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Adherence & Antibiotic & Clinical Practice Guidelines

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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
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/27524422/determinants-of-practice-patterns-in-pediatric-uti-management
#5
R E Selekman, I E Allen, H L Copp
INTRODUCTION: Urinary tract infection (UTI) affects 10% of girls and 3% of boys by age 16. Both the American Academy of Pediatrics and National Institute for Health and Clinical Excellence Guidelines recommend urine testing prior to initiation of antibiotic treatment and the use of local antibiograms to guide empiric antibiotic therapy. Urine culture results not only provide the opportunity to halt empiric therapy if there is no bacterial growth, but also allow for tailoring of broad-spectrum therapy...
July 5, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27437042/sinusitis-treatment-guideline-adherence-in-the-e-visit-setting-a-performance-improvement-project
#6
Kevin L Smith, Dang Tran, Bonnie L Westra
BACKGROUND: Studies demonstrate poor guideline adherence by health care providers for the treatment of upper respiratory infections, particularly acute bacterial rhinosinusitis (ABRS), in the appropriate prescribing of antibiotic medications. OBJECTIVE: The purpose of this quality improvement project was to evaluate the effect of implementing interventions for improving adherence to a clinical practice guideline for the management of ABRS for patients treated in the e-visit setting...
2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27316262/drug-prescribing-patterns-among-optometrists-and-nonophthalmologist-physicians-at-a-tertiary-care-centre-in-kingston-ontario
#7
Davin Johnson, Sherif R El-Defrawy, Simon Hollands, Jonathan Hurst, Christine Law, Cody Li, Stephanie Baxter, Erica de L P Campbell, Robert J Campbell
OBJECTIVE: To report on patterns of optometry prescribing and adherence to prescribing regulations at a tertiary care ophthalmology centre. DESIGN: Prospective cohort study. PARTICIPANTS: All new referrals from optometrists and other health care professionals to the emergency eye care service (n = 1965) between July 2011 and June 2012, as well as optometry referrals to 2 subspecialty services (glaucoma [n = 71] and cornea [n = 212]). METHODS: In our primary analysis, the frequency of prescribing and classes of medications prescribed were reported and compared amongst various referral sources to the emergency eye care service...
June 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/27281440/cost-of-medications-recommended-by-canadian-acne-clinical-practice-guidelines
#8
Tiffany Czilli, Jerry Tan, Sanja Knezevic, Colin Peters
BACKGROUND: Acne affects a large proportion of the Canadian population and has psychosocial and financial consequences. OBJECTIVE: We provide cost information for treatments recommended by the Canadian acne guidelines. METHODS: Highest level recommendations were selected for 3-month usage cost. RESULTS: Three-month estimated treatment costs were as follows: topical retinoids ($14.40-$73.80), benzoyl peroxide (BPO; $6...
June 8, 2016: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/27267983/changing-the-antibiotic-prescribing-of-general-practice-registrars-the-chap-study-protocol-for-a-prospective-controlled-study-of-a-multimodal-educational-intervention
#9
Mieke L van Driel, Simon Morgan, Amanda Tapley, Lawrie McArthur, Patrick McElduff, Lucy Yardley, Anthea Dallas, Laura Deckx, Katie Mulquiney, Joshua S Davis, Andrew Davey, Kim Henderson, Paul Little, Parker J Magin
BACKGROUND: Australian General Practitioners (GPs) are generous prescribers of antibiotics, prompting concerns including increasing antimicrobial resistance in the community. Recent data show that GPs in vocational training have prescribing patterns comparable with the high prescribing rate of their established GP supervisors. Evidence-based guidelines consistently advise that antibiotics are not indicated for uncomplicated upper respiratory tract infections (URTI) and are rarely indicated for acute bronchitis...
