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Antimicrobial stewardship

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https://www.readbyqxmd.com/read/28526402/outpatient-antibiotic-stewardship-interventions-and-opportunities
#1
Erica L Dobson, Michael E Klepser, Jason M Pogue, Matthew J Labreche, Alex J Adams, Timothy P Gauthier, R Brigg Turner, Christy P Su, David M Jacobs, Katie J Suda
Improving the use of antibiotics across the continuum of care is a national priority. Data outlining the misuse of antibiotics in the outpatient setting justify the expansion of antibiotic stewardship programs (ASPs) into this health care setting; however, best practices for outpatient antibiotic stewardship (AS) are not yet defined. In a companion article, we focused on recommendations to overcome challenges related to the implementation of an outpatient ASP (e.g., building the AS team and defining program metrics)...
May 16, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#2
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28526309/antimicrobial-stewardship-for-hospitalized-patients-with-viral-respiratory-tract-infections
#3
Christopher F Lowe, Michael Payne, David Puddicombe, Allison Mah, Davie Wong, Allison Kirkwood, Mark W Hull, Victor Leung
BACKGROUND: The purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection. METHODS: This was a quasi-experimental before and after audit and feedback intervention of adult inpatients with a positive polymerase chain reaction for a respiratory virus in 2 acute care hospitals in Vancouver, Canada. Audit and feedback was implemented based on 2 criteria: microbiology (no positive bacterial cultures) and chest imaging (absence of pneumonia or consolidation on radiology dictation)...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28524255/enablers-and-barriers-to-the-use-of-antibiotic-guidelines-in-the-assessment-and-treatment-of-community-acquired-pneumonia-a-qualitative-study-of-clinicians-perspectives
#4
Antoine Sedrak, Mahesan Anpalahan, Karen Luetsch
BACKGROUND: Community-acquired pneumonia (CAP) is a common condition and a number of guidelines have been developed for its assessment and treatment. Adherence to guidelines by clinicians varies and particularly the prescribing of antibiotics often remains suboptimal. OBJECTIVE: The aim of this study was to elucidate potential barriers and enablers to the adherence to antibiotic guidelines by clinicians treating CAP in an Australian hospital. METHODS: Semi-structured interviews were conducted with purposively recruited senior prescribers who regularly treat CAP in an Australian hospital...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28520865/impact-of-an-integrated-antibiotic-allergy-testing-program-on-antimicrobial-stewardship-a-multicenter-evaluation
#5
Jason A Trubiano, Karin A Thursky, Andrew J Stewardson, Karen Urbancic, Leon J Worth, Cheryl Jackson, Wendy Stevenson, Michael Sutherland, Monica A Slavin, M Lindsay Grayson, Elizabeth J Phillips
Background.: Despite the high prevalence of patient-reported antibiotic allergy (so-called antibiotic allergy labels [AALs]) and their impact on antibiotic prescribing, incorporation of antibiotic allergy testing (AAT) into antimicrobial stewardship (AMS) programs (AAT-AMS) is not widespread. We aimed to evaluate the impact of an AAT-AMS program on AAL prevalence, antibiotic usage, and appropriateness of prescribing. Methods.: AAT-AMS was implemented at two large Australian hospitals during a 14-month period beginning May 2015...
May 18, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28516820/blogging-in-infectious-diseases-and-clinical-microbiology-assessment-of-blogosphere-content
#6
Gabriel Birgand, Rachael Troughton, Luke S P Moore, Esmita Charani, Timothy M Rawson, Enrique Castro-Sánchez, Alison H Holmes
OBJECTIVE To analyze influential infectious diseases, antimicrobial stewardship, infection control, or medical microbiology blogs and bloggers SETTING World wide web DESIGN We conducted a systematic search for blogs in accordance with the PRISMA guidelines in September 2015. METHODS A snowball sampling approach was applied to identify blogs using various search engines. Blogs were eligible if they (1) focused on infectious diseases, antimicrobial stewardship, infection control, or medical microbiology; (2) were intended for health professionals; and (3) were written in English and (4) were updated regularly...
May 18, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28514013/antimicrobial-prescribing-in-dogs-and-cats-in-australia-results-of-the-australasian-infectious-disease-advisory-panel-survey
#7
L Y Hardefeldt, S Holloway, D J Trott, M Shipstone, V R Barrs, R Malik, M Burrows, S Armstrong, G F Browning, M Stevenson
BACKGROUND: Investigations of antimicrobial use in companion animals are limited. With the growing recognition of the need for improved antimicrobial stewardship, there is urgent need for more detailed understanding of the patterns of antimicrobial use in this sector. OBJECTIVES: To investigate antimicrobial use for medical and surgical conditions in dogs and cats by Australian veterinarians. METHODS: A cross-sectional study was performed over 4 months in 2011...
