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https://www.readbyqxmd.com/read/29781385/procalcitonin-guided-use-of-antibiotics-for-lower-respiratory-tract-infection
#1
David T Huang, Donald M Yealy, Michael R Filbin, Aaron M Brown, Chung-Chou H Chang, Yohei Doi, Michael W Donnino, Jonathan Fine, Michael J Fine, Michelle A Fischer, John M Holst, Peter C Hou, John A Kellum, Feras Khan, Michael C Kurz, Shahram Lotfipour, Frank LoVecchio, Octavia M Peck-Palmer, Francis Pike, Heather Prunty, Robert L Sherwin, Lauren Southerland, Thomas Terndrup, Lisa A Weissfeld, Jonathan Yabes, Derek C Angus
Background The effect of procalcitonin-guided use of antibiotics on treatment for suspected lower respiratory tract infection is unclear. Methods In 14 U.S. hospitals with high adherence to quality measures for the treatment of pneumonia, we provided guidance for clinicians about national clinical practice recommendations for the treatment of lower respiratory tract infections and the interpretation of procalcitonin assays. We then randomly assigned patients who presented to the emergency department with a suspected lower respiratory tract infection and for whom the treating physician was uncertain whether antibiotic therapy was indicated to one of two groups: the procalcitonin group, in which the treating clinicians were provided with real-time initial (and serial, if the patient was hospitalized) procalcitonin assay results and an antibiotic use guideline with graded recommendations based on four tiers of procalcitonin levels, or the usual-care group...
May 20, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29771104/-appropriateness-of-antimicrobial-prescriptions-in-the-emergency-department-of-a-tertiary-hospital
#2
L Yunquera-Romero, I Márquez-Gómez, A Henares-López, M J Morales-Lara, C Gallego Fernández, R Asensi-Díez
OBJECTIVE: Antibiotics are widely prescribed in the Emergency Department (ED), representing 26-62% of outpatient antibiotic prescriptions. Around 40% of antibiotic prescriptions in hospitalized patients are inappropriate or unnecessary. The aim of the study was to assess the appropriateness of antibiotic prescriptions according to local empirical antibiotic treatment guidelines, in the ED of a tertiary hospital. METHODS: Observational, retrospective study including patients attending the ED in November 2016, with an antibiotic prescription, excluding those from residents...
May 16, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29750767/potential-for-more-rational-use-of-antibiotics-in-hospitalized-children-in-a-country-with-low-resistance-data-from-eight-point-prevalence-surveys
#3
Christian Magnus Thaulow, Dag Berild, Beate Horsberg Eriksen, Tor Åge Myklebust, Hege Salvesen Blix
BACKGROUND: Antimicrobial resistance (AMR) is low in Norway, but to prevent an increase the Norwegian Government has launched a National Strategy including a 30% reduction of broad-spectrum antibiotics (BSA) in hospitals within 2020. BSA are defined as second- and third-generation cephalosporins, carbapenems, piperacillin/tazobactam and quinolones. There are no recent studies of antibiotic use in Norwegian hospitalized children. AIM OF THE STUDY: To describe the use of antibiotics with emphasis on BSA in Norwegian hospitalized children and neonates in order to detect possibilities for optimization...
May 10, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29722052/the-methodological-quality-of-guidelines-for-hospital-acquired-pneumonia-and-ventilator-associated-pneumonia-a-systematic-review
#4
REVIEW
R Ambaras Khan, Z Aziz
WHAT IS KNOWN AND OBJECTIVES: Clinical practice guidelines serve as a framework for physicians to make decisions and to support best practice for optimizing patient care. However, if the guidelines do not address all the important components of optimal care sufficiently, the quality and validity of the guidelines can be reduced. The objectives of this study were to systematically review current guidelines for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), evaluate their methodological quality and highlight the similarities and differences in their recommendations for empirical antibiotic and antibiotic de-escalation strategies...
