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Antimicrobial stewardship

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https://www.readbyqxmd.com/read/28083399/antimicrobial-stewardship-the-effectiveness-of-educational-interventions-to-change-risk-related-behaviours-in-the-general-population-a-systematic-review
#1
Sarah King, Josephine Exley, Jirka Taylor, Kristy Kruithof, Jody Larkin, Mafalda Pardal
RAND Europe undertook a systematic review of the evidence of effectiveness and cost effectiveness on changing the public's risk related behaviour pertaining to antimicrobial use to inform the development of a NICE public health guideline aimed at delaying antimicrobial resistance (AMR). The review considered educational interventions targeting individuals, communities or the general public delivered via any mode. Specifically, it aimed to address: 1. Which educational interventions are effective and cost-effective in changing the public's behaviour to ensure they only ask for antimicrobials when appropriate and use them correctly? 2...
January 29, 2016: Rand Health Q
https://www.readbyqxmd.com/read/28082302/impact-of-a-national-antimicrobial-stewardship-mentoring-program-insights-and-lessons-learned
#2
Debra A Goff, George H Karam, Stuart T Haines
PURPOSE: The impact of an interprofessional mentoring program to advance antimicrobial stewardship programs (ASPs) in selected U.S. hospitals and lessons learned are described. SUMMARY: A seven-step mentoring process with self-assessment, telephone calls, continuing education, a one-day onsite visit, action plan, and outcome data collection and analysis was provided to ASP teams at nine hospitals. Six hospitals completed the program. A significant improvement in the timeliness and appropriateness of i...
January 12, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28079629/duration-of-pneumonia-therapy-and-the-role-of-biomarkers
#3
Katerina Kaziani, Adamantia Sotiriou, George Dimopoulos
PURPOSE OF REVIEW: Increasing antimicrobial resistance is a worldwide phenomenon that is threatening public health. Lower respiratory infections are one of the leading causes of morbidity that contribute to antibiotic consumption and thus the emergence of multidrug-resistant microbial strains. The goal of shortening antibiotic regimens' duration in common bacterial infections has been prioritized by antimicrobial stewardship programs as an action against this problem. RECENT FINDINGS: Data coming from randomized controlled trials, meta-analyses, and systematic reviews support the shortening of antimicrobial regimens in community-acquired, hospital-acquired, and ventilator-associated pneumonia...
January 12, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28074531/antibiotic-use-during-infectious-episodes-in-the-first-6-months-of-anticancer-treatment-a-swedish-cohort-study-of-children-aged-7-16-years
#4
M Af Sandeberg, E Johansson, L Wettergren, O Björk, O Hertting, A Nilsson
BACKGROUND: Children undergoing cancer therapy are at risk for infectious complications that require hospitalization and antimicrobial therapy. Host factors such as age and underlying disease may predict the risk of severe infections in these children. To describe the increased morbidity due to infections in children with cancer, we characterized the antibiotic use during the infectious complications in a national cohort of children 7-16 years of age with cancer. PROCEDURE: Data on infectious complications were prospectively collected from the medical records of all newly diagnosed children with cancer, aged 7-16 years, in Sweden between 2004 and 2006...
January 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28073966/extended-stability-of-antimicrobial-agents-in-administration-devices
#5
Abi Jenkins, Tim Hills, Mark Santillo, Mark Gilchrist
BACKGROUND: Outpatient parenteral antimicrobial therapy (OPAT) is an established approach to patient care. A lack of data on antimicrobial stability within administration devices is a barrier to service expansion, and poses an antimicrobial stewardship dilemma. Often broad-spectrum, long half-life agents are used instead of narrow-spectrum agents, which need more frequent administration, but could possibly be used if stability data were available. OBJECTIVES: To complete a comprehensive literature review of published antimicrobial stability data, and assess these against a nationally recognized minimum dataset for medicines compounded into administration devices...
