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Antibiotic stewardship

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https://www.readbyqxmd.com/read/28318900/epidemiological-and-mycological-characteristics-of-candidemia-in-iran-a-systematic-review-and-meta-analysis
#1
REVIEW
A Vaezi, H Fakhim, S Khodavaisy, A Alizadeh, M Nazeri, A Soleimani, T Boekhout, H Badali
To date, there has been no comprehensive review of the epidemiology, risk factors, species distribution, and outcomes of candidemia in Iran. This study aimed to perform a systematic review and meta-analysis of all reported candidemia cases in Iran until December 2015. The review process occurred in three steps, namely a literature search, data extraction and statistical analyses. After a comprehensive literature search, we identified 55 cases. The mean age of patients was 46.80±24.30 years (range 1-81 years)...
March 16, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28318891/lessons-from-a-national-audit-of-acute-pancreatitis-a-summary-of-the-ncepod-report-treat-the-cause
#2
REVIEW
D A O'Reilly, S J McPherson, M T Sinclair, N Smith
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is an independent organisation whose remit is to review the quality of medical and surgical care provided in the United Kingdom. We undertook a review into the care provided to patients treated for acute pancreatitis during a 6 month study period between 1st January and 30th June 2014. This included assessment of care at an organisational level, clinical level within hospitals and external peer review. From a random sample, 712 patients underwent hospital clinician review and 418 patients had external peer review...
February 17, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28303388/the-impact-of-antibiotic-stewardship-programs-in-combating-quinolone-resistance-a-systematic-review-and-recommendations-for-more-efficient-interventions
#3
REVIEW
Vasiliki Pitiriga, Georgia Vrioni, George Saroglou, Athanasios Tsakris
Quinolones are among the most commonly prescribed antibiotics worldwide. A clear relationship has been demonstrated between excessive quinolone use and the steady increase in the incidence of quinolone-resistant bacterial pathogens, both in hospital and community sites. In addition, exposure to quinolones has been associated with colonization and infection with healthcare-associated pathogens such as methicillin-resistant Staphylococcus aureus and Clostridium difficile in hospitalized patients. Therefore, the management of quinolone prescribing in hospitals through antibiotic stewardship programs is considered crucial...
March 16, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28302674/urine-culture-follow-up-and-antimicrobial-stewardship-in-a-pediatric-urgent-care-network
#4
Dipanwita Saha, Jimisha Patel, Don Buckingham, David Thornton, Terry Barber, Joshua R Watson
BACKGROUND AND OBJECTIVES: Empiric antibiotic therapy for presumed urinary tract infection (UTI) leads to unnecessary antibiotic exposure in many children whose urine culture results fail to confirm the diagnosis. The objective of this quality improvement study was to improve follow-up management of negative urine culture results in the off-campus urgent care network of Nationwide Children's Hospital to reduce inappropriate antibiotic exposure in children. METHODS: A multidisciplinary task force developed and implemented a protocol for routine nurse and clinician follow-up of urine culture results, discontinuation of unnecessary antibiotics, and documentation in the electronic medical record...
March 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28302376/emerging-trends-in-antibiotic-resistance-implications-for-emergency-medicine
#5
Ali Pourmand, Maryann Mazer-Amirshahi, Gregory Jasani, Larissa May
BACKGROUND: Many bacteria are demonstrating increasing levels of resistance to commonly used antibiotics. While this has implications for the healthcare system as a whole, many patients infected with these resistant organisms will initially present to the emergency department (ED). The purpose of this review is to provide a summary of current trends in infections caused by the most clinically relevant resistant organisms encountered in emergency medicine. METHODS: Bacteria were selected based on the Centers for Disease Control and Prevention's National Action Plan for Combating Antibiotic Resistant Bacteria, and PubMed database...
March 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28298480/antimicrobial-stewardship-programmes-bedside-rationing-by-another-name
#6
Simon Oczkowski
Antimicrobial therapy is a cornerstone of therapy in critically ill patients; however, the wide use of antibiotics has resulted in increased antimicrobial resistance and outbreaks of resistant disease. To counter this, many hospitals have instituted antimicrobial stewardship programmes as a way to reduce the inappropriate use of antibiotics. However, uptake of antimicrobial stewardship programmes has been variable, as many clinicians fear that they may put individual patients at risk of treatment failure. In this paper, I argue that antimicrobial stewardship programmes are indeed a form of bedside rationing, and explore the risks and benefits of such programmes for individual patients in the intensive care unit, and the critically ill population in general...