2016: BMC Family Practice
https://www.readbyqxmd.com/read/27267201/prevention-of-clostridium-difficile-infection-a-systematic-survey-of-clinical-practice-guidelines
#10
Lyubov Lytvyn, Dominik Mertz, Behnam Sadeghirad, Faisal Alaklobi, Anna Selva, Pablo Alonso-Coello, Bradley C Johnston
BACKGROUND Clostridium difficile infection (CDI) is the most common cause of hospital-acquired infectious diarrhea. OBJECTIVE To analyze the methodological quality, content, and supporting evidence among clinical practice guidelines (CPGs) on CDI prevention. DESIGN AND SETTING We searched medical databases and gray literature for CPGs on CDI prevention published January 2004-January 2015. Three reviewers independently screened articles and rated CPG quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, composed of 23 items, rated 1-7, within 6 domains...
August 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27206294/implementing-the-surviving-sepsis-campaign-in-an-ambulatory-clinic-for-patients-with-hematologic-malignancies
#11
Brenda K Shelton, Julie Stanik-Hutt, Joyce Kane, Richard J Jones
BACKGROUND: Infectious complications can occur in patients receiving cancer treatment and are the most common cause of death not directly related to malignancy. Established international best practices for recognition and management of early sepsis with bundled interventions reduce sepsis-related morbidity and mortality in many patient populations. Integration of these practices is common in emergency departments but has not been documented in ambulatory oncology clinics, where many patients with cancer present for evaluation of infectious symptoms...
June 1, 2016: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/27197372/the-path-of-least-resistance-in-oral-surgery
#12
REVIEW
Laura Fee
STATEMENT OF THE PROBLEM: Antibiotic resistance is an imminent threat to worldwide public health. Dental professionals must demonstrate judicious use of antibiotics and educate their patients about the risks associated with their overuse. PURPOSE OF THE PAPER: To encourage the dental profession to prescribe responsibly in order to optimise the use of antibiotics in oral surgery. Antibiotic stewardship programmes are recommended to help reduce the emergence of infections that are multidrug-resistant...
April 2016: Journal of the Irish Dental Association
https://www.readbyqxmd.com/read/27188438/uncertainty-in-clinical-practice-an-interview-study-with-swedish-gps-on-patients-with-sore-throat
#13
Malin Andre, Hedvig Gröndal, Eva-Lena Strandberg, Annika Brorsson, Katarina Hedin
BACKGROUND: Uncertainty is inevitable in clinical practice in primary care and tolerance for uncertainty and concern for bad outcomes has been shown to vary between physicians. Uncertainty is a factor for inappropriate antibiotic prescribing. Evidence-based guidelines as well as near-patient tests are suggested tools to decrease uncertainty in the management of patients with respiratory tract infections. The aim of this paper was to describe strategies for coping with uncertainty in patients with pharyngotonsillitis in relation to guidelines...
2016: BMC Family Practice
https://www.readbyqxmd.com/read/27177989/a-consensus-based-practical-and-daily-guide-for-the-treatment-of-acne-patients
#14
H P Gollnick, V Bettoli, J Lambert, E Araviiskaia, I Binic, C Dessinioti, I Galadari, R Ganceviciene, N Ilter, M Kaegi, L Kemeny, J L López-Estebaranz, A Massa, C Oprica, W Sinclair, J C Szepietowski, B Dréno
BACKGROUND: Many current guidelines provide detailed evidence-based recommendations for acne treatment. OBJECTIVE: To create consensus-based, simple, easy-to-use algorithms for clinical acne treatment in daily office-based practice and to provide checklists to assist in determining why a patient may not have responded to treatment and what action to take. METHODS: Existing treatment guidelines and consensus papers were reviewed. The information in them was extracted and simplified according to daily clinical practice needs using a consensus-based approach and based on the authors' clinical expertise...
September 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/27138235/-non-antibiotic-strategies-to-prevent-the-recurrence-of-uncomplicated-urinary-tract-infections-in-women
#15
H W Bauer, W G Bessler
The aim of all medical treatment is "primum nihil nocere" ("First, do no harm").Restoring the integrity of intestinal microbiota and optimising the immune response in recurrent infections, especially in the urinary tract, are treatment alternatives which are closer to this target than the usual focus on antibiotic prevention of recurrence.In the future, antibiotics will continue to be recommended for the prevention of urinary tract infections on a case-by-case basis. However, the problems of an excessive use of antibiotics, e...
