelines, and pediatric-specific infectious diseases reference texts, while not causing significant delay in the initial administration of antibiotic therapy...
April 12, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28406949/antimicrobial-resistant-infections-among-postpartum-women-at-a-ugandan-referral-hospital
#11
Lisa M Bebell, Joseph Ngonzi, Joel Bazira, Yarine Fajardo, Adeline A Boatin, Mark J Siedner, Ingrid V Bassett, Dan Nyehangane, Deborah Nanjebe, Yves Jacquemyn, Jean-Pierre van Geertruyden, Juliet Mwanga-Amumpaire, David R Bangsberg, Laura E Riley, Yap Boum
INTRODUCTION: Puerperal sepsis causes 10% of maternal deaths in Africa, but prospective studies on incidence, microbiology and antimicrobial resistance are lacking. METHODS: We performed a prospective cohort study of 4,231 Ugandan women presenting to a regional referral hospital for delivery or postpartum care, measured vital signs after delivery, performed structured physical exam, symptom questionnaire, and microbiologic evaluation of febrile and hypothermic women...
2017: PloS One
https://www.readbyqxmd.com/read/28400686/convergence-of-minds-for-better-patient-outcome-in-intensive-care-unit-infections
#12
Chand Wattal, Yash Javeri, Neeraj Goel, Debashish Dhar, Sonal Saxena, Sarman Singh, Jaswinder Kaur Oberoi, B K Rao, Purva Mathur, Vikas Manchanda, Vivek Nangia, Arti Kapil, Ashok Rattan, Supradip Ghosh, Omender Singh, Vinod Singh, Iqbal Kaur, Sanghamitra Datta, Sharmila Sen Gupta
BACKGROUND: There is emergence of resistance to the last-line antibiotics such as carbapenems in Intensive Care Units (ICUs), leaving little effective therapeutic options. Since there are no more newer antibiotics in the armamentarium in the near future, it has become imperative that we harness the interdisciplinary knowledge for the best clinical outcome of the patient. AIMS: The aim of the conference was to utilize the synergies between the clinical microbiologists and critical care specialists for better patient care and clinical outcome...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399946/impact-of-a-multifaceted-antimicrobial-stewardship-program-a-front-line-ownership-driven-quality-improvement-project-in-a-large-urban-emergency-department
#13
Adam Jonathan Kaufman, Janine McCready, Jeff Powis
BACKGROUND: Antibiotic overuse has promoted growing rates of antimicrobial resistance and secondary antibiotic-associated infections such as Clostridium difficile (C. difficile). Antimicrobial stewardship programs (ASPs) are effective in reducing antimicrobial use in the inpatient setting; however, the unique environment of the emergency department (ED) lends itself to challenges for successful implementation. Front-line ownership (FLO) methodology has been shown to be a potentially effective strategy for the implementation of inpatient ASPs through an iterative multi-pronged approach driven by front-line providers...
April 12, 2017: CJEM
https://www.readbyqxmd.com/read/28395369/antibiotics-prescriptions-in-the-neonatal-intensive-care-unit-how-to-overcome-everyday-challenges
#14
D Donà, E Mozzo, V Mardegan, U Trafojer, P Lago, S Salvadori, E Baraldi, C Giaquinto
Antimicrobial prescriptions in neonatal intensive care units (NICUs) represent a point of concern for the emergence of MDROs and for morbidity associated with prolonged antibiotic exposure (e.g., invasive candidiasis, necrotizing enterocolitis, and late-onset sepsis). Antimicrobial stewardship programs (ASPs) have shown to be a valuable tool for the prevention of resistance with the goals of optimizing clinical outcomes while decreasing unnecessary prescribing. The most frequent ASP strategies include the correct collection and interpretation of microbiological specimens, prescription of the narrowest-spectrum antibiotic appropriate for a particular case, and de-escalation or discontinuation of therapy in defined situations...