March 15, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28298366/antibiotics-for-acute-respiratory-tract-infections-a-mixed-methods-study-of-patient-experiences-of-non-medical-prescriber-management
#7
Molly Courtenay, Samantha Rowbotham, Rosemary Lim, Rhian Deslandes, Karen Hodson, Katie MacLure, Sarah Peters, Derek Stewart
OBJECTIVE: To (1) explore patients' expectations and experiences of nurse and pharmacist non-medical prescriber-led management of respiratory tract infections (RTIs), (2) examine whether patient expectations for antibiotics affect the likelihood of receiving them and (3) understand factors influencing patient satisfaction with RTI consultations. DESIGN: Mixed methods. SETTING: Primary care. PARTICIPANTS: Questionnaires from 120 patients and follow-up interviews with 22 patients and 16 nurse and pharmacist non-medical prescribers (NMPs)...
March 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28288838/routine-ertapenem-prophylaxis-for-transrectal-ultrasound-guided-prostate-biopsy-does-not-select-for-carbapenem-resistant-organisms-a-prospective-cohort-study
#8
Maxim G Bloomfield, Matthew J Page, Alice G McLachlan, Rodney C Studd, Timothy K Blackmore
PURPOSE: Post-transrectal ultrasound-guided prostate biopsy sepsis is an increasing problem in this era of rising antibiotic resistance. Ertapenem prophylaxis has proven very effective at our institution for reducing this, however has raised local and regional antimicrobial stewardship concerns. This study investigated the possible selective effect of single dose ertapenem prophylaxis on fecal colonization with carbapenem-resistant Enterobacteriaceae. MATERIALS AND METHODS: Patients had a rectal swab taken prior to receiving pre-biopsy ertapenem prophylaxis...
March 10, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28285740/fight-antibiotic-resistance-it-s-in-your-hands-to-improve-antibiotic-stewardship
#9
EDITORIAL
A Bashir, J Gray
No abstract text is available yet for this article.
March 9, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28285605/using-clinical-scenarios-to-understand-preventability-of-clostridium-difficile-infections-by-inpatient-antibiotic-stewardship-programs
#10
Jessica Seidelman, Kristen V Dicks, Michael J Durkin, Arthur W Baker, Rebekah W Moehring, Deverick J Anderson, Daniel J Sexton, Luke F Chen, Sarah S Lewis
No abstract text is available yet for this article.
March 13, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28284685/identifying-priorities-to-improve-paediatric-in-hospital-antimicrobial-use-by-cross-sectional-evaluation-of-prevalence-and-appropriateness-of-prescription
#11
Walter Alfredo Goycochea-Valdivia, Francisco Moreno-Ramos, José Ramón Paño-Pardo, Francisco Javier Aracil-Santos, Fernando Baquero-Artigao, Teresa Del Rosal-Rabes, María José Mellado-Peña, Luis Escosa-García
INTRODUCTION: Information about paediatric in-hospital antimicrobial usage and prescribing patterns to guide improvement strategies is scant. We aim to use an evaluation of the prevalence and appropriateness of antimicrobial prescription to identify antimicrobial stewardship priorities in children. METHODS: A cross-sectional point study was performed on hospitalised paediatric patients in a Spanish tertiary hospital, assessing the prevalence of antimicrobial prescription (PAP) and appropriateness of antimicrobial prescription (AAP)...
March 8, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28270546/variability-in-antibiotic-prescribing-for-community-acquired-pneumonia
#12
Lori K Handy, Matthew Bryan, Jeffrey S Gerber, Theoklis Zaoutis, Kristen A Feemster
BACKGROUND AND OBJECTIVES: Published guidelines recommend amoxicillin for most children with community-acquired pneumonia (CAP), yet macrolides and broad-spectrum antibiotics are more commonly prescribed. We aimed to determine the patient and clinician characteristics associated with the prescription of amoxicillin versus macrolide or broad-spectrum antibiotics for CAP. METHODS: Retrospective cohort study in an outpatient pediatric primary care network from July 1, 2009 to June 30, 2013...
March 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/28270268/antibiotic-stewardship-new-frontier-familiar-journey
#13
Caren McHenry Martin
Recent changes in regulations by the Centers for Medicare & Medicaid Services require long-term care facilities to meet specific requirements on antibiotic stewardship, promoting the appropriate use of antibiotics and antimicrobials. The goal is to improve patient outcomes and decrease the spread of infections caused by multi-drug-resistant organisms. Consultant pharmacists can help facility personnel implement policies and procedures for effective antibiotic stewardship, assist prescribers and facility staff in understanding how to use the facility's antibiogram, find appropriate resources, and provide facility personnel with feedback on their antimicrobial stewardship efforts...