May 17, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28503879/impact-of-an-antimicrobial-stewardship-intervention-on-appropriateness-of-prescribing-for-community-acquired-pneumonia-in-an-australian-regional-hospital
#8
Stuart E Bond, Craig S Boutlis, Wilfred W Yeo, Spiros Miyakis
Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP.
May 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28499717/a-call-to-action-for-outpatient-antibiotic-stewardship
#9
Michael E Klepser, Erica L Dobson, Jason M Pogue, Matthew J Labreche, Alex J Adams, Timothy P Gauthier, R Brigg Turner, Christy P Su, David M Jacobs, Katie J Suda
OBJECTIVES: To address the public health threat of antibiotic resistance, there has been an enhanced call for antibiotic stewardship programs throughout the health care continuum. SUMMARY: While antibiotic stewardship programs have been well described in the inpatient setting, data on effectiveness and guidance on implementing outpatient programs is scarce. Establishing stewardship practices in the outpatient setting is necessary because more than 60% of human antibiotic use occurs in this setting...
May 9, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28499421/patterns-of-use-and-appropriateness-of-antibiotics-prescribed-to-patients-receiving-haemodialysis-an-observational-study
#10
Katrina Hui, Michelle Nalder, Kirsty Buising, Aspasia Pefanis, Khai Y Ooi, Eugenie Pedagogos, Craig Nelson, Carl M J Kirkpatrick, David C M Kong
BACKGROUND: There are limited published data on the types and appropriateness of oral and intravenous (IV) antibiotics prescribed to patients receiving haemodialysis. This information is critical to optimise antibiotic prescribing. Therefore this study aims to describe the patterns of use and the appropriateness of oral and IV antibiotics prescribed to patients receiving haemodialysis. METHODS: This was a prospective, observational study across four community and two hospital inpatient haemodialysis units in Melbourne, Australia...
May 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28490386/pharmacists-familiarity-with-and-institutional-utilization-of-rapid-diagnostic-technologies-for-antimicrobial-stewardship
#11
Rachel A Foster, Kristi Kuper, Z Kevin Lu, P Brandon Bookstaver, Christopher M Bland, Monica V Mahoney
Rapid diagnostic technologies (RDTs) significantly reduce organism identification time and can augment antimicrobial stewardship program (ASP) activities. An electronic survey quantified familiarity with and utilization of RDTs by clinical pharmacists participating in ASPs. Familiarity was highest with polymerase chain reaction (PCR). Formal infectious diseases training was the only significant factor influencing RDT familiarity. Infect Control Hosp Epidemiol 2017;1-4.
May 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28487582/antimicrobial-stewardship-initiative-in-treatment-of-urinary-tract-infections-at-a-rehabilitation-and-complex-continuing-care-hospital
#12
Anne Cheung, Gulzar Karmali, Sandina Noble, Howard Song
No abstract text is available yet for this article.
March 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28485087/impact-of-an-antimicrobial-stewardship-programme-on-antibiotic-usage-and-resistance-in-a-tertiary-hospital-in-china
#13
Z-G Zhang, F Chen, Y Ou
WHAT IS KNOWN AND OBJECTIVE: Antimicrobial misuse has been commonly observed in China. This phenomenon can cause antibiotic resistance. This study was designed to evaluate the impact of an antimicrobial stewardship programme implemented in a tertiary hospital in China from 2011 to 2014. METHODS: The antimicrobial stewardship programme began in 2011. Data on the consumption of antibiotics and antimicrobial resistance between 2011 and 2014 were collected. RESULTS: Comparison of the 2011 data with those of 2014 showed that antibiotic defined daily doses/per 100 patient-days decreased from 92...
May 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28480770/an-update-on-the-pharmacotherapeutic-management-of-lower-respiratory-tract-infections
#14
Mario Cazzola, Paola Rogliani, Stefano Aliberti, Francesco Blasi, Maria Gabriella Matera
Our knowledge about lower respiratory tract infections (LRTIs) has improved substantially in the last years, but the management of respiratory infections is still a challenge and we are still far from precision medicine in the treatment of LRTIs. Areas covered: The approaches developed in recent years to improve the pharmacotherapeutic management of LRTIs, such as novel diagnostic assays to facilitate medical decision-making, attempts for selecting an optimal empiric antibiotic regimen, and the role of new and possibly unproven adjunctive therapies, are described...
