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https://www.readbyqxmd.com/read/28291497/variation-in-postinjury-antibiotic-prophylaxis-patterns-over-five-years-in-a-combat-zone
#1
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/28012492/guidelines-concordant-empiric-antimicrobial-therapy-and-mortality-in-patients-with-severe-community-acquired-pneumonia-requiring-mechanical-ventilation
#2
Yukiyo Sakamoto, Yasuhiro Yamauchi, Hideo Yasunaga, Hideyuki Takeshima, Wakae Hasegawa, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Takahide Nagase
BACKGROUND: Community-acquired pneumonia (CAP) has high morbidity and mortality among adults. Several clinical guidelines recommend prompt administration of combined antimicrobial therapy. However, the association between guidelines concordance and mortality in patients with severe pneumonia remains unclear. The present study aimed to examine the impact of guidelines-concordant empiric antimicrobial therapy on 7-day mortality in patients with extremely severe pneumonia who required mechanical ventilation at admission, using a nationwide inpatient database in Japan...
January 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28002979/antibiotic-stewardship-in-community-acquired-pneumonia
#3
Diego Viasus, Milly Vecino-Moreno, Juan M De La Hoz, Jordi Carratalà
Community-acquired pneumonia (CAP) continues to be associated with significant mortality and morbidity. As with other infectious diseases, in recent years there has been a marked increase in resistance to the antibiotics commonly used against the pathogens that cause CAP. Antimicrobial stewardship denotes coordinated interventions to improve and measure the appropriate use of antibiotics by encouraging the selection of optimal drug regimens. Areas covered: Several elements can be applied to antibiotic stewardship strategies for CAP in order to maintain or improve patient outcomes...
December 27, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27999061/from-guidelines-to-practice-a-pharmacist-driven-prospective-audit-and-feedback-improvement-model-for-peri-operative-antibiotic-prophylaxis-in-34-south-african-hospitals
#4
Adrian J Brink, Angeliki P Messina, Charles Feldman, Guy A Richards, Dena van den Bergh
BACKGROUND: Few data exist on the implementation of process measures to facilitate adherence to peri-operative antibiotic prophylaxis (PAP) guidelines in Africa. OBJECTIVES: To implement an improvement model for PAP utilizing existing resources, in order to achieve a reduction in surgical site infections (SSIs) across a heterogeneous group of 34 urban and rural South African hospitals. METHODS: A pharmacist-driven, prospective audit and feedback strategy involving change management and improvement principles was utilized...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27928632/ventriculostomy-related-infections-in-subarachnoid-hemorrhage-patients-a-retrospective-study-of-incidence-etiology-and-antimicrobial-therapy
#5
Johan Widén, Britt-Marie Eriksson, Elisabeth Ronne-Engström, Per Enblad, Gabriel Westman
BACKGROUND: This study was performed to investigate the incidence and etiology of ventriculostomy-related infections (VRIs) in patients with subarachnoid hemorrhage (SAH) and to assess adherence to local clinical guidelines regarding empirical antimicrobial therapy and diagnostic routines. METHODS: A total of 191 consecutive SAH patients treated in the neuro-intensive care unit of Uppsala University Hospital between 2010 and 2013 were included retrospectively. Information regarding cerebrospinal fluid samples, bacterial cultures, ventriculostomy treatment, patient characteristics, and antibiotic treatment were collected from electronic patient records...
February 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27925427/spleen-australia-guidelines-for-the-prevention-of-sepsis-in-patients-with-asplenia-and-hyposplenism-in-australia-and-new-zealand
#6
REVIEW
Kudzai Kanhutu, Penelope Jones, Allen C Cheng, Louise Grannell, Emma Best, Denis Spelman
People with asplenia or hyposplenism are at increased risk of fulminant sepsis which carries a high mortality rate. A range of preventive measures are recommended although there is ongoing evidence that knowledge of and adherence to these strategies is poor. There have been significant changes in recommended vaccinations since the previously published recommendations in 2008. We provide current recommendations to help Australian and New Zealand clinicians in the prevention of sepsis in patients with asplenia and hyposplenia...
December 7, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27895904/poor-adherence-to-guidelines-for-preventing-central-line-associated-bloodstream-infections-clabsi-results-of-a-worldwide-survey
#7
Cristina Valencia, Naïma Hammami, Antonella Agodi, Alain Lepape, Eduardo Palencia Herrejon, Stijn Blot, Jean-Louis Vincent, Marie-Laurence Lambert
BACKGROUND: Central line-associated bloodstream infections (CLABSI) are a cause of increased morbidity and mortality, and are largely preventable. We documented attitudes and practices in intensive care units (ICUs) in 2015 in order to assess compliance with CLABSI prevention guidelines. METHODS: Between June and October 2015, an online questionnaire was made available to medical doctors and nurses working in ICUs worldwide. We investigated practices related to central line (CL) insertion, maintenance and measurement of CLABSI-related data following the SHEA guidelines as a standard...