May 2, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29719370/evaluation-of-physician-prescribing-patterns-for-antibiotics-in-the-treatment-of-nonnecrotizing-skin-and-soft-tissue-infections
#5
Michael C Ezebuenyi, Fatima Brakta, Ifeanyichukwu O Onor, Daniel F Sarpong, Kendrea Bryant-Burks, Julio E Figueroa
Purpose: Skin and soft tissue infections (SSTIs) cause about 15 million cases of infection that result in more than 869,000 annual hospitalizations in the United States. Cellulitis accounted for 63% of all patients hospitalized with SSTIs between 2009 and 2011. The primary objective of this study was to evaluate physician adherence rates to evidence-based practice guidelines. Secondary objectives included evaluating antibiotic selection preferences and duration of therapy. The goal of the project was to generate data to inform the development of a hospital-based protocol for nonnecrotizing SSTI treatment...
May 2018: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29688837/use-and-effectiveness-of-peri-operative-cefotetan-versus-cefazolin-plus-metronidazole-for-prevention-of-surgical-site-infection-in-abdominal-surgery-patients
#6
Eleanor Danan, Janessa Smith, Rachel M Kruer, Edina Avdic, Pamela Lipsett, Melanie S Curless, Andrew S Jarrell
BACKGROUND: Current practice guidelines for antimicrobial prophylaxis in surgery recommend a cephamycin or cefazolin plus metronidazole for various abdominal surgeries. In February 2016, cephamycin drug shortages resulted in a change in The Johns Hopkins Hospital's (JHH) recommendation for peri-operative antibiotic prophylaxis in abdominal surgeries from cefotetan to cefazolin plus metronidazole. The primary objective of this study was to quantify the percentage of abdominal surgeries adherent to JHH peri-operative antibiotic prophylaxis guidelines...
April 24, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29688647/-position-statement-for-intermittent-catheterization-of-urinary-bladder
#7
Michael Vainrib, Kobi Stav, Ilan Gruenwald, Gabriel Gilon, Shahar Aharony, Miki Gross, Vadim Bluvshtein, Yakova Kauffman
A position paper presents the standpoint of the Israeli Urological Association on clean intermittent catheterization (CIC) for all physicians and nurses. The position paper is based on international guidelines and professional literature and is adapted to medical activities in Israel. CIC is indicated for the treatment of temporary/permanent disability in the emptying of the bladder, which is expressed by large post-voided urine/urine retention and related complications. There are a few contra-indications for CIC (low bladder volume or compliance, pressure sores/external infection of the urethra, anatomical, functional or cognitive disorder that does not allow to perform CIC, recurrent macrohematuria or urethrorrhagia, urethral pain that does not allow frequent catheterization, patient unwillingness to perform CIC by himself or by another person)...
April 2018: Harefuah
https://www.readbyqxmd.com/read/29681513/antimicrobial-consumption-and-resistance-in-adult-hospital-inpatients-in-53-countries-results-of-an-internet-based-global-point-prevalence-survey
#8
Ann Versporten, Peter Zarb, Isabelle Caniaux, Marie-Françoise Gros, Nico Drapier, Mark Miller, Vincent Jarlier, Dilip Nathwani, Herman Goossens
BACKGROUND: The Global Point Prevalence Survey (Global-PPS) established an international network of hospitals to measure antimicrobial prescribing and resistance worldwide. We aimed to assess antimicrobial prescribing and resistance in hospital inpatients. METHODS: We used a standardised surveillance method to collect detailed data about antimicrobial prescribing and resistance from hospitals worldwide, which were grouped by UN region. The internet-based survey included all inpatients (adults, children, and neonates) receiving an antimicrobial who were on the ward at 0800 h on one specific day between January and September, 2015...
April 19, 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29678565/simplification-of-first-line-antibacterial-regimen-for-complicated-appendicitis-in-children-was-associated-with-better-adherence-to-guidelines-and-reduced-use-of-antibiotics
#9
Marion Taleb, Nicolas Nardi, Alexis Arnaud, Nathalie Costet, Pierre-Yves Donnio, Charlotte Engrand, Edouard Habonimana, Eric Wodey, Pierre Tattevin
Acute appendicitis in children requires early surgery, and a short course of antibiotics active on Enterobacteriaceae and anaerobes. Although aminoglycoside-containing 3-drug regimen have been used successfully for decades, simpler regimens with similar efficacy are increasingly used. We aimed to evaluate the impact of a switch from the combination of cefotaxime, metronidazole, and gentamicin (regimen 1), to piperacillin-tazobactam (regimen 2), as first-line regimen for complicated acute appendicitis in children...