May 2016: Aktuelle Urologie
https://www.readbyqxmd.com/read/26971448/remote-links-redesigning-maternity-care-for-aboriginal-women-from-remote-communities-in-northern-australia%C3%A2-a-comparative-cohort-study
#16
Sue Kildea, Yu Gao, Margaret Rolfe, Cathryn M Josif, Sarah J Bar-Zeev, Malinda Steenkamp, Sue Kruske, Desley Williams, Terry Dunbar, Lesley M Barclay
OBJECTIVE: to compare the quality of care before and after the introduction of the new Midwifery Group Practice. DESIGN: a cohort study. SETTING: the health centers (HCs) in two of the largest remote Aboriginal communities (population 2200-2600) in the Top End of the Northern Territory (NT), each located approximately 500km from Darwin. The third study site was the Royal Darwin Hospital (RDH) which provides tertiary care. METHODS: a 2004-06 retrospective cohort (n=412 maternity cases) provided baseline data...
March 2016: Midwifery
https://www.readbyqxmd.com/read/26945362/optimizing-prophylactic-antibiotic-practice-for-cardiothoracic-surgery-by-pharmacists-effects
#17
Ling Zhou, Jingjing Ma, Jie Gao, Shiqi Chen, Jianan Bao
Pharmacists' role may be ideal for improving rationality of drug prescribing practice. We aimed to study the impact of multifaceted pharmacist interventions on antibiotic prophylaxis in patients undergoing clean or clean-contaminated operations in cardiothoracic department. A pre-test-post-test quasiexperimental study was conducted in a cardiothoracic ward at a tertiary teaching hospital in Suzhou, China. Patients admitted to the ward were collected as baseline group (2011.7-2012.12) and intervention group (2013...
March 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26920549/an-audit-and-feedback-intervention-study-increased-adherence-to-antibiotic-prescribing-guidelines-at-a-norwegian-hospital
#18
June Utnes Høgli, Beate Hennie Garcia, Frode Skjold, Vegard Skogen, Lars Småbrekke
BACKGROUND: Appropriate antibiotic prescribing is associated with favourable levels of antimicrobial resistance (AMR) and clinical outcomes. Most intervention studies on antibiotic prescribing originate from settings with high level of AMR. In a Norwegian hospital setting with low level of AMR, the literature on interventions for promoting guideline-recommended antibiotic prescribing in hospital is scarce and requested. Preliminary studies have shown improvement potentials regarding antibiotic prescribing according to guidelines...
2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/26777255/bite-wounds-and-antibiotic-prescription-among-patients-presenting-to-an-australian-emergency-department
#19
Matthew Birdsey, Gail Edwards, Jeremy Abetz, Natasha Jennings, Biswadev Mitra
INTRODUCTION: Emergency department presentations after mammalian bites may be associated with injection of bacteria into broken skin and may require prophylactic antibiotics to prevent subsequent infection. We aim to describe the epidemiology of patients presenting with a mammalian bite injury and antibiotic choice to an Australian adult tertiary centre. METHODS: A retrospective cohort study was performed capturing all presentations after mammalian bite wounds between 01 Jan 2014 and 31 Dec 2014...
July 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/26708998/-identifying-gaps-between-guidelines-and-clinical-practice-in-clostridium-difficile-infection
#20
C Rodríguez-Martín, A Serrano-Morte, L A Sánchez-Muñoz, P A de Santos-Castro, M A Bratos-Pérez, R Ortiz de Lejarazu-Leonardo
OBJECTIVES: The first aim was to determine whether patients are being treated in accordance with the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America (IDSA/SHEA) Clostridium difficile guidelines and whether adherence impacts patient outcomes. The second aim was to identify specific action items in the guidelines that are not being translated into clinical practice, for their subsequent implementation. MATERIAL AND METHODS: A retrospective, descriptive study was conducted over a 36 month period, on patients with compatible clinical symptoms and positive test for C...
May 2016: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
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