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Clinical Practice Guidelines Antibiotic

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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/28814443/antibiotic-use-by-pediatric-residents-identifying-opportunities-and-strategies-for-antimicrobial-stewardship
#2
Prateek J Shukla, Maria Behnam-Terneus, Beatriz Cunill-De Sautu, Geovanny F Perez
OBJECTIVES: To determine the antibiotic prescribing practices of pediatric residents and assess how they acquire knowledge leading to prescribing behaviors. METHODS: We performed a cross-sectional electronic survey of all pediatric residents at the Children's National Medical Center and Nicklaus Children's Hospital, assessing antibiotic prescribing patterns for common pediatric infections, use of antibiograms, and factors influencing antibiotic choice. RESULTS: Eighty-five surveys (45%) were returned complete and included in the analysis...
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28814258/management-of-complicated-pneumonia-in-childhood-a-review-of-recent-literature
#3
John B Darby, Amrita Singh, Ricardo Quinonez
BACKGROUND: Despite declining rates of community acquired pneumonia (CAP) in children, complicated pneumonia has been on the rise in the last two decades. The management of complicated pneumonia is challenging and continues to be an area of investigation. Despite recently published guidelines, many gaps exist and recent studies attempt to answer challenging questions. OBJECTIVE: To review recently published literature to inform the clinician on the most up to date management of complicated pneumonia in children...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28808771/multicentre-controlled-randomized-clinical-trial-to-compare-the-efficacy-and-safety-of-ambulatory-treatment-of-mild-acute-diverticulitis-without-antibiotics-with-the-standard-treatment-with-antibiotics
#4
Laura Mora Lopez, Neus Ruiz-Edo, Sheila Serra Pla, Anna Pallisera Llovera, Salvador Navarro Soto, Xavier Serra-Aracil
PURPOSE: Acute diverticulitis (AD) is a highly prevalent disease in Spain. Its chronic-recurrent appearance and high rate of relapse mean that it has a major epidemiological and economic impact on our health system. In spite of this, it has not been studied in any great depth. Reassessing its etiopathology, recent studies have observed that it is an inflammatory disease-not, as classic theories had postulated, an infectious one. In the light of these findings, the suitability of antibiotics for its treatment has been reconsidered...
August 14, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28808076/influence-of-the-duration-of-penicillin-prescriptions-on-outcomes-for-acute-sore-throat-in-adults-the-descarte-prospective-cohort-study-in-uk-general-practice
#5
Michael Moore, Beth Stuart, Fd Richard Hobbs, Chris C Butler, Alastair D Hay, John Campbell, Brendan C Delaney, Sue Broomfield, Paula Barratt, Kerenza Hood, Hazel Everitt, Mark Mullee, Ian Williamson, David Mant, Paul Little
BACKGROUND: Guidelines recommend 10-day treatment courses for acute sore throat, but shorter courses may be used in practice. AIM: To determine whether antibiotic duration predicts adverse outcome of acute sore throat in adults in routine care. DESIGN AND SETTING: A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study of 12 829 adults presenting in UK general practice with acute sore throat...
August 14, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28791973/pattern-of-prescription-of-antibiotics-among-dental-practitioners-in-jeddah-ksa-a-cross-sectional-survey
#6
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/28790042/multicentre-randomised-controlled-trial-to-investigate-the-usefulness-of-continuous-pneumatic-regulation-of-tracheal-cuff-pressure-for-reducing-ventilator-associated-pneumonia-in-mechanically-ventilated-severe-trauma-patients-the-agate-study-protocol
#7
Nicolas Marjanovic, Denis Frasca, Karim Asehnoune, Catherine Paugam, Sigismond Lasocki, Carole Ichai, Jean-Yves Lefrant, Marc Leone, Claire Dahyot-Fizelier, Julien Pottecher, Dominique Falcon, Benoit Veber, Jean-Michel Constantin, Sabrina Seguin, Jérémy Guénézan, Olivier Mimoz
INTRODUCTION: Severe trauma represents the leading cause of mortality worldwide. While 80% of deaths occur within the first 24 hours after trauma, 20% occur later and are mainly due to healthcare-associated infections, including ventilator-associated pneumonia (VAP). Preventing underinflation of the tracheal cuff is recommended to reduce microaspiration, which plays a major role in the pathogenesis of VAP. Automatic devices facilitate the regulation of tracheal cuff pressure, and their implementation has the potential to reduce VAP...