April 17, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29676194/dose-duration-and-cost-opportunities-to-improve-use-of-long-term-oral-antibiotics-for-people-with-rosacea
#10
Joanne S Rill, Hadar Lev-Tov, Guodong Liu, Joslyn S Kirby
BACKGROUND: Systemic antibiotics are often used to treat rosacea and tetracyclines are the most common antibiotic prescribed; however, there is ambiguity among clinical guideline suggestions. Importantly, there is an increasing call to all clinicians to curtail antibiotic use. OBJECTIVE: Investigate the utilization and cost of long-term oral antibiotic use for the treatment of rosacea, including ocular rosacea. METHODS: This was a retrospective cohort study of MarketScan® Commercial Claims and Encounters database, from January 1, 2005 through December 31, 2014...
April 20, 2018: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29676050/part-2-current-prescribing-trends-of-dental-non-antibacterial-medicines-in-australia-from-2013-to-2016
#11
L Teoh, K Stewart, R J Marino, M J McCullough
BACKGROUND: There is limited literature regarding dental prescribing preferences for medicines other than antibiotics. This study aimed to describe the prescribing trends of dispensed prescription medicines by dentists in Australia from 2013 and 2016 and assess adherence to current guidelines. METHODS: Data was accessed from the Department of Health of all dental prescriptions dispensed under the Pharmaceutical Benefits Scheme (PBS) from 2013 to 2016 and prescribing patterns were analysed...
April 19, 2018: Australian Dental Journal
https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#12
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29675117/adherence-to-international-guidelines-for-the-treatment-of-uncomplicated-urinary-tract-infections-in-lebanon
#13
Wissam K Kabbara, Mohamad M Meski, Wijdan H Ramadan, Dina S Maaliki, Pascale Salameh
Objective: The purpose of this study is to evaluate antibiotic-prescribing practices and adherence to IDSA guidelines for the treatment of uncomplicated urinary tract infections in Lebanon. Methods: This observational prospective study was conducted in 15 community pharmacies in Lebanon over 1 year in adult females. A regimen of nitrofurantoin 100 mg bid for 5 days or fosfomycin 3 grams single dose were considered appropriate. For the bivariate analysis, the chi-square test was used...
2018: Canadian Journal of Infectious Diseases & Medical Microbiology
https://www.readbyqxmd.com/read/29663969/adherence-to-infective-endocarditis-prevention-guidelines-by-israeli-dentists-who-treat-children
#14
Nili Tickotsky, Sarit Faibis, Geula Gellman, Michael Shoshani, Yael Kutiner, Moti Moskovitz
PURPOSE: To examine the rate of adherence of Israeli dentists who treat children and their rate of adherence, in 2010-2011 and in 2016, to changes made to the 2008 American Heart Association (AHA) guidelines for endocarditis prevention. METHODS: A questionnaire on adherence to AHA guidelines was handed out in two consecutive continuing education courses in 2010-2011 and again in 2016. Data were analyzed using student's t test, chi-square, and analysis of variance...
January 15, 2018: Journal of Dentistry for Children
https://www.readbyqxmd.com/read/29629681/antibiotic-prescribing-practice-and-adherence-to-guidelines-in-primary-care-in-the-cape-town-metro-district-south-africa
#15
J Gasson, M Blockman, B Willems
BACKGROUND: Knowledge of antibiotic prescribing practice in primary care in South Africa is limited. As 80% of human antibiotic use is in primary care, this knowledge is important in view of the global problem of antibiotic resistance. OBJECTIVES: To assess antibiotic prescribing in primary care facilities in the Cape Town Metro District and compare it with current national guidelines, and to assess the reasons why prescriptions were not adherent to guidelines. METHODS: A retrospective medical record review was performed in April/May 2016...
