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Adherence & Antibiotic & Clinical Practice Guidelines

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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
#1
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
#2
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
#3
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 morality 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 ten months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
April 5, 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
#4
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
#5
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 centers. This is probably due to the fact that most recommendations are not based on hard evidence, so that the consensus obtained for the guidelines does not represent actual practices. For this reason, we aimed at evaluating this question in the particular field of antibiotic therapy. METHODS: Thirteen international centers 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
#6
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
#7
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...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28119402/a-national-pharmacoepidemiological-study-of-antibiotic-use-in-korean-paediatric-outpatients
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
October 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27437042/sinusitis-treatment-guideline-adherence-in-the-e-visit-setting-a-performance-improvement-project
#15
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
#16
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
#17
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...
November 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
#18
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
#19
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
#20
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
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