March 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28267992/clostridium-difficile-disease-diagnosis-pathogenesis-and-treatment-update
#14
REVIEW
Lena M Napolitano, Charles E Edmiston
Clostridium difficile infections are the leading cause of health care-associated infectious diarrhea, posing a significant risk for both medical and surgical patients. Because of the significant morbidity and mortality associated with C difficile infections, knowledge of the epidemiology of C difficile in combination with a high index of suspicion and susceptible patient populations (including surgical, postcolectomy, and inflammatory bowel disease patients) is warranted. C difficile infections present with a wide spectrum of disease, ranging from mild diarrhea to fulminant colitis or small bowel enteritis and recurrent C difficile infections...
March 3, 2017: Surgery
https://www.readbyqxmd.com/read/28267763/molecular-characterization-of-vancomycin-resistant-enterococcus-faecium-isolates-from-bermuda
#15
Patrick Eberechi Akpaka, Shivnarine Kissoon, Clyde Wilson, Padman Jayaratne, Ashley Smith, George R Golding
Molecular characteristics of vancomycin resistant enterococci isolates from Bermuda Island is currently unknown. This study was conducted to investigate phenotypic and genotypic characteristics of VRE isolates from Bermuda Island using the chromogenic agar, E-tests, polymerase chain reaction (PCR), pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Eighteen E. faecium isolates were completely analyzed and were all resistant to vancomycin, susceptible to linezolid and quinupristin/dalfopristin, positive for vanA and esp genes...
2017: PloS One
https://www.readbyqxmd.com/read/28265870/correlation-between-antibiotic-consumption-and-resistance-of-bloodstream-bacteria-in-a-university-hospital-in-north-eastern-italy-2008-2014
#16
Marta Mascarello, Omar Simonetti, Anna Knezevich, Ludovica Ilaria Carniel, Jacopo Monticelli, Marina Busetti, Paolo Schincariol, Lucio Torelli, Roberto Luzzati
PURPOSE: The spread of multidrug-resistant bacteria is a worrisome problem worldwide. This study investigated the correlation between antibiotic consumption and antimicrobial resistance trends of the most important bacteria causing bacteremia at the University hospital of Trieste, Italy, from 2008 to 2014. METHODS: Antibiotic consumption (Defined Daily Dose-DDD-per 100 patient/days) and antibiotic resistance (percentage of antibiotic intermediate o resistant isolates) were analyzed independently with linear correlation by year...
March 6, 2017: Infection
https://www.readbyqxmd.com/read/28260538/intervention-to-reduce-broad-spectrum-antibiotics-and-treatment-durations-prescribed-at-the-time-of-hospital-discharge-a-novel-stewardship-approach
#17
Norihiro Yogo, Katherine Shihadeh, Heather Young, Susan L Calcaterra, Bryan C Knepper, William J Burman, Philip S Mehler, Timothy C Jenkins
OBJECTIVE For most common infections requiring hospitalization, antibiotic treatment is completed after hospital discharge. Postdischarge therapy is often unnecessarily broad spectrum and prolonged. We developed an intervention to improve antibiotic selection and shorten treatment durations. DESIGN Single center, quasi-experimental retrospective cohort study METHODS Patients prescribed oral antibiotics at hospital discharge before (July 2012-June 2013) and after (October 2014-February 2015) an intervention consisting of (1) institutional guidance for oral step-down antibiotic selection and duration of therapy and (2) pharmacy audit of discharge prescriptions with real-time prescribing recommendations to providers...
March 6, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28258234/polishing-the-tarnished-silver-bullet-the-quest-for-new-antibiotics
#18
REVIEW
Mark A T Blaskovich, Mark S Butler, Matthew A Cooper
We are facing a potential catastrophe of untreatable bacterial infections, driven by the inexorable rise of extensively drug-resistant bacteria, coupled with a market failure of pharmaceutical and biotech companies to deliver new therapeutic options. While global recognition of the problem is finally apparent, solutions are still a long way from being implemented. In addition to drug stewardship programmes and better diagnostics, new antibiotics are desperately needed. The question remains as to how to achieve this goal...
February 28, 2017: Essays in Biochemistry
https://www.readbyqxmd.com/read/28258225/antimicrobial-resistance-in-healthcare-agriculture-and-the-environment-the-biochemistry-behind-the-headlines
#19
REVIEW
Henrietta Venter, Michael L Henningsen, Stephanie L Begg
The crisis of antimicrobial resistance (AMR) is one of the most serious issues facing us today. The scale of the problem is illustrated by the recent commitment of Heads of State at the UN to coordinate efforts to curb the spread of AMR infections. In this review, we explore the biochemistry behind the headlines of a few stories that were recently published in the public media. We focus on examples from three different issues related to AMR: (i) hospital-acquired infections, (ii) the spread of resistance through animals and/or the environment and (iii) the role of antimicrobial soaps and other products containing disinfectants in the dissemination of AMR...
February 28, 2017: Essays in Biochemistry
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#20
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
March 2, 2017: Current Opinion in Pulmonary Medicine
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