March 28, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29628669/variation-in-the-practice-of-central-venous-catheter-and-chest-tube-insertions-among-surgery-residents
#16
Edward Eun Cho, Elizabeth Bevilacqua, Jeffrey Brewer, James Hassett, Weidun Alan Guo
Objectives: Central venous catheter (CVC) and chest tube (CT) insertions are common bedside procedures frequently performed by surgery residents. Despite published guidelines, variability in the practice exists. We sought to characterize the surgery residents' practice patterns surrounding these two bedside procedures. Materials and Methods: Over the last 1½ months of the academic year in 2012 and 2013, surgery residents across the US were surveyed online. Participants reported levels of agreement for 15 questions in a 5-point Likert scale format...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29625943/drug-utilization-and-prescribing-pattern-of-antibiotics-in-a-tertiary-care-setups-trends-and-practices
#17
Huma Ali, Farya Zafar, Shazia Alam, Anwar Ejaz Beg, Rabia Bushra, Ammara Manzoor, Ghazala R Naqvi, Riffat Yasmeen, Yousra Shafiq, Anum Tariq, Saba Zubair, Saima Saleem
Irrational, over and misuse of antibiotics arise as global concern in both hospital and community settings and lead to adverse events including antimicrobial resistance, associated health problems, amplified hospitalization stay and cost. Hence, Drug Utilization Evaluation (DUE) studies are designed to evaluate and improve the prescribing, administration and the rational use of medications. The present study was designed to assess the pattern of antimicrobial drug utilization in in-patients cohort of tertiary care setup in Karachi, Pakistan...
March 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29605347/diagnosis-and-management-of-pediatric-sinusitis-a-survey-of-primary-care-otolaryngology-and-urgent-care-providers
#18
Laurie Newton, Amanda Kotowski, Melissa Grinker, Robert Chun
OBJECTIVES: The aims of this project were two-fold: 1) To assess pediatric primary care (PCP), pediatric otolaryngology (ENT) and pediatric urgent care (UC) providers' perception of their adherence to the 2013 American Academy of Pediatrics (AAP) established guidelines for the diagnosis and management of acute bacterial rhinosinusitis (ABRS) in children 1-18 years old and 2) to assess the same providers' practice patterns in the diagnosis and management of pediatric chronic rhinosinusitis (PCRS)...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29574175/developing-process-maps-as-a-tool-for-a-surgical-infection-prevention-quality-improvement-initiative-in-resource-constrained-settings
#19
Jared A Forrester, Luca A Koritsanszky, Demisew Amenu, Alex B Haynes, William R Berry, Seifu Alemu, Fekadu Jiru, Thomas G Weiser
BACKGROUND: Surgical infections cause substantial morbidity and mortality in low-and middle-income countries (LMICs). To improve adherence to critical perioperative infection prevention standards, we developed Clean Cut, a checklist-based quality improvement program to improve compliance with best practices. We hypothesized that process mapping infection prevention activities can help clinicians identify strategies for improving surgical safety. STUDY DESIGN: We introduced Clean Cut at a tertiary hospital in Ethiopia...
March 21, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29573103/efficacy-and-adverse-effects-of-topical-chloramphenicol-ointment-use-for-surgical-wounds-a-systematic-review
#20
REVIEW
Amanda Y Shen, Elie J Haddad, David J Hunter-Smith, Warren M Rozen
BACKGROUND: Chloramphenicol ointment is often used in plastic and dermatologic surgery as a topical antibiotic for surgical wounds, but evidence regarding its efficacy and side effects is lacking. In addition, anecdotal fear of aplastic anaemia exists from the oral use of this drug. We performed a systematic review of the literature to assess the efficacy and side effect profile of topical chloramphenicol ointment on non-ocular surgical wounds. METHODS: A systematic search of MEDLINE, EMBASE and the Cochrane Library from inception until 4 September 2017 was undertaken...
March 23, 2018: ANZ Journal of Surgery
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