August 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28779832/evaluation-and-management-of-necrotizing-soft-tissue-infections
#8
REVIEW
Stephanie L Bonne, Sameer S Kadri
Despite advances in antibiotic and surgical management and supportive care for necrotizing soft tissue infections, morbidity and mortality remain substantial. Although there are clinical practice guidelines in place, there still remains much variability in choice and duration of antibiotic therapy, time to initial surgical debridement, and use of adjuvant medical therapies. This article offers an overview of necrotizing soft tissue infections with a focus on current diagnostic and treatment modalities.
September 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28745729/highlights-of-skin-disease-education-foundation-s-41st-annual-hawaii-dermatology-seminar%C3%A2
#9
Kenneth B Gordon, Craig L Leonardi, Daniel E Furst, Neal Bhatia, Lawrence F Eichenfield, Katie Beleznay
New therapies, recent pathophysiological findings, and updated guidelines combined to create compelling presentations at the Skin Disease Education Foundation's 41st Annual Hawaii Dermatology Seminar™. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. A growing understanding of the biology of psoriasis has facilitated the development of increasingly efficacious medications. Skin clearance used to be regarded as an impractical goal for psoriasis therapy...
June 2017: Seminars in Cutaneous Medicine and Surgery
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...
July 26, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28729110/no-211-screening-and-management-of-bacterial-vaginosis-in-pregnancy
#11
Mark H Yudin, Deborah M Money
OBJECTIVE: To review the evidence and provide recommendations on screening for and management of bacterial vaginosis in pregnancy. OPTIONS: The clinical practice options considered in formulating the guideline. OUTCOMES: Outcomes evaluated include antibiotic treatment efficacy and cure rates, and the influence of the treatment of bacterial vaginosis on the rates of adverse pregnancy outcomes such as preterm labour and delivery and preterm premature rupture of membranes...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28711429/-appropriateness-of-antibiotic-prescribing-in-paediatric-patients-in-a-hospital-emergency-department
#12
Borja Croche Santander, Elena Campos Alonso, Adela Sánchez Carrión, Laura Marcos Fuentes, Isabel Diaz Flores, Juan Carlos Vargas, Bárbara Fernández Domínguez, Cristóbal Toro Ibañez
INTRODUCTION: Antibiotics represent one of the most widely prescribed therapeutic agents in children. It has been estimated that 30-50% of antibiotic prescriptions for this population are inappropriate. In this scenario, analysis of prescription data provides an invaluable source of information as a basis for implementing strategies for improvement in this field. OBJECTIVE: To assess the appropriateness of antibiotic prescriptions in a paediatric population at an emergency department...
July 12, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28696803/thai-pediatricians-current-practice-toward-childhood-asthma
#13
Harutai Kamalaporn, Pongpan Chawalitdamrong, Aroonwan Preutthipan
BACKGROUND: Childhood asthma is a substantial health burden in Thailand. Due to a lack of pediatric respiratory specialists (pediatric pulmonologists and allergists; RS), most Thai children are cared for by general pediatricians (pediatric primary care providers (PCP)). OBJECTIVES: We investigated whether current practices of Thai pediatricians complied with asthma guidelines and compared practices (diagnosis and treatments) provided by PCP and RS. METHODS: A cross-sectional study was conducted using electronic surveys including four case scenarios of different asthma phenotypes distributed to Thai pediatricians...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28687464/antibiotic-stewardship-in-the-retail-clinic-setting-implementation-in-1100-clinics-nationwide
#14
Jennifer M Polinski, Sandra L Harmon, Kimberly J Henderson, Tobias Barker, Andrew Sussman, Nancy J Gagliano
In light of increasing antibiotic resistance and a slowed antibiotic development pipeline, stewardship is more urgent than ever. To date, most stewardship guidelines and best practice recommendations for implementation focus on local or regional health care organizations. CVS MinuteClinic has implemented a consistent, evidence-based stewardship approach in its >1100 clinics in 33 states. The approach is associated with higher quality antibiotic use than that in primary care practices and emergency departments...
