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Antibiotic stewardship

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https://www.readbyqxmd.com/read/27899924/global-antimicrobial-stewardship-a-closer-look-at-the-formidable-implementation-challenges
#1
John J L Tiong, Jason S E Loo, Chun-Wai Mai
Antimicrobial stewardship (AMS) has been touted as one of the key strategies required in tackling worldwide escalation of antibiotic resistance. Although AMS has optimized antibiotic usage and reduced the incidence of resistance development in some regions, its full global potential has been curtailed by various AMS-impeding factors. This article seeks to highlight in a detailed perspective, the key challenges that hamper global AMS endeavors, some of which include the paucity of effective implementation strategies that cater for the challenging settings of developing nations, the slow response of governments, uncoordinated AMS activities as well as implementation fragmentation across different sectors and countries...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27899072/appropriateness-of-antibiotic-management-of-uncomplicated-skin-and-soft-tissue-infections-in-hospitalized-adult-patients
#2
Thomas L Walsh, Lynn Chan, Chelsea I Konopka, Michael J Burkitt, Matthew A Moffa, Derek N Bremmer, Monika A Murillo, Courtney Watson, Noreen H Chan-Tompkins
BACKGROUND: Skin and soft tissue infections (SSTIs) are a leading cause for hospitalizations in the United States. Few studies have addressed the appropriateness of antibiotic therapy in the management of SSTIs without complicating factors. We aimed to determine the appropriateness of antibiotic treatment duration for hospitalized adult patients with uncomplicated SSTIs. METHODS: This was a retrospective analysis performed at two academic medical centers in Pittsburgh, Pennsylvania on patients aged 18 years and older with primary ICD-9 code for SSTIs admitted August 1st, 2014-March 31st, 2015...
November 29, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27895446/a-case-of-fatal-sepsis-due-to-multidrug-resistant-corynebacterium-striatum
#3
M Chatzopoulou, T Koufakis, I Voulgaridi, I Gabranis, M Tsiakalou
BACKGROUND: Although non-diphtheria corynebacteria have traditionally been regarded as avirulent members of human bacterial flora, their pathogenic potential is increasingly recognized in our time. Reasons for this include the prolonged survival of severely ill and immunocompromised patients, the development of more invasive diagnostic and therapeutic procedures and the sub-optimal use of antibiotics that disrupts normal microbial balance and favors superinfections. CASE REPORT: We present a rare case of sepsis due to multidrug-resistant Corynebacterium striatum in a 76-year-old host...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27894763/extended-spectrum-beta-lactamase-esbl-producing-bacteria-urinary-tract-infections-and-complex-pediatric-urology
#4
Ruth Wragg, Anna Harris, Mitul Patel, Andrew Robb, Harish Chandran, Liam McCarthy
AIM OF THE STUDY: Extended spectrum beta lactamase (ESBL) producing bacteria are resistant to most beta-lactam antibiotics including third-generation cephalosporins, quinolones and aminoglycosides. This resistance is plasmid-borne and can spread between species. Management of ESBL is challenging in children with recurrent urinary tract infections (UTIs) and complex urological abnormalities. We aim to quantify the risk in children and specifically in urological patients. METHODS: Retrospective review of a microbiology database (April 2014 to November 2015)...
November 13, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27890038/an-evaluation-of-antibiotic-prescribing-practices-upon-hospital-discharge
#5
Sarah J Scarpato, Daniel R Timko, Valerie C Cluzet, Jillian P Dougherty, Jonathan J Nunez, Neil O Fishman, Keith W Hamilton
We conducted a retrospective study of the appropriateness of antimicrobial agents prescribed on discharge from an acute care hospital. Seventy percent of discharge antibiotics were inappropriate in antibiotic drug choice, dose, or duration. Our findings suggest there is a significant need for antimicrobial stewardship at transitions in care. Infect Control Hosp Epidemiol 2016;1-3.
November 28, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27887595/antimicrobial-stewardship-of-chinese-ministry-of-health-reduces-multidrug-resistant-organism-isolates-in-critically-ill-patients-a-pre-post-study-from-a-single-center
#6
Xudong Ma, Jianfeng Xie, Yi Yang, Fengmei Guo, Zhiwei Gao, Hua Shao, Yingzi Huang, Congshan Yang, Haibo Qiu
BACKGROUND: China's Ministry of Health (MOH) has established a policy about the antimicrobial stewardship. To date, the effects of this policy on multidrug-resistant organism (MDRO) in critically ill patients are unknown. METHODS: A pre-post study was conducted on intensive care unit (ICU) patients from June 2010 to May 2011 and from June 2012 to May 2013. Bacterial cultures were conducted at ICU admission and discharge. In June 2011, our hospital started to administer the antimicrobial stewardship program of Chinese MOH...
