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Adherence & Antibiotic & Clinical Practice Guidelines

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https://www.readbyqxmd.com/read/28814444/implementing-an-inpatient-pediatric-prospective-audit-and-feedback-antimicrobial-stewardship-program-within-a-larger-medical-center
#1
Jennifer Lighter-Fisher, Sonya Desai, Anna Stachel, Vinh Philip Pham, Liana Klejmont, Yanina Dubrovskaya
BACKGROUND: Pediatric antimicrobial stewardship programs (ASPs) within larger institutions have unique opportunities to develop programs specialized to the needs of the pediatric program. In January 2013, our institution established a formalized pediatric ASP utilizing the prospective audit and feedback process. In an effort to standardize therapy and improve quality of care, members of the ASP developed evidence-based guidelines for management of common inpatient pediatric infections...
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28791973/pattern-of-prescription-of-antibiotics-among-dental-practitioners-in-jeddah-ksa-a-cross-sectional-survey
#2
K Al-Johani, S G Reddy, A S Al Mushayt, A El-Housseiny
BACKGROUND: Inappropriate use of antibiotics by clinicians leads to antibiotic resistance, and is a serious global health concern. AIM: The aim of this study was to determine antibiotic prescription practices of dental practitioners and their adherence to professional guidelines while treating oral health problems among children. MATERIALS AND METHODS: All the dentists working in Jeddah were invited to participate and 126 dentists consented to be a part of this study...
July 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28745260/implementation-of-an-antimicrobial-stewardship-program-in-a-neonatal-intensive-care-unit
#3
Nneka I Nzegwu, Michelle R Rychalsky, Loren A Nallu, Xuemei Song, Yanhong Deng, Amber M Natusch, Robert S Baltimore, George R Paci, Matthew J Bizzarro
OBJECTIVE To evaluate antimicrobial utilization and prescription practices in a neonatal intensive care unit (NICU) after implementation of an antimicrobial stewardship program (ASP). DESIGN Quasi-experimental, interrupted time-series study. SETTING A 54-bed, level IV NICU in a regional academic and tertiary referral center. PATIENTS AND PARTICIPANTS All neonates prescribed antimicrobials from January 1, 2011, to June 30, 2016, were eligible for inclusion. INTERVENTION Implementation of a NICU-specific ASP beginning July 2012...
July 26, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28580893/appropriateness-of-surgical-antibiotic-prophylaxis-in-pediatric-patients-in-italy
#4
Mariavalentina Giordano, Lorena Squillace, Maria Pavia
OBJECTIVES Appropriate use of surgical antibiotic prophylaxis (SAP) reduces intraoperative wound contamination in pediatric surgery, thus minimizing the risk of surgical site infection (SSIs). Conversely, inappropriate use of SAP exposes patients to the risk of antibiotic side effects and contributes to the emergence of antimicrobial resistance. Our aims were to describe SAP administration and to analyze factors associated with nonadherence in pediatric patients. DESIGN Descriptive study. SETTING Overall, 955 pediatric patients underwent 1,038 surgical procedures...
June 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28577933/impact-of-selective-reporting-of-antibiotic-susceptibility-test-results-on-the-appropriateness-of-antibiotics-chosen-by-french-general-practitioners-in-urinary-tract-infections-a-randomised-controlled-case-vignette-study
#5
Loic Bourdellon, Nathalie Thilly, Sébastien Fougnot, Céline Pulcini, Sandrine Henard
Selective reporting of antibiotic susceptibility test (AST) results is a potential intervention for laboratory-based antibiotic stewardship. The aim of this study was to assess the impact of AST reporting on the appropriateness of antibiotics selected by French general practitioners for urinary tract infections (UTIs). A randomised controlled case-vignette study in a region of northeast France surveyed general practitioners between July and October 2015 on treatment of four clinical cases of community-acquired Escherichia coli UTIs (two cases of complicated cystitis, one of acute pyelonephritis and one male UTI)...
May 31, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28526836/characterisation-of-antibiotic-prescriptions-for-acute-respiratory-tract-infections-in-danish-general-practice-a-retrospective-registry-based-cohort-study
#6
Rune Aabenhus, Malene Plejdrup Hansen, Laura Trolle Saust, Lars Bjerrum
Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice...
