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Inappropriate prescribing

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https://www.readbyqxmd.com/read/28346924/early-life-antibiotic-exposure-gut-microbiota-development-and-predisposition-to-obesity
#1
Meghan B Azad, Shirin Moossavi, Arthur Owora, Shadi Sepehri
Antibiotics are often prescribed inappropriately to infants and young children, with potentially adverse effects on the developing gut microbiota and related metabolic processes. We review evidence from 17 epidemiologic studies suggesting that antibiotic exposure during critical periods of early development may influence weight gain and the development of obesity. Complementary research in both humans and rodents indicates that gut microbiota play a key role in this process, although further research is needed to confirm and characterize the causal mechanisms involved...
2017: Nestlé Nutrition Institute Workshop Series
https://www.readbyqxmd.com/read/28346296/antipsychotic-drug-use-in-nursing-home-residents-with-and-without-dementia-keep-an-eye-on-the-pro-re-nata-medication
#2
Katharina Allers, Michael Dörks, Guido Schmiemann, Falk Hoffmann
Behavioral and psychological symptoms of dementia often lead to the prescription of antipsychotics, especially in nursing homes, but their use remains controversial. This study aimed to assess antipsychotic drug use in residents with dementia compared with those without dementia. Data were obtained through the cross-sectional 'inappropriate medication in patients with renal insufficiency in nursing homes' (IMREN) study including data from 21 nursing homes. Descriptive statistics were used and factors associated with the prescription of antipsychotics were identified by logistic regression...
March 24, 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28343444/a-pilot-study-for-antimicrobial-stewardship-post-discharge
#3
Justin M Jones, Nathan D Leedahl, Ashley Losing, Paul J Carson, David D Leedahl
PURPOSE: Lack of patient follow-up is a major concern during care transitions, and the role of an antimicrobial stewardship program (ASP) in assessing antimicrobial regimens after hospital discharge is not well described. We implemented an expanded ASP to include patients recently discharged from the hospital and measured its impact on inappropriate antimicrobial therapy 72 hours after inpatient culture data were finalized. METHODS: A prospective cohort study was conducted at a 583-bed tertiary care center in the Upper Midwest of America...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28338813/antibiotic-prescribing-for-acute-respiratory-infections-in-children-in-jordan
#4
Mera A Ababneh, Sayer I Al-Azzam, Rawan Ababneh, Abeer M Rababa'h, Saddam Al Demour
Background: Most acute respiratory infections (ARIs) in children are due to viral etiology; however, over-prescribing of antibiotics for ARIs is common. The aim of this investigation was to identify antibiotic prescribing prevalence for children with ARIs and to identify predictors of broad-spectrum antibiotic prescribing. Methods: This was a prospective cross sectional study in a sample of ambulatory care settings in Jordan. Children (<18 years) presenting with ARIs were assessed in terms of patient's demographics, antibiotic prescription and clinical diagnosis...
February 24, 2017: International Health
https://www.readbyqxmd.com/read/28334979/the-effectiveness-of-optimised-clinical-medication-reviews-for-geriatric-patients-opti-med-a-cluster-randomised-controlled-trial
#5
Floor Willeboordse, François G Schellevis, Sek Hung Chau, Jacqueline G Hugtenburg, Petra J M Elders
Background.: Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use. Objective.: The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual care in older patients with geriatric problems in the general practice. Methods...
February 23, 2017: Family Practice
https://www.readbyqxmd.com/read/28334910/evaluating-pharmacist-input-into-the-pharmaceutical-care-of-patients-in-dispensing-medical-practices-in-remote-and-rural-areas-of-scotland
#6
Derek Stewart, Breda Anthony, Clare Morrison, Yvonne MacRae, Lucy Dixon, Emer Friel, Evelyn Yoong, Scott Cunningham, Katie MacLure
Background.: The Highlands and the Western Isles are the two most remote and rural areas of Scotland, with many medical practices in areas where pharmacies would not be viable. Recent regulations state that that dispensing medical practices in these areas must receive pharmacist support for patients who would benefit. Objective.: This study aimed to evaluate pilot services, which centred on the provision of patient centred pharmaceutical care. Methods...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28333200/antibiotic-prescribing-frequency-amongst-patients-in-primary-care-a-cohort-study-using-electronic-health-records
#7
Laura Shallcross, Nick Beckley, Greta Rait, Andrew Hayward, Irene Petersen
Background: Reducing inappropriate antibiotic prescribing in primary care is a public health priority. Objectives: We hypothesized that a subset of patients account for the majority of antibiotic prescriptions in primary care. We investigated the relationship between the total amount of antibiotics prescribed, individual-level antibiotic use and comorbidity. Methods: This was a cohort study using electronic health records from 1 948 390 adults registered with 385 primary care practices in the UK in 2011-13...
