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Antibiotic stewardship

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https://www.readbyqxmd.com/read/28207078/emerging-infectious-diseases-animals-and-future-epidemics
#1
Herbert L DuPont
Emerging and reemerging infections have become prevalent in the United States since the 1970s, causing illness, death, and fear among the public. The published literature was reviewed to offer a perspective on risk factors for disease acquisition and to allow a prediction of the next microbial assault after Ebola and Zika. Four well-integrated factors likely will contribute simultaneously: animals colonized or infected by pathogens capable of human transmission, microbes recurrently changing their virulence, a growing number of susceptible people, and climatic and environmental factors encouraging disease transmission...
February 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28202493/a-klebsiella-pneumoniae-antibiotic-resistance-mechanism-that-subdues-host-defences-and-promotes-virulence
#2
Timothy J Kidd, Grant Mills, Joana Sá-Pessoa, Amy Dumigan, Christian G Frank, José L Insua, Rebecca Ingram, Laura Hobley, José A Bengoechea
Klebsiella pneumoniae is an important cause of multidrug-resistant infections worldwide. Recent studies highlight the emergence of multidrug-resistant K. pneumoniae strains which show resistance to colistin, a last-line antibiotic, arising from mutational inactivation of the mgrB regulatory gene. However, the precise molecular resistance mechanisms of mgrB-associated colistin resistance and its impact on virulence remain unclear. Here, we constructed an mgrB gene K. pneumoniae mutant and performed characterisation of its lipid A structure, polymyxin and antimicrobial peptide resistance, virulence and inflammatory responses upon infection...
February 15, 2017: EMBO Molecular Medicine
https://www.readbyqxmd.com/read/28197223/a-multifaceted-approach-to-decrease-inappropriate-antibiotic-use-in-a-pediatric-outpatient-clinic
#3
Jaffar A Al-Tawfiq, Amel H Alawami
BACKGROUND: Inappropriate use of antimicrobial agents is the major cause for the development of resistance. Thus, it is important to include outpatient clinics in the development of antibiotic stewardship program. METHODS: We report a multifaceted approach to decrease inappropriate antibiotic use in upper respiratory tract infections (URTIs) in an outpatient pediatric clinic. The interventions included educational grand round, academic detailing, and prospective audit and feedback and peer comparison...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28189411/an-online-course-improves-nurses-awareness-of-their-role-as-antimicrobial-stewards-in-nursing-homes
#4
Brigid M Wilson, Sue Shick, Rebecca R Carter, Barbara Heath, Patricia A Higgins, Basia Sychla, Danielle M Olds, Robin L P Jump
BACKGROUND: To support the role of nurses as active proponents of antimicrobial stewardship in long-term care facilities, we developed an educational intervention consisting of a free online course comprised of 6 interactive modules. Here, we report the effect of the course on the knowledge, beliefs, and attitudes toward antimicrobial stewardship of nurses working in long-term care facilities. METHODS: We used a paired pre- and postcourse survey instrument to assess nurses' knowledge regarding the care of long-term care facility residents with infections and attitudes and beliefs regarding antimicrobial stewardship...
February 8, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28187481/-hospital-antibiotic-stewardship-new-guidelines-and-new%C3%A2-findings
#5
Katja de With, Katja Wilke, Gesche Först, Evelyn Kramme, Winfried V Kern
No abstract text is available yet for this article.
February 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28187059/clinical-and-microbiologic-characteristics-of-early-onset-sepsis-among-vlbw-infants-opportunities-for-antibiotic-stewardship
#6
Sagori Mukhopadhyay, Karen M Puopolo
BACKGROUND: Most very-low birth weight (birth weight <1500 grams, VLBW) infants receive empiric antibiotics for risk of early-onset sepsis (EOS). The objective of this study was to determine the characteristics of VLBW infants with culture-confirmed EOS at a single center during 25 years, to identify opportunities for antibiotic stewardship. METHODS: Retrospective cohort study including VLBW infants admitted from 1990-2015. EOS was defined as isolation of a pathogen in blood or cerebrospinal fluid culture obtained < 72 hours of age...