May 19, 2017: NPJ Primary Care Respiratory Medicine
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
#7
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/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#8
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28410366/brief-educational-interventions-to-improve-performance-on-novel-quality-metrics-in-ambulatory-settings-in-kenya-a-multi-site-pre-post-effectiveness-trial
#9
Robert Ryan Korom, Stephanie Onguka, Peter Halestrap, Maureen McAlhaney, Mary Adam
BACKGROUND: The quality of primary care delivered in resource-limited settings is low. While some progress has been made using educational interventions, it is not yet clear how to sustainably improve care for common acute illnesses in the outpatient setting. Management of urinary tract infection is particularly important in resource-limited settings, where it is commonly diagnosed and associated with high levels of antimicrobial resistance. We describe an educational programme targeting non-physician health care providers and its effects on various clinical quality metrics for urinary tract infection...
2017: PloS One
https://www.readbyqxmd.com/read/28383471/clinical-practice-guideline-adherence-during-operation-inherent-resolve
#10
Timothy P Plackett, Darren C Cherry, Gerald Delk, Steven Satterly, Jared Theler, Derek McVay, Jacqueline Moore, Stacy A Shackelford
BACKGROUND: The Joint Trauma System (JTS) clinical practice guidelines (CPGs) contributed to the decrease in battlefield mortality over the past 15 years. However, it is unknown to what degree the guidelines are being followed in current military operations. METHODS: A retrospective review was performed of all patients treated at three separate US Army Role II facilities during the first 10 months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28345188/treatment-of-gonorrhoea-in-auckland-new-zealand-marked-variation-in-prescriber-adherence-to-treatment-guidelines
#11
Rose Forster, Ms Diana Ng, Arlo Upton, Rick Franklin, Mark Thomas
BACKGROUND: The relentless emergence and spread of strains of Neisseria gonorrhoeae that are resistant to many antimicrobial agents has led to frequent changes in treatment guidelines, with a consequent risk that prescribers may not be aware of current guidelines. METHODS: We audited the treatment given to adult patients with laboratory proven gonorrhoea in Auckland, New Zealand, during the first six months of 2015. RESULTS: Treatment compliant with the current New Zealand Sexual Health Society (NZSHS) guidelines was administered in only 65% (458/706) episodes overall...
March 27, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28323194/international-experts-practice-in-the-antibiotic-therapy-of-infective-endocarditis-is-not-following-the-guidelines
#12
H Tissot-Dupont, J P Casalta, F Gouriet, S Hubert, E Salaun, G Habib, M P Fernandez-Gerlinger, J L Mainardi, P Tattevin, M Revest, F Lucht, E Botelho-Nevers, A Gagneux-Brunon, U Snygg-Martin, K L Chan, J Bishara, I Vilacosta, C Olmos, J A San Román, J López, P Tornos, N Fernández-Hidalgo, E Durante-Mangoni, R Utili, M Paul, L M Baddour, D C De Simone, M R Sohail, J M Steckelberg, W R Wilson, D Raoult
OBJECTIVE: The management of infective endocarditis (IE) may differ from international guidelines, even in reference centres. This is probably because most recommendations are not based on hard evidence, so the consensus obtained for the guidelines does not represent actual practices. For this reason, we aimed to evaluate this question in the particular field of antibiotic therapy. METHODS: Thirteen international centres specialized in the management of IE were selected, according to their reputation, clinical results, original research publications and quotations...
March 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28291497/variation-in-postinjury-antibiotic-prophylaxis-patterns-over-five-years-in-a-combat-zone
#13
Bradley A Lloyd, Clinton K Murray, William Bradley, Faraz Shaikh, Deepak Aggarwal, M Leigh Carson, David R Tribble
In 2008, a clinical practice guideline (CPG) was developed for the prevention of infections among combat casualties and was later revised in 2011. We evaluated utilization of antimicrobials within 48 hours following injury in the combat zone over a 5-year period (June 2009 through May 2014) with regard to number of regimens, type of antimicrobial, and adherence to the 2011 CPG. The study population consisted of 5,196 wounded military personnel. Open fractures and skin and soft-tissue injuries were the most frequent injuries...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28258279/management-of-respiratory-tract-infections-in-young-children-a-qualitative-study-of-primary-care-providers-perspectives
#14
Ruby Biezen, Bianca Brijnath, Danilla Grando, Danielle Mazza
Respiratory tract infections in young children are the most common cause of general practice visits in Australia. Despite the availability of clinical practice guidelines, the treatment and management of respiratory tract infections in young children is inconsistent. The aim of the study was to explore the management of respiratory tract infections in young children from a multi-disciplinary perspective using across-sectional qualitative research design based on the theoretical domains framework and the Capability, Opportunity and Motivation-B model...