January 10, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28065331/antimicrobial-stewardship-in-kansas-results-from-a-statewide-survey
#6
Carrie Poteete, Joseph M Scaletta
BACKGROUND: The availability of effective antibiotics is considered one of the most important developments in medicine. However, many organisms that were once susceptible to common antibiotics are becoming resistant. Antimicrobial stewardship programs (ASPs) are considered to be vital for combating the emergence of resistance. To understand current antimicrobial stewardship practices in Kansas, the authors designed a 36-question survey. Results of this survey will be used to develop a coordinated, public health strategy for improving current practices...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28064452/in-vitro-data-support-the-investigation-of-vinegar-as-an-antimicrobial-agent-for-pd-associated-pseudomonas-exit-site-infections
#7
Christine F Carson, Oliver Ash, Aron Chakera
Peritoneal dialysis exit site infections caused by Pseudomonas spp. are difficult to treat and can lead to peritonitis and/or modality failure. Effective alternative or adjunct non-antibiotic antimicrobial agents could improve treatment as well as reduce the use of antibiotics and contribute to a reduction in antibiotic selection pressure and the further development of antibiotic resistance. Vinegar is popularly promoted as a topical antimicrobial agent and has been recommended as an adjunct treatment for Pseudomonas exit site infections in PD patients...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28056839/molecular-epidemiology-of-bla-oxa-23-producing-carbapenem-resistant-acinetobacter-baumannii-in-a-single-institution-over-a-65-month-period-in-north-china
#8
Nian-Zhi Ning, Xiong Liu, Chun-Mei Bao, Su-Ming Chen, En-Bo Cui, Ju-Ling Zhang, Jie Huang, Fang-Hong Chen, Tao Li, Fen Qu, Hui Wang
BACKGROUND: Carbapenem-resistant Acinetobacter baumannii poses a significant threat to hospitalized patients, as few therapeutic options remain. Thus, we investigated the molecular epidemiology and mechanism of resistance of carbapenem-resistant A.baumannii isolates in Beijing, China. METHODS: Carbapenem-resistant A.baumannii isolates (n = 101) obtained between June 2009 and November 2014 were used. Multilocus sequence typing (MLST) and PCR assays for class C and D β-lactamase were performed on all isolates...
January 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28056822/the-first-occurrence-of-a-ctx-m-esbl-producing-escherichia-coli-outbreak-mediated-by-mother-to-neonate-transmission-in-an-irish-neonatal-intensive-care-unit
#9
Ciara O'Connor, Roy K Philip, John Kelleher, James Powell, Alan O'Gorman, Barbara Slevin, Neil Woodford, Jane F Turton, Elaine McGrath, Cathriona Finnegan, Lorraine Power, Nuala H O'Connell, Colum P Dunne
BACKGROUND: Escherichia coli (E. coli) comprise part of the normal vaginal microflora. Transfer from mother to neonate can occur during delivery resulting, sometimes, in neonatal bacterial disease. Here, we aim to report the first outbreak of CTX-M ESBL-producing E. coli with evidence of mother-to-neonate transmission in an Irish neonatal intensive care unit (NICU) followed by patient-to-patient transmission. METHODS: Investigation including molecular typing was conducted...
January 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28054236/antibiotic-resistance-patterns-of-escherichia-coli-urinary-isolates-and-comparison-with-antibiotic-consumption-data-over-10%C3%A2-years-2005-2014
#10
P J Stapleton, D J Lundon, R McWade, N Scanlon, M M Hannan, F O'Kelly, M Lynch
INTRODUCTION: Escherichia coli is a common cause of urinary tract infections (UTI). Reviews of antibiotic resistance of this organism can inform choice of empiric treatment of UTI and other infections and strategies for combating antimicrobial resistance. We reviewed laboratory and hospital pharmacy records to assess trends in non-susceptibility rates and the effect of antimicrobial stewardship interventions. METHODS: A retrospective observational study of isolates of E...
January 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28042151/estimated-antimicrobial-dispensing-frequency-and-preferences-for-lactating-cow-therapy-by-ontario-dairy-veterinarians
#11
David F Léger, Nathalie C Newby, Richard Reid-Smith, Neil Anderson, David L Pearl, Kerry D Lissemore, David F Kelton
In this cross-sectional study, data were collected from responses to a questionnaire on dispensing frequencies of antimicrobials used by dairy practitioners in Ontario in dairy cattle in 2001. Data were validated through clinical case scenarios. Respondents reported using antimicrobials across all categories of importance to human medicine (medically important, Categories I to III) with a diversity of treatment combinations and routes of administration. Respondents anticipated that a request for direct veterinary supervision by producers was dependent on case severity, highlighting the importance of on-farm diagnostic and treatment protocols...
January 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28035690/%C3%AE-lactam-therapy-for-methicillin-susceptible-staphylococcus-aureus-bacteremia-a-comparative-review-of-cefazolin-versus-antistaphylococcal-penicillins
#12
Julius Li, Kelly L Echevarria, Kristi A Traugott
Methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia is associated with high morbidity and mortality. Traditionally, antistaphylococcal penicillins (ASPs) have been considered the agents of choice for the treatment of MSSA bacteremia. Vancomycin has been demonstrated to have poorer outcomes in several studies and is only recommended for patients with severe penicillin allergies. Although cefazolin is considered as an alternative to the ASPs for patients with nonsevere penicillin allergies, cefazolin offers several pharmacologic advantages over ASPs, such as more convenient dosing regimens, and antimicrobial stewardship programs are increasingly using cefazolin as the preferential agent for MSSA infections as part of cost-saving initiatives...
December 30, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28034535/journal-club-social-media-as-an-antimicrobial-stewardship-tool
#13
Laurie J Conway, Shanina C Knighton
No abstract text is available yet for this article.