November 25, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27880718/contribution-of-jac-to-antimicrobial-stewardship
#7
REVIEW
Alan P Johnson
Antimicrobial stewardship programmes are increasingly being used to improve the quality of antimicrobial prescribing, with the dual aim of optimizing clinical outcomes and minimizing the emergence and spread of antimicrobial resistance. The Journal of Antimicrobial Chemotherapy (JAC) is celebrating its 40th anniversary and, as part of activities to commemorate this event, this article highlights the contribution of JAC to antimicrobial stewardship. Papers published in JAC have contributed to the evidence base for stewardship, have highlighted educational and behavioural change initiatives aimed at improving antibiotic prescribing practice, and have actively sought to foster the practice of antimicrobial stewardship amongst its readers...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27880668/the-role-of-the-multidisciplinary-team-in-antifungal-stewardship
#8
Samir Agrawal, Rosemary Barnes, Roger J Brüggemann, Riina Rautemaa-Richardson, Adilia Warris
There are a variety of challenges faced in the management of invasive fungal diseases (IFD), including high case-fatality rates, high cost of antifungal drugs and development of antifungal resistance. The diagnostic challenges and poor outcomes associated with IFD have resulted in excessive empirical use of antifungals in various hospital settings, exposing many patients without IFD to potential drug toxicities as well as causing spiralling antifungal drug costs. Further complexity arises as different patient groups show marked variation in their risk for IFD, fungal epidemiology, sensitivity and specificity of diagnostic tests and the pharmacokinetics and pharmacodynamics of antifungal drugs...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27876477/current-prescribing-practices-for-skin-and-soft-tissue-infections-in-nursing-homes
#9
Diana Feldstein, Philip D Sloane, David Weber, Kimberly Ward, David Reed, Sheryl Zimmerman
OBJECTIVES: Antibiotic stewardship has been called for across all sites of health care, including nursing homes (NHs). Skin and soft tissue infections (SSTIs) are the third most common indication for antibiotics in the NH, and so should be a focus of stewardship. This study audited medical records to identify signs and symptoms of SSTIs treated with antibiotics in relation to the McGeer criteria for surveillance, the Loeb minimum criteria for antibiotic initiation, and prescribing recommendations of the Infectious Disease Society of America...
November 18, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27875349/the-revival-of-old-antibiotics-for-treatment-of-uncomplicated-urinary-tract-infections-in-the-era-of-antibiotic-stewardship
#10
Jennifer Kranz, Sina Helbig, Falitsa Mandraka, Stefanie Schmidt, Kurt G Naber
PURPOSE OF REVIEW: In the era of increasing antibiotic resistance worldwide, this review highlights the advantages of revival of old antibiotics for treatment of uncomplicated urinary tract infections (uUTIs). RECENT FINDINGS: Recent studies have shown that these four oral old antibiotics, fosfomycin trometamol, nitrofurantoin, nitroxoline and pivmecillinam, show no increasing antibiotic resistance against uropathogens causing uUTI, are still effective for the treatment of uUTI and exhibit only minimal or no collateral damage as compared with fluoroquinolones or third-generation cephalosporines...
November 21, 2016: Current Opinion in Urology
https://www.readbyqxmd.com/read/27874151/a-stepwise-introduction-of-a-successful-antimicrobial-stewardship-program-experience-from-a-tertiary-care-university-hospital-in-western-saudi-arabia
#11
Maha M Alawi, Bayan M Darwesh
OBJECTIVES: To analyze and evaluate the safety and cost-effectiveness of a gradually-implemented antimicrobial stewardship programs (ASP) in a tertiary care center. METHODS: Prospective data were collected from an ASP that was gradually introduced between April 2012 and December 2013 in 6 hospital departments, over successive periods of 3 months each. A multidisciplinary team supervised antibiotic use and regulated pharmacy dispensations of a list of restricted antimicrobials (RAs)...
December 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27866945/a-global-call-from-five-countries-to-collaborate-in-antibiotic-stewardship-united-we-succeed-divided-we-might-fail
#12
REVIEW
Debra A Goff, Ravina Kullar, Ellie J C Goldstein, Mark Gilchrist, Dilip Nathwani, Allen C Cheng, Kelly A Cairns, Kevin Escandón-Vargas, Maria Virginia Villegas, Adrian Brink, Dena van den Bergh, Marc Mendelson
In February, 2016, WHO released a report for the development of national action plans to address the threat of antibiotic resistance, the catastrophic consequences of inaction, and the need for antibiotic stewardship. Antibiotic stewardship combined with infection prevention comprises a collaborative, multidisciplinary approach to optimise use of antibiotics. Efforts to mitigate overuse will be unsustainable without learning and coordinating activities globally. In this Personal View, we provide examples of international collaborations to address optimal prescribing, focusing on five countries that have developed different approaches to antibiotic stewardship-the USA, South Africa, Colombia, Australia, and the UK...
November 17, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27866661/a-critical-question-for-nec-researchers-can-we-create-a-consensus-definition-of-nec-that-facilitates-research-progress
#13
REVIEW
Phillip V Gordon, Jonathan R Swanson, Brianna C MacQueen, Robert D Christensen
In the last decades the reported incidence of preterm necrotizing enterocolitis (NEC) has been declining in large part due to implementing comprehensive NEC prevention initiatives, including breast milk feeding, standardized feeding protocols, transfusion guidelines, and antibiotic stewardship and improving the rigor with which non-NEC cases are excluded from NEC data. However, after more than 60 years of NEC research in animal models, the promise of a "magic bullet" to prevent NEC has yet to materialize. There are also serious issues involving clinical NEC research...
