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Adherence & Antibiotic & Clinical Practice Guidelines

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https://www.readbyqxmd.com/read/29101616/a-multifaceted-intervention-to-reduce-guideline-non-adherence-among-prescribing-physicians-in-dutch-hospitals
#1
Jacqueline M Bos, Stephanie Natsch, Patricia M L A van den Bemt, Johan L W Pot, J Elsbeth Nagtegaal, Andre Wieringa, Gert Jan van der Wilt, Peter A G M De Smet, Cornelis Kramers
Background Despite the potential of clinical practice guidelines to improve patient outcomes, adherence to guidelines by prescribers is inconsistent. Objective The aim of the study was to determine whether an approach of introducing an educational programme for prescribers in the hospital combined with audit and feedback by the hospital pharmacist reduces non-adherence of prescribing physicians to key pharmacotherapeutic guidelines. Setting This prospective intervention study with a before-after design evaluated patients at surgical, urological and orthopaedic wards...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29083083/fever-under-3-months-and-the-full-septic-screen-time-to-think-again-a-retrospective-cohort-study-at-a-tertiary-level-paediatric-hospital
#2
Patrick Aldridge, Arjun Rao, Rebecca Sethumadavan, Nancy Briggs
AIM: To assess adherence to the Iocal guideline (LG) for the management of fever in infants under 3 months and whether the application of a risk-stratified protocol (RSP) to this population would miss any serious bacterial infections (SBI) compared to current practice (CP) and LG. METHODS: All presentations to the authors' Emergency Department of infants 0-3 months with fever from 1 July 2015 to 28 April 2016 were included (n = 219), along with a detailed analysis of CP...
October 30, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28991775/evidence-based-practice-in-using-antibiotics-for-acute-tonsillitis-in-primary-care-practice
#3
Valentina Risteska Nejashmikj, Snezana Stojkovska, Irena Kondova Topuzovska, Katarina Stavrikj
The increased use of antibiotics for acute tonsillitis is a public health problem. 80% of the antibiotic prescriptions for acute tonsillitis are done in the Primary Care practice (PCP). The inappropriate use of the antibiotic causes bacterial resistance and treatment failure. Only patients with acute tonsillitis caused by Group A beta-hemolytic streptococcus (GAS) have benefit of the antibiotic treatment, which is a predict cause in 5-20%. In order to assess the antibiotic prescribing for acute tonsillitis by the doctors in the PCP in Macedonia we use the data from the national project about antibiotic prescribing for acute respiratory tract infections which was conducted in November 2014 during a period of 4 weeks as part of the E-quality program sponsored by the IPCRG...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28943077/evaluation-of-an-evidence-based-throat-pain-protocol-to-reduce-left-without-being-seen-length-of-stay-and-antibiotic-prescribing
#4
Deanna Settelmeyer
BACKGROUND: Increasing numbers of people are seeking unscheduled medical care in United States' emergency departments, which contributes to delayed throughput and increased patient length of stay. Implementation of nurse-initiated protocols, such as those for throat pain, initiates early diagnostic testing, optimizes patient throughput strategies, and promotes adherence to clinic practice guidelines for an additional segment of patients. AIM: To evaluate the effect of an evidence-based throat-pain protocol...
September 21, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28883911/antibiotic-resistance-and-biofilm-formation-among-coagulase-negative-staphylococci-isolated-from-clinical-samples-at-a-tertiary-care-hospital-of-eastern-nepal
#5
Lok Bahadur Shrestha, Narayan Raj Bhattarai, Basudha Khanal
BACKGROUND: Coagulase negative staphylococci were long regarded non-pathogenic as they are the commensals of human skin and mucosa but the recent changes in the medical practice and changes in underlying host populations, they are being considered significant pathogens associated with number of nosocomial infections. The objective of the study was to determine the species, antimicrobial susceptibility pattern, biofilm forming ability of the clinically significant CoNS isolates and to compare the different methods for the detection of biofilm formation...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28858915/how-to-translate-the-new-hospital-acquired-and-ventilator-associated-pneumonia-guideline-to-the-bedside
#6
Mario F Perez, Mark L Metersky, Andre C Kalil
PURPOSE OF REVIEW: Hospital-acquired pneumonia and ventilator-associated pneumonia remain significant causes of morbidity, mortality, and financial burden in the United States and around the globe. Although guidelines for the management of patients with these conditions have been available for several years, implementation remains challenging. Here, we review the most common barriers faced by clinicians in implementing the current guidelines and offer suggestions for improved adherence...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28846153/international-survey-of-knowledge-attitudes-and-practices-of-cardiologists-regarding-prevention-and-management-of-cardiac-implantable-electronic-device-infections
#7
Daniel C DeSimone, Anwar A Chahal, Christopher V DeSimone, Samuel J Asirvatham, Paul A Friedman, Larry M Baddour, M Rizwan Sohail
BACKGROUND: Cardiovascular implantable electronic devices (CIEDs) can be life-saving. However, complications from CIED infection can be life-threatening, often requiring device removal. Despite publication of CIED infection management guidelines, there remains marked variation in clinical practice. OBJECTIVE: To better understand and quantify these differences, we conducted a multinational survey of practitioners of CIED management. METHODS: An electronic survey was sent to Heart Rhythm Society members, spanning 70 countries across six continents...
August 28, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28814444/implementing-an-inpatient-pediatric-prospective-audit-and-feedback-antimicrobial-stewardship-program-within-a-larger-medical-center
#8
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...
September 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28791973/pattern-of-prescription-of-antibiotics-among-dental-practitioners-in-jeddah-ksa-a-cross-sectional-survey
#9
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
#10
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...
October 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28580893/appropriateness-of-surgical-antibiotic-prophylaxis-in-pediatric-patients-in-italy
#11
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
#12
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)...
August 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
#13
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
#14
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...
October 1, 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
#15
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
#16
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
#17
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
#18
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
#19
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 DeSimone, 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...
October 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28291497/variation-in-postinjury-antibiotic-prophylaxis-patterns-over-five-years-in-a-combat-zone
#20
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
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