February 21, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28331354/utilization-and-prescribing-patterns-of-direct-oral-anticoagulants
#8
Maegan M Whitworth, Krystal K Haase, David S Fike, Ravindra M Bharadwaj, Rodney B Young, Eric J MacLaughlin
BACKGROUND: Scant literature exists evaluating utilization patterns for direct oral anticoagulants (DOACs). OBJECTIVES: The primary objective was to assess DOAC prescribing in patients with venous thromboembolism (VTE) and nonvalvular atrial fibrillation (NVAF) in outpatient clinics. Secondary objectives were to compare utilization between family medicine (FM) and internal medicine (IM) clinics, characterize potentially inappropriate use, and identify factors associated with adverse events (AEs)...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28315116/evaluating-the-prevalence-of-potentially-inappropriate-prescribing-in-older-adults-in-intermediate-care-facilities-a-cross-sectional-observational-study
#9
Anna Millar, Carmel Hughes, Cristín Ryan
Background Potentially inappropriate prescribing (PIP) [encompassing potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs)], is prevalent amongst older adults in primary and secondary care. However, PIP prevalence in intermediate care (IC) is unknown. Objective To determine the prevalence of PIMs/PPOs and associated patient factors. Setting Three IC facilities in Northern Ireland. Method The Screening Tool of Older People's Prescriptions and the Screening Tool to Alert doctors to Right Treatment were used to identify PIP over 8 weeks...
March 17, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28306610/30-day-potentially-avoidable-readmissions-due-to-adverse-drug-events
#10
Olivia Dalleur, Patrick E Beeler, Jeffrey L Schnipper, Jacques Donzé
OBJECTIVE: To analyze the patterns of potentially avoidable readmissions due to adverse drug events (ADEs) to identify the most appropriate risk reduction interventions. METHODS: In this observational study, we analyzed a random sample of 534 potentially avoidable 30-day readmissions from 10,275 consecutive discharges from the medical department of an academic hospital. Readmissions due to ADEs were reviewed to identify the causative drugs and the severity and interventions to prevent them...
March 17, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28302674/urine-culture-follow-up-and-antimicrobial-stewardship-in-a-pediatric-urgent-care-network
#11
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/28301676/deprescribing-versus-continuation-of-chronic-proton-pump-inhibitor-use-in-adults
#12
REVIEW
Taline A Boghossian, Farah Joy Rashid, Wade Thompson, Vivian Welch, Paul Moayyedi, Carlos Rojas-Fernandez, Kevin Pottie, Barbara Farrell
BACKGROUND: Proton pump inhibitors (PPIs) are a class of medications that reduce acid secretion and are used for treating many conditions such as gastroesophageal reflux disease (GERD), dyspepsia, reflux esophagitis, peptic ulcer disease, and hypersecretory conditions (e.g. Zollinger-Ellison syndrome), and as part of the eradication therapy for Helicobacter pylori bacteria. However, approximately 25% to 70% of people are prescribed a PPI inappropriately. Chronic PPI use without reassessment contributes to polypharmacy and puts people at risk of experiencing drug interactions and adverse events (e...
March 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28298164/the-most-appropriate-therapeutic-strategy-for-acute-lower-respiratory-tract-infections-a-delphi-based-approach
#13
Francesco Blasi, Ercole Concia, Bruno Del Prato, Massimo Giusti, Teresita Mazzei, Barbara Polistena, Alessandro Rossi, Stefania Stefani, Andrea Novelli
Lower respiratory tract infections (LRTIs) cause high morbidity and mortality worldwide. Empiric therapy often base the choice of antibiotic treatment on antibacterial spectrum of the agent rather than on its pharmacological properties or the pathogen resistance profile. Inappropriate prescribing leads to therapeutic failure and antibiotic resistance, with increasing direct and indirect health costs. A consensus on appropriate prescribing in LRTI therapy was appraised by this Delphi exercise, based on a panel of 70 pulmonologists, coordinated by a Scientific Committee of nine experts in respiratory medical care...