December 26, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/28034534/antimicrobial-stewardship-practices-in-virginia
#14
Kimberly B Lee, Jesus Aaron Ramirez, Rebeccah Collins, John Bucheit, Kakotan Sanogo, Michael P Stevens
The Society of Healthcare Epidemiology of America, the Centers for Disease Control and Prevention, and the President's Council of Advisors on Science and Technology recognize the need to combat antimicrobial resistance through the promotion of antimicrobial stewardship programs. Health care facilities in Virginia were surveyed using a 23-item survey focused on facility characteristics and antimicrobial stewardship strategies. Antimicrobial stewardship activities were highly variable and many are missing key personnel and resources...
December 26, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/28031432/implementation-of-rapid-molecular-infectious-disease-diagnostics-the-role-of-diagnostic-and-antimicrobial-stewardship
#15
Kevin Messacar, Sarah K Parker, James K Todd, Samuel R Dominguez
New rapid molecular infectious disease diagnostic technologies enable expedited accurate microbiologic diagnoses. However, diagnostic and antimicrobial stewardship are necessary to ensure these technologies conserve, rather than consume, additional health care resources and optimally impact patient care. Diagnostic stewardship is needed to implement appropriate tests for the clinical setting and direct testing towards appropriate patients. Antimicrobial stewardship is needed to ensure prompt, appropriate clinical action to translate faster diagnostic test results in the laboratory into improved outcomes at the bedside...
December 28, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28031074/improving-the-culture-of-culturing-critical-asset-to-antimicrobial-stewardship
#16
Mohamad G Fakih, Riad Khatib
No abstract text is available yet for this article.
December 29, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28028434/infection-prevention-and-control-of-clostridium-difficile-a-global-review-of-guidelines-strategies-and-recommendations
#17
Evelyn Balsells, Teodora Filipescu, Moe H Kyaw, Camilla Wiuff, Harry Campbell, Harish Nair
BACKGROUND: Clostridium difficile is the leading cause of health care-associated infections. Given the high incidence of C. difficile infection (CDI) and the lack of primary prevention through immunization, health care professionals should be aware of the most current guidance, as well as strengths and limitations of the evidence base underpinning this guidance. METHODS: We identified publicly available national or organizational guidelines related to CDI infection and prevention control (IPC) published between 2000 and 2015 and for any health care setting through an internet search using the Google search engine...
December 2016: Journal of Global Health
https://www.readbyqxmd.com/read/28012684/bioavailability-of-voriconazole-in-hospitalised-patients
#18
Anette Veringa, Sanne Geling, Lambert F R Span, Karin M Vermeulen, Jan G Zijlstra, Tjip S van der Werf, Jos G W Kosterink, Jan-Willem C Alffenaar
An important element in antimicrobial stewardship programmes is early switch from intravenous (i.v.) to oral antimicrobial treatment, especially for highly bioavailable drugs. The antifungal agent voriconazole is available both in i.v. and oral formulations and bioavailability is estimated to be >90% in healthy volunteers, making this drug a suitable candidate for such a transition. Recently, two studies have shown that the bioavailability of voriconazole is substantially lower in patients. However, for both studies various factors that could influence the voriconazole serum concentration, such as inflammation, concomitant intake of food with oral voriconazole, and gastrointestinal complications, were not included in the evaluation...
November 23, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28010959/urine-culture-guided-antibiotic-interventions-a-pharmacist-driven-antimicrobial-stewardship-effort-in-the-emergency-department
#19
Xi Zhang, Nicole Rowan, Bethann Mangel Pflugeisen, Sanjin Alajbegovic
BACKGROUND: Antibiotics are overprescribed for abnormal urine tests including asymptomatic bacteriuria (AB), contributing to rising antimicrobial resistance rates. Pharmacists reviewed urine cultures daily from emergency department (ED) encounters to assess antibiotic appropriateness. We studied antibiotic prescribing practices and assessed compliance to national guidelines, correlations with urine analysis (UA) components, and opportunities for antimicrobial stewardship in the ED. METHODS: This quality improvement project (QIP) was a prospective cohort study at a community hospital ED, with data collected from finalized urine cultures resulting October 30, 2014 through January 5, 2015...
December 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28005932/the-use-of-procalcitonin-pct-for-diagnosis-of-sepsis-in-burn-patients-a-meta-analysis
#20
Luís Cabral, Vera Afreixo, Luís Almeida, José Artur Paiva
The continuous development of resuscitation techniques and intensive care reduced the mortality rate induced by the initial shock in burn patients and, currently, infections (especially sepsis) are the main causes of mortality of these patients. The misuse of antimicrobial agents is strongly related to antimicrobial and adverse patient outcomes, development of microbial resistance and increased healthcare-related costs. To overcome these risks, antimicrobial stewardship is mandatory and biomarkers are useful to avoid unnecessary medical prescription, to monitor antimicrobial therapy and to support the decision of its stop...
2016: PloS One
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