March 7, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28119402/a-national-pharmacoepidemiological-study-of-antibiotic-use-in-korean-paediatric-outpatients
#15
Yun-Kyoung Song, Nayoung Han, Myeong Gyu Kim, Hyeu-Jin Chang, Hyun Soon Sohn, Eunhee Ji, Jung Mi Oh
BACKGROUND: Information on the use of antibiotics in Eastern Asian children is limited. The objectives of this study were to evaluate in Korean paediatric outpatients (1) the nationwide pattern of prescribing antibiotics according to age group and medical institution and (2) the adherence of antibiotic use for acute respiratory tract infections to both national guidelines and European antibiotic prescribing quality indicators. METHOD: This population-based study used the national insurance reimbursement database for 2011...
January 24, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27989273/beyond-test-and-treat-malaria-diagnosis-for-improved-pediatric-fever-management-in-sub-saharan-africa
#16
Emily White Johansson
BACKGROUND: Malaria rapid diagnostic tests (RDTs) have great potential to improve quality care and rational drug use in malaria-endemic settings although studies have shown common RDT non-compliance. Yet, evidence has largely been derived from limited hospital settings in few countries. This article reviews a PhD thesis that analyzed national surveys from multiple sub-Saharan African countries to generate large-scale evidence of malaria diagnosis practices and its determinants across different contexts...
2016: Global Health Action
https://www.readbyqxmd.com/read/27884552/estimated-saving-of-antibiotics-in-pharyngitis-and-lower-respiratory-tract-infections-if-general-practitioners-used-rapid-tests-and-followed-guidelines
#17
Carles Llor, Ana Moragas, Josep M Cots, Beatriz González López-Valcárcel
INTRODUCTION: General practitioners (GP) in Spain do not have access to rapid tests and adherence to guidelines is usually suboptimal. The aim of the study is to evaluate the estimated number of antibiotics that could have been saved if GPs had appropriately used these tests and had followed the guidelines. DESIGN: Observational study. SETTING: Primary care centres from eight Autonomous Communities in Spain. PARTICIPANTS: GPs who had not participated in previous studies on rational use of antibiotics...
November 21, 2016: Atencion Primaria
https://www.readbyqxmd.com/read/27814677/a-single-center-observational-study-on-emergency-department-clinician-non-adherence-to-clinical-practice-guidelines-for-treatment-of-uncomplicated-urinary-tract-infections
#18
Catherine Zatorski, Mark Zocchi, Sara E Cosgrove, Cynthia Rand, Gillian Brooks, Larissa May
BACKGROUND: The Emergency Department (ED) is a frequent site of antibiotic use; poor adherence with evidence-based guidelines and broad-spectrum antibiotic overuse is common. Our objective was to determine rates and predictors of inappropriate antimicrobial use in patients with uncomplicated urinary tract infections (UTI) compared to the 2010 International Clinical Practice Guidelines (ICPG). METHODS: A single center, prospective, observational study of patients with uncomplicated UTI presenting to an urban ED between September 2012 and February 2014 that examined ED physician adherence to ICPG when treating uncomplicated UTIs...
November 4, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27723904/-diagnostic-and-therapeutic-management-of-helicobacter-pylori-a-survey-among-german-gastroenterologists-in-private-practice
#19
S Miehlke, R Loibl, S Meszaros, J Labenz
Purpose: The acceptance and realization of clinical guidelines in daily routine practice is unknown. The aim of this study was to evaluate the behaviour of private gastroenterologists in Germany with respect to the diagnostic and therapeutic management of H. pylori infection in times of increasing antibiotic resistance. Methods: Between 12/2014 and 02/2015 a standardized questionnaire with 19 multiple choice questions were sent to 1507 private gastroenterologists in Germany. The data were electronically captured and analyzed using SurveyMonkey...
October 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27670801/clinical-practice-audit-of-perioperative-antimicrobial-prophylaxis-in-a-tertiary-care-hospital-do-routine-academic-activities-improve-adherence-to-practice-guidelines
#20
Mehul Agrawal, Pramod Kumar Sharma, S P Dhaneria
BACKGROUND: Antimicrobial prophylaxis should be used in circumstances where efficacy has been demonstrated and benefits outweigh the risk. Each hospital must have an antibiotic policy that is implementable and fully adhered to. METHODS: A prospective observational study was conducted in 209 patients, admitted to swards of various surgical departments including surgery, obstetrics & gynaecology (O&G), otorhinolaryngology (ENT) and orthopaedics. Relevant antimicrobial use data of each patient was collected in a customized Case Record Form (CRF) from day one until patient was discharged...
September 26, 2016: Reviews on Recent Clinical Trials
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