April 10, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28385463/clinical-and-social-barriers-to-antimicrobial-stewardship-in-pulmonary-medicine-a-qualitative-study
#15
Jennifer K Broom, Alex F Broom, Emma R Kirby, Alexandra F Gibson, Jeffrey J Post
BACKGROUND: The treatment of pulmonary infections is one of the largest indications for antibiotics in human health care, offering significant potential for antibiotic optimization internationally. This study explores the perspectives of pulmonary clinicians on antibiotic use in hospital pulmonary infections. METHODS: Twenty-eight pulmonary doctors and nurses from 2 hospitals participated in semi-structured interviews focusing on their experiences of antibiotic use...
April 3, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28384858/antimicrobial-resistance-surveillance-among-intensive-care-units-of-a-tertiary-care-hospital-in-southern-india
#16
Kailash Moolchandani, Apurba Sankar Sastry, R Deepashree, Sujatha Sistla, B N Harish, Jharna Mandal
INTRODUCTION: Hospital Acquired Infections (HAIs) are the rising threat in the health care facilities across the globe. As most Intesive Care Unit (ICU) patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. AIM: To study the occurrence of different types of HAIs in patients admitted to various ICUs of JIPMER and the AMR pattern of the bacterial pathogens isolated from them...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28381609/the-modified-carbapenem-inactivation-method-mcim-for-phenotypic-detection-of-carbapenemase-production-among-enterobacteriaceae
#17
Virginia M Pierce, Patricia J Simner, David R Lonsway, Darcie E Roe-Carpenter, J Kristie Johnson, William B Brasso, April M Bobenchik, Zabrina C Lockett, Angella Charnot-Katsikas, Mary Jane Ferraro, Richard B Thomson, Stephen G Jenkins, Brandi M Limbago, Sanchita Das
The ability of clinical microbiology laboratories to reliably detect carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) is an important element of the effort to prevent and contain the spread of these pathogens and an integral part of antimicrobial stewardship. Existing methods each have limitations. A new, straightforward, inexpensive, and specific phenotypic method for the detection of carbapenemase production, the carbapenem inactivation method (CIM), was recently described. Here we describe a two-stage evaluation of a modified carbapenem inactivation method (mCIM), in which tryptic soy broth was substituted for water during the inactivation step and the length of this incubation was extended...
April 5, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28379408/sharing-antimicrobial-reports-for-pediatric-stewardship-sharps-a-quality-improvement-collaborative
#18
Jason G Newland, Jeffrey S Gerber, Matthew P Kronman, Georgann Meredith, Brian R Lee, Cary Thurm, Adam L Hersh
Background.: Although many children's hospitals have established antimicrobial stewardship programs (ASPs), data-driven benchmarks for optimizing antimicrobial use across centers are lacking. We developed a multicenter quality improvement collaborative focused on sharing data reports and benchmarking antimicrobial use to improve antimicrobial prescribing among hospitalized children. Methods.: A national antimicrobial stewardship collaborative among children's hospitals, Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS), was established in 2013...
April 4, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28379326/an-automated-pharmacist-driven-initiative-improves-quality-of-care-for-staphylococcus-aureus-bacteremia
#19
Eric Wenzler, Fei Wang, Debra A Goff, Beth Prier, John Mellett, Julie E Mangino, Karri A Bauer
Background: Infectious diseases (ID) consultation and antimicrobial stewardship intervention have been shown to improve the management of Staphylococcus aureus bacteremia (SAB). As the workload of antimicrobial stewardship programs (ASPs) continues to increase, ASPs must find a way to maximize the efficiency of the program while optimizing patient outcomes. The objective of this study was to evaluate the impact of incorporating health informatics into the management of SAB via a pharmacist-driven initiative...
April 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28376958/an-antimicrobial-stewardship-toolkit-to-promote-appropriate-antibiotic-prescribing-in-dental-practice
#20
Nikolaus Oa Palmer, Jamie Woodward
No abstract text is available yet for this article.
February 28, 2017: Primary Dental Journal
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