May 6, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28480243/colonization-with-vancomycin-resistant-enterococci-and-risk-for-bloodstream-infection-among-patients-with-malignancy-a-systematic-review-and-meta-analysis
#15
Michail Alevizakos, Apostolos Gaitanidis, Dimitrios Nasioudis, Katerina Tori, Myrto Eleni Flokas, Eleftherios Mylonakis
BACKGROUND: Vancomycin-resistant enterococci (VRE) cause severe infections among patients with malignancy, and these infections are usually preceded by gastrointestinal colonization. METHODS: We searched the PubMed and EMBASE databases (up to May 26, 2016) to identify studies that reported data on VRE gastrointestinal colonization among patients with solid or hematologic malignancy. RESULTS: Thirty-four studies, reporting data on 8391 patients with malignancy, were included in our analysis...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28480242/outcomes-associated-with-antimicrobial-de-escalation-of-treatment-for-pneumonia-within-the-veterans-healthcare-administration
#16
Jefferson G Bohan, Richard Remington, Makoto Jones, Matthew Samore, Karl Madaras-Kelly
De-escalation, an antimicrobial stewardship concept, involves narrowing broad-spectrum empiric antimicrobial therapy based on clinical data. Current health outcomes evidence is lacking to support de-escalation. Studying Veterans Healthcare Administration pneumonia patients, de-escalation was associated with improved length of stay without affecting 30-day readmission or 30-day Clostridium difficile infection rates.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28480231/an-interprofessional-curriculum-on-antimicrobial-stewardship-improves-knowledge-and-attitudes-toward-appropriate-antimicrobial-use-and-collaboration
#17
Conan MacDougall, Brian S Schwartz, Lisa Kim, Mari Nanamori, Sharmin Shekarchian, Peter V Chin-Hong
BACKGROUND: Inappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare. METHODS: We created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28476493/promoting-appropriate-urine-culture-management-to-improve-health-care-outcomes-and-the-accuracy-of-catheter-associated-urinary-tract-infections
#18
REVIEW
Robert Garcia, Eric D Spitzer
Published literature indicates that the unjustified ordering or improper collection of urine for urinalysis or culture from either catheterized patients or those without indwelling devices, or misinterpretation of positive results, often leads to adverse health care events, including increased financial burdens, overreporting of mandated catheter-associated urinary tract infection events, overtreatment of patients with antimicrobial agents, selection of multidrug-resistant organisms, and Clostridium difficile infection...
May 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28475792/clinical-and-molecular-epidemiology-of-carbapenem-resistant-enterobacteriaceae-among-adult-inpatients-in-singapore
#19
Kalisvar Marimuthu, Indumathi Venkatachalam, Wei Xin Khong, Tse Hsien Koh, Benjamin Pei Zhi Cherng, My Van La, Partha Pratim De, Prabha Unny Krishnan, Thean Yen Tan, Raymond Fong Kok Choon, Surinder Kaur Pada, Choong Weng Lam, Say Tat Ooi, Rama Narayana Deepak, Nares Smitasin, Eng Lee Tan, Jia Jun Lee, Asok Kurup, Barnaby Young, Nancy Tee Wen Sim, Koh Cheng Thoon, Dale Fisher, Moi Lin Ling, Brenda Ang Sze Peng, Yik-Ying Teo, Li Yang Hsu, Raymond Tzer Pin Lin, Rick Twee-Hee Ong, Jeanette Teo, Oon Tek Ng
Background: Since 2010, the incidence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing in Singapore. We analyzed the clinical and molecular epidemiology of CRE among adult inpatients in Singapore. Methods: Quarterly incidence of unique subjects (per 100000 patient-days) with positive clinical and surveillance cultures for CRE were estimated based on mandatory data submitted to the National Public Health Laboratory by public hospitals between 2010 and 2015...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28475791/prevention-and-control-of-multidrug-resistant-gram-negative-bacteria-in-adult-intensive-care-units-a-systematic-review-and-network-meta-analysis
#20
Nattawat Teerawattanapong, Kirati Kengkla, Piyameth Dilokthornsakul, Surasak Saokaew, Anucha Apisarnthanarak, Nathorn Chaiyakunapruk
Background: This study evaluated the relative efficacy of strategies for the prevention of multidrug-resistant gram-negative bacteria (MDR-GNB) in adult intensive care units (ICUs). Methods: A systematic review and network meta-analysis was performed; searches of the Cochrane Library, PubMed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) included all randomized controlled trials and observational studies conducted in adult patients hospitalized in ICUs and evaluating standard care (STD), antimicrobial stewardship program (ASP), environmental cleaning (ENV), decolonization methods (DCL), or source control (SCT), simultaneously...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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