July 4, 2017: Healthcare
https://www.readbyqxmd.com/read/28674308/improved-clinical-outcomes-in-patients-with-positive-blood-culture-by-proactive-intervention-of-antimicrobial-use-impact-of-antimicrobial-stewardship-program-implementation-on-clinical-practice
#15
Takehiro Yamada, Keisuke Kagami, Shungo Imai, Koji Akizawa, Sumio Iwasaki, Tatsuya Fukumoto, Nobuhisa Ishiguro, Ken Iseki
 Bacteremia is one of the most serious infectious illness resulting from nosocomial infection. Therefore, appropriate antimicrobial chemotherapy should be provided as soon as possible to patients exhibiting symptoms of infectious disease and having positive blood culture results. Antimicrobial stewardship (AS) guidelines were recently released by the Infectious Diseases Society of America. The guidelines recommend "proactive intervention and feedback" as one of the core strategies for implementing optimal antimicrobial drug use to improve patient outcomes in clinical settings...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28666918/urinary-tract-infection-after-retrograde-urethrogram-in-children-a-multicenter-study
#16
Neha R Malhotra, Jared R Green, Cynthia K Rigsby, Jane L Holl, Earl Y Cheng, Emilie K Johnson
INTRODUCTION: The risk of post-procedural urinary tract infection (ppUTI) after retrograde urethrogram (RUG) has not been well quantified. Prophylactic antibiotics may reduce the risk, but must be weighed against the risks of antibiotic resistance. Prior research has shown that this risk is variable after voiding cystourethrogram (0-42% reported ppUTI rate) and appears to be low after urodynamics (0-4.8%) but this risk has not been well documented for patients undergoing RUG. OBJECTIVE: We aimed to (1) describe the rate of ppUTI after RUG, and (2) examine factors associated with use of antibiotics at the time of RUG...
June 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28666562/emergency-medicine-myths-computed-tomography-of-the-head-prior%C3%A2-to-lumbar-puncture-in-adults-with-suspected-bacterial-meningitis-due-diligence-or-antiquated-practice
#17
Michael D April, Brit Long, Alex Koyfman
BACKGROUND: Various sources purport an association between lumbar puncture and brainstem herniation in patients with intracranial mass effect lesions. Several organizations and texts recommend head computed tomography (CT) prior to lumbar puncture in selected patients. OBJECTIVE: To review the evidence regarding the utility of obtaining head CT prior to lumbar puncture in adults with suspected bacterial meningitis. DISCUSSION: Observational studies report a risk of post-lumbar puncture brainstem herniation in the presence of intracranial mass effect (1...
June 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28624753/treatment-of-asymptomatic-uti-in-older-delirious-medical-in-patients-a-prospective-cohort-study
#18
Monidipa Dasgupta, Chris Brymer, Sameer Elsayed
BACKGROUND: Despite clinical practice guidelines, asymptomatic bacteriuria (ASB) in older people is frequently treated. A common reason for treating ASB is a change in mental status. OBJECTIVE: To determine how often asymptomatic UTI is treated in older medically ill delirious individuals and its association with functional recovery. METHODS: Consecutive older medical in-patients were screened for delirium, and followed in hospital. Treatment for asymptomatic UTI was defined as documented treatment for a possible urinary tract infection with antibiotics, without concurrent infectious or urinary symptoms...
September 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28618862/probiotic-guidelines-and-physician-practice-a-cross-sectional-survey-and-overview-of-the-literature
#19
K Draper, C Ley, J Parsonnet
Probiotic use by patients and physicians has dramatically increased over the last decade, although definitive evidence is often lacking for their use. We examined probiotic-prescribing practices among health care providers (HCP) at a tertiary medical centre and compared these practices to clinical guidelines. HCP at the Stanford Medical Center received a survey on probiotic prescribing practices including choice of probiotic and primary indications. A broad overview of the literature was performed. Among 2,331 HCP surveyed, 632 responded...
June 16, 2017: Beneficial Microbes
https://www.readbyqxmd.com/read/28618388/simultaneous-determination-of-nine-%C3%AE-lactam-antibiotics-in-human-plasma-by-an-ultrafast-hydrophilic-interaction-chromatography-tandem-mass-spectrometry
#20
Alan Abdulla, Soma Bahmany, Rixt A Wijma, Bart C H van der Nagel, Birgit C P Koch
Contemporary β-lactam antibiotic dosing is debatable in severely ill patients, since the occurrence of pathophysiological changes in critical illness can result in great inter-individual variability. Therapeutic drug monitoring (TDM) is a commonly used dosing strategy to optimize exposure and thereby minimize toxicity and maximize the efficacy. Currently, TDM of β-lactam antibiotics is rarely performed, due to poor availability in clinical practice. We describe an ultrafast Hydrophilic-Interaction Chromatography (HILIC) based UPLC-MS/MS method for the determination of amoxicillin, benzylpenicillin, cefotaxime, cefuroxime, ceftazidime, flucloxacillin, imipenem, meropenem and piperacillin in human plasma...
June 8, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
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