March 15, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28288172/the-impact-of-an-intervention-to-introduce-malaria-rapid-diagnostic-tests-on-fever-case-management-in-a-high-transmission-setting-in-uganda-a-mixed-methods-cluster-randomized-trial-prime
#14
Clare I R Chandler, Emily L Webb, Catherine Maiteki-Sebuguzi, Susan Nayiga, Christine Nabirye, Deborah D DiLiberto, Emmanuel Ssemmondo, Grant Dorsey, Moses R Kamya, Sarah G Staedke
BACKGROUND: Rapid diagnostic tests for malaria (mRDTs) have been scaled-up widely across Africa. The PRIME study evaluated an intervention aiming to improve fever case management using mRDTs at public health centers in Uganda. METHODS: A cluster-randomized trial was conducted from 2010-13 in Tororo, a high malaria transmission setting. Twenty public health centers were randomized in a 1:1 ratio to intervention or control. The intervention included training in health center management, fever case management with mRDTs, and patient-centered services; plus provision of mRDTs and artemether-lumefantrine (AL) when stocks ran low...
2017: PloS One
https://www.readbyqxmd.com/read/28287295/-differential-diagnostic-dilemmas-after-use-of-an-out-of-date-antihypertensive-medication-case-report
#15
Péter Arányi, János Tomcsányi
Hydrochlorothiazide became one of the most commonly prescribed first-line antihypertensive medication, though its use is often complicated with serious side-effects. A 66-year-old female patient with a history of hypertension had suffered a transient loss of consciousness, and referred to our cardiology unit with an ST-segment elevation and giant negative T-waves in V1-2 ECG leads, long QT-segment and elevated serum creatine-kinase (5392 U/L) and troponin I (4,357 ng/ml) levels. Acute myocardial infarction was not proven (later coronarography revealed preserved coronary circulation), but severe hyponatraemia and hypokalaemia was detected, explaining a possible symptomatic seizure, and which could be accounted for a 25 mg daily hydrochlorothiazide antihypertensive treatment and - as a precipitating insult - a one-week history of gastroenteritis...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28286940/comparison-of-tolvaptan-treatment-between-patients-with-the-siadh-and-congestive-heart-failure-a-single-center-experience
#16
Gun Ha Park, Chang Min Lee, Jae Won Song, Moon Chan Jung, Jwa Kyung Kim, Young Rim Song, Hyung Jik Kim, Sung Gyun Kim
Background/Aims: Tolvaptan is a very effective treatment for hypervolemic or euvolemic hyponatremia. We compared the clinical efficacy of and response to tolvaptan in patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and congestive heart failure (CHF). Methods: We retrospectively reviewed the medical records of 50 patients (SIADH, n = 30; CHF, n = 20) who were prescribed tolvaptan between July 2013 and October 2015. Tolvaptan was prescribed when the serum sodium level was < 125 mmol/L and the standard treatment failed...
March 13, 2017: Korean Journal of Internal Medicine
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
#17
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/28284416/using-the-beers-criteria-to-identify-potentially-inappropriate-medication-use-by-older-adult-dental-patients
#18
Daniel D Skaar, Heidi O'Connor
BACKGROUND: An aging population indicates that increasing numbers of older adults will seek oral health care and have multiple chronic conditions treated with a number of medications. The authors examined the Medicare Current Beneficiary Survey administrative data set to characterize potentially inappropriate medication (PIM) use by older adults visiting the dentist and related adverse experiences that may affect oral health care. METHODS: The authors used the 2015 Beers criteria to identify PIMs for older adults...
March 8, 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28280891/number-of-medications-and-adverse-drug-events-by-unintentional-poisoning-among-older-adults-in-consideration-of-inappropriate-drug-use-a-swedish-population-based-matched-case-control-study
#19
Christian Rausch, L Laflamme, U Bültmann, J Möller
PURPOSE: This national, population-based study aims to determine the association between the number of prescribed medications and adverse drug events (ADE) by unintentional poisoning and examine this risk when known indicators of inappropriate drug use (IDU) are accounted for. METHODS: We employed a matched case-control design among people living in Sweden who were 50 years and older. Cases experiencing an ADE by unintentional poisoning resulting in hospitalization or death (n = 5336) were extracted from the National Health and Death Registers from January 2006 to December 2009...
March 9, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28270547/inappropriate-antibiotic-prescribing-wind-at-our-backs-or-flapping-in-the-breeze
#20
Adam L Hersh, Matthew P Kronman
No abstract text is available yet for this article.
March 7, 2017: Pediatrics
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