November 17, 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27863948/tree-structured-survival-analysis-of-patients-with-pseudomonas-aeruginosa-bacteremia-a-multicenter-observational-cohort-study
#14
Young Kyung Yoon, Hyun Ah Kim, Seong Yeol Ryu, Eun Jung Lee, Mi Suk Lee, Jieun Kim, Seong Yeon Park, Kyung Sook Yang, Shin Woo Kim
This study aimed to construct a prediction algorithm, which is readily applicable in the clinical setting, to determine the mortality rate for patients with P. aeruginosa bacteremia. A multicenter observational cohort study was performed retrospectively in seven university-affiliated hospitals in Korea from March 2012 to February 2015. In total, 264 adult patients with monomicrobial P. aeruginosa bacteremia were included in the analyses. Among the predictors independently associated with 30-day mortality in the Cox regression model, Pitt bacteremia score >2 and high-risk source of bacteremia were identified as critical nodes in the tree-structured survival analysis...
October 7, 2016: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/27859453/past-present-and-future-of-antibacterial-economics-increasing-bacterial-resistance-limited-antibiotic-pipeline-and-societal-implications
#15
Katherine H Luepke, Katie J Suda, Helen Boucher, Rene L Russo, Michael W Bonney, Timothy D Hunt, John F Mohr
Growing antimicrobial resistance and a dwindling antibiotic pipeline has resulted in an emerging postantibiotic era, as patients are now dying from bacterial infections that were once treatable. The fast-paced "Golden Age" of antibiotic development that started in the 1940s has lost momentum, as from the 1980s to the early 2000s, there was a 90% decline in approval of new antibiotics as well as discovery of few new novel classes. Many companies have shifted away from development due to scientific, regulatory, and economic hurdles that proved antibiotic development to be less attractive compared with more lucrative therapeutic areas...
November 12, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27856730/multidrug-and-carbapenem-resistant-pseudomonas-aeruginosa-in-children-united-states-1999-2012
#16
Latania K Logan, Sumanth Gandra, Siddhartha Mandal, Eili Y Klein, Jordan Levinson, Robert A Weinstein, Ramanan Laxminarayan
BACKGROUND: Pseudomonas aeruginosa is a common cause of healthcare-associated infection. Multidrug-resistant (MDR) (>3 classes) and carbapenem-resistant (CR) P aeruginosa are significant threats globally. We used a large reference-laboratory database to study the epidemiology of P aeruginosa in children in the United States. METHODS: Antimicrobial susceptibility data from the Surveillance Network were used to phenotypically identify MDR and CR P aeruginosa isolates in children aged 1 to 17 years between January 1999 and July 2012...
November 16, 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/27856724/variability-in-antibiotic-use-across-ontario-acute-care-hospitals
#17
Charlie Tan, Marian Vermeulen, Xuesong Wang, Rosemary Zvonar, Gary Garber, Nick Daneman
BACKGROUND: Antibiotic stewardship is a required organizational practice for Canadian acute care hospitals, yet data are scarce regarding the quantity and composition of antibiotic use across facilities. We sought to examine the variability, and risk-adjusted variability, in antibiotic use across acute care hospitals in Ontario, Canada's most populous province. METHODS: Antibiotic purchasing data from IMS Health, previously demonstrated to correlate strongly with internal antibiotic dispensing data, were acquired for 129 Ontario hospitals from January to December 2014 and linked to patient day (PD) denominator data from administrative datasets...
November 17, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27856081/-antibiotic-stewardship-what-s-new
#18
EDITORIAL
B Castan, P Lesprit, S Alfandari, E Bonnet, S Diamantis, R Gauzit, S Kernéis, J Leroy, F X Lescure, V Mondain, P Pavese, C Rabaud, J P Stahl, P Tattevin, F Roblot, C Pulcini
No abstract text is available yet for this article.
November 14, 2016: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/27850397/759-procalcitonin-and-antibiotic-stewardship-in-brain-injured-patients-admitted-to-the-nicu
#19
Umer Muhktar, Muhammad Athar, David Boorman, Umer Shoukat, Fred Rincon
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27845153/daptomycin-non-susceptible-enterococcus-faecium-in-leukemia-patients-role-of-prior-daptomycin-exposure
#20
Adam J DiPippo, Frank P Tverdek, Jeffrey J Tarrand, Jose M Munita, Truc T Tran, Cesar A Arias, Samuel A Shelburne, Samuel L Aitken
OBJECTIVES: We sought to determine the association between previous daptomycin exposure and daptomycin non-susceptible Enterococcus faecium (DNSEf) bloodstream infections (BSI) in adult leukemia patients. METHODS: We retrospectively identified adult (≥18 years old) leukemia patients with Enterococcus spp. bacteremia at The University of Texas MD Anderson Cancer Center (MDACC) from 6/1/2013 to 7/22/2015. Antimicrobial susceptibility and previous antibiotic exposure within the 90 days prior to bacteremia were collected...
November 11, 2016: Journal of Infection
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