February 9, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28186948/patient-and-physician-attitudes-regarding-risk-and-benefit-in-streamlined-development-programmes-for-antibacterial-drugs-a-qualitative-analysis
#7
Thomas L Holland, Stephen Mikita, Diane Bloom, Jamie Roberts, Jonathan McCall, Deborah Collyar, Jonas Santiago, Rosemary Tiernan, Joseph Toerner
OBJECTIVES: To explore patient, caregiver and physician perceptions and attitudes regarding the balance of benefit and risk in using antibacterial drugs developed through streamlined development processes. DESIGN: Semistructured focus groups and in-depth interviews were conducted to elicit perceptions and attitudes about the use of antibacterial drugs to treat multidrug-resistant infections. Participants were given background information about antibiotic resistance, streamlined drug development programmes and FDA drug approval processes...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28179620/effectiveness-of-antibiotic-use-management-in-tianjin-2011-2013-a-quasi-experimental-study
#8
Hai-Hong Zhang, Yue Du, Wei Liu, Shi-Duo Song, Wen Zhao, Guo-Wei Huang, He-Sheng Wang
BACKGROUND In this study we investigated changes in the status of antibiotic use in Tianjin since the implementation of the Antibiotic Stewardship Program (ASP) (2011-2013), as well as existing problems, strategies, and outcomes to promote rational clinical antibiotic use. MATERIAL AND METHODS A quasi-experimental study was performed to investigate situations of antibiotic use in secondary and tertiary general hospitals in Tianjin from April 2011 to 2013. Five major indicators were analyzed: percentage of antibiotic use in inpatient cases (%), antibacterial use density (AUD), proportion of prophylactic antibiotic application for type I surgical incision, compliance rate of medication administration 0...
February 9, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28179249/penicillin-skin-testing-as-an-antimicrobial-stewardship-initiative
#9
Bruce M Jones, Christopher M Bland
PURPOSE: An initiative to determine the effects of penicillin skin testing (PST) from an antimicrobial stewardship perspective is described. SUMMARY: Penicillin allergy is one of the most frequently reported allergies; however, only about 10% of self-reports of penicillin allergy are accurate. Incorrect penicillin allergies are therefore a significant barrier to antimicrobial stewardship, with important clinical and economic implications, including increased antimicrobial resistance, an increased overall cost of care, increased length of stay, and, ultimately, increased mortality...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28178770/interventions-to-improve-antibiotic-prescribing-practices-for-hospital-inpatients
#10
REVIEW
Peter Davey, Charis A Marwick, Claire L Scott, Esmita Charani, Kirsty McNeil, Erwin Brown, Ian M Gould, Craig R Ramsay, Susan Michie
BACKGROUND: Antibiotic resistance is a major public health problem. Infections caused by multidrug-resistant bacteria are associated with prolonged hospital stay and death compared with infections caused by susceptible bacteria. Appropriate antibiotic use in hospitals should ensure effective treatment of patients with infection and reduce unnecessary prescriptions. We updated this systematic review to evaluate the impact of interventions to improve antibiotic prescribing to hospital inpatients...
February 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28174914/penicillin-allergy-testing-a-key-component-of-antibiotic-stewardship
#11
Eric Macy, David A Khan, Mariana C Castells, David M Lang
No abstract text is available yet for this article.
February 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28173888/current-state-of-antimicrobial-stewardship-in-children-s-hospital-emergency-departments
#12
Rakesh D Mistry, Jason G Newland, Jeffrey S Gerber, Adam L Hersh, Larissa May, Sarah M Perman, Nathan Kuppermann, Peter S Dayan
BACKGROUND Antimicrobial stewardship programs (ASPs) effectively optimize antibiotic use for inpatients; however, the extent of emergency department (ED) involvement in ASPs has not been described. OBJECTIVE To determine current ED involvement in children's hospital ASPs and to assess beliefs and preferred methods of implementation for ED-based ASPs. METHODS A cross-sectional survey of 37 children's hospitals participating in the Sharing Antimicrobial Resistance Practices collaboration was conducted. Surveys were distributed to ASP leaders and ED medical directors at each institution...
February 8, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28165758/early-antibiotic-exposure-and-risk-of-childhood-obesity-in-latinos
#13
Annette P Ville, Melvin B Heyman, Rosalinda Medrano, Janet M Wojcicki
We investigated the relationship between early antibiotic exposure before 6 months age and risk for obesity at 2 years in a high-risk, low-income, urban Latino cohort (n = 97), with the hypothesis that antibiotic exposure would increase risk for obesity by 2 years. Data were collected through maternal report of infant 24-hour dietary intake at 4-6 weeks, 6 months, 1, and 2 years; and food frequency questionnaires at 4-6 weeks, 6 months, 1, and 2 years. Antibiotic use data, including type and frequency, were collected through maternal self-report at 6 months and 1 year...
February 6, 2017: Childhood Obesity
https://www.readbyqxmd.com/read/28160952/antibiotic-trends-amid-multidrug-resistant-gram-negative-infections-in-intensive-care-units
#14
REVIEW
Leanne H Fowler, Susan Lee
Isolates from ICUs most commonly find multidrug-resistant (MDR) gram-negative bacteria. The purpose of this article is to discuss the significant impact MDR gram-negative infections are having on ICUs, the threat on health and mortality, and effective and new approaches aimed to combat MDR gram-negative infections in critically ill populations. Inappropriate antibiotic therapies for suspected or documented infections are the leading cause of the emergence of bacterial resistance. A variety of strategies are aimed at combatting this international burden via antibiotic stewardship programs...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160269/infections-in-cancer-patients-with-solid-tumors-a-review
#15
REVIEW
Kenneth V I Rolston
Solid tumors are much more common than hematologic malignancies. Although severe and prolonged neutropenia is uncommon, several factors increase the risk of infection in patients with solid tumors, and the presence of multiple risk factors in the same patient is not uncommon. These include obstruction (most often caused by progression of the tumor), disruption of natural anatomic barriers such as the skin and mucosal surfaces, and treatment-related factors such as chemotherapy, radiation, diagnostic and/or therapeutic surgical procedures, and the increasing use of medical devices such as various catheters, stents, and prostheses...
February 3, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28160023/the-intensive-care-medicine-research-agenda-on-multidrug-resistant-bacteria-antibiotics-and-stewardship
#16
REVIEW
Marin H Kollef, Matteo Bassetti, Bruno Francois, Jason Burnham, George Dimopoulos, Jose Garnacho-Montero, Jeffrey Lipman, Charles-Edouard Luyt, David P Nicolau, Maarten J Postma, Antonio Torres, Tobias Welte, Richard G Wunderink
PURPOSE: To concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to the management of multidrug-resistant (MDR) bacteria, antibiotic use, and antimicrobial stewardship in the intensive care unit (ICU) setting. METHODS: Narrative review based on a systematic analysis of the medical literature, national and international guidelines, and expert opinion...
February 4, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28159174/antimicrobial-therapy-for-legionnaire-s-disease-antibiotic-stewardship-implications
#17
REVIEW
Cheston B Cunha, Burke A Cunha
Legionnaire's disease is a common cause of community-acquired pneumonia (CAP). Although no single clinical feature is diagnostic, if characteristic extrapulmonary findings are present a presumptive clinical syndromic diagnosis is possible. Depending on geographic location, season, and physician awareness, Legionnaire's disease may be included in the differential diagnosis of CAP. Some antibiotics effective against Legionella sp are also effective in treating the typical bacterial causes of CAP. From an antimicrobial stewardship program (ASP) perspective, monotherapy is preferred to double-drug therapy...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28155020/risks-factors-and-outcomes-of-clostridium-difficile-infection-in-patients-with-cancer-a-matched-case-control-study
#18
Andrew I T Hebbard, Monica A Slavin, Caroline Reed, Jason A Trubiano, Benjamin W Teh, Gabrielle M Haeusler, Karin A Thursky, Leon J Worth
PURPOSE: Clostridium difficile infection (CDI) is the leading cause of diarrhoea in hospitalised patients. Cancer populations are at high-risk for infection, but comprehensive evaluation in the current era of cancer care has not been performed. The objective of this study was to describe characteristics, risk factors, and outcomes of CDI in cancer patients. METHODS: Fifty consecutive patients with CDI at a large Australian cancer centre (2013-2015) were identified from the hospital pathology database...
February 2, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28155015/nitrofurantoin-safety-and-effectiveness-in-treating-acute-uncomplicated-cystitis-auc-in-hospitalized-adults-with-renal-insufficiency-antibiotic-stewardship-implications
#19
B A Cunha, C B Cunha, B Lam, J Giuga, J Chin, V F Zafonte, S Gerson
Nitrofurantoin remains a key oral antibiotic stewardship program (ASP) option in the treatment of acute uncomplicated cystitis (AUC) due to multi-drug resistant (MDR) Gram negative bacilli (GNB). However, there have been concerns regarding decreased nitrofurantoin efficacy with renal insufficiency. In our experience over the past three decades, nitrofurantoin has been safe and effective in treating AUC in hospitalized adults with renal insufficiency. Accordingly, we retrospectively reviewed our recent experience treating AUC in hospitalized adults with decreased renal function (CrCl < 60 ml/min) with nitrofurantoin...
February 2, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28152171/mixed-methods-pilot-study-to-assess-perceptions-of-antimicrobial-stewardship-in-nursing-homes
#20
Rebecca R Carter, Michelle M Montpetite, Robin L P Jump
OBJECTIVES: To identify features of community nursing home (NH) environments associated with lower rates of overall antibiotic use. DESIGN: This pilot study used an explanatory sequential design that incorporated comparative feedback about antibiotic use to inform a discussion about antimicrobial stewardship practices in community NHs. SETTING: NHs. PARTICIPANTS: Clinical leadership of five NHs. MEASUREMENTS: For the quantitative phase, the number of antibiotic prescriptions, length of therapy, and days of therapy/1,000 days of care were measured at six NHs...
February 2, 2017: Journal of the American Geriatrics Society
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