2016: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/27884486/epidemiologic-analysis-prophylaxis-and-multidrug-resistance-in-surgery
#8
H Solís-Téllez, E E Mondragón-Pinzón, M Ramírez-Marino, F R Espinoza-López, F Domínguez-Sosa, J F Rubio-Suarez, R D Romero-Morelos
BACKGROUND: Surgical site infection is defined as an infection related to the surgical procedure in the area of manipulation occurring within the first 30 postoperative days. The diagnostic criteria include: purulent drainage, isolation of microorganisms, and signs of infection. AIMS: To describe the epidemiologic characteristics and differences among the types of prophylactic regimens associated with hospital-acquired infections at the general surgery service of a tertiary care hospital...
November 21, 2016: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/27861259/tailored-perioperative-antimicrobial-prophylaxis-in-urological-surgery-myth-or-reality
#9
Magnus J Grabe, Karl-Johan Lundström
PURPOSE OF REVIEW: The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients' risk factors, the level of contamination and grading of surgical procedures is discussed...
March 2017: Current Opinion in Urology
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
#10
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/27670801/clinical-practice-audit-of-perioperative-antimicrobial-prophylaxis-in-a-tertiary-care-hospital-do-routine-academic-activities-improve-adherence-to-practice-guidelines
#11
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/27664820/usefulness-of-quality-indicators-for-antibiotic-use-case-study-for-the-netherlands
#12
Alike W van der Velden, Monique Roukens, Ewoudt van de Garde, Marco Lourens, Stephanie Natsch
QUALITY PROBLEM: Inappropriate antibiotic use drives development of antimicrobial resistance. Worldwide, guideline adherence for antibiotic treatment of infectious disease is far from optimal. Insight in prescribing quality is pivotal for healthcare professionals and policy makers to intervene appropriately. INITIAL ASSESSMENTS: European countries uniformly monitor antibiotic use, which is reported yearly by the European Centre for Disease Prevention and Control...
September 24, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27609336/impact-of-a-clinical-pathway-on-appropriate-empiric-vancomycin-use-in-cancer-patients-with-febrile-neutropenia
#13
Mildred Vicente, Mohammad Al Nahedh, Sandeep Parsad, Randall W Knoebel, Jennifer Pisano, Natasha N Pettit
OBJECTIVES: Febrile neutropenia management guidelines recommend the use of vancomycin as part of an empiric antimicrobial regimen when specific criteria are met. Often, vancomycin use among patients with febrile neutropenia is not indicated and may be over utilized for this indication. We sought to evaluate the impact of implementing a febrile neutropenia clinical pathway on empiric vancomycin use for febrile neutropenia and to identify predictors of vancomycin use when not indicated...
September 8, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27540225/how-well-do-outpatient-prescriptions-adhere-to-good-antimicrobial-stewardship
#14
Hirminder Ubhi, Mitul Patel, Lisa Ludwig
AIM: Aims of the study included evaluation of outpatient antibiotic prescribing practices relating to good Antimicrobial Stewardship1 focusing on documentation of indication and duration. METHOD: Prescriptions dispensed at the Outpatient Pharmacy over a 6 week were evaluated. Data collected include patient's hospital identification in full, the antibiotic prescribed, duration of treatment, indication (in a specifically allocated area on the prescription) and route of administration, prescriber speciality and grade...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27429557/knowledge-and-attitude-of-physicians-toward-prescribing-antibiotics-and-the-risk-of-resistance-in-two-reference-hospitals
#15
Adel Alothman, Abdullah Algwizani, Mohammed Alsulaiman, Abdullah Alalwan, Salih Binsalih, Mohammad Bosaeed
INTRODUCTION: Antibiotics are essential and abundantly prescribed in hospitals because of their effectiveness and lifesaving benefits. However, the unnecessary use of antibiotics has been observed in earlier studies, and it has persisted through recent years as a major issue since it is one of the leading causes of antibiotic resistance. The increase in antibiotic resistance nowadays is one of the most critical concerns in global public health around the world. The objective of this study was to evaluate the knowledge and perceptions related to antibiotic prescription among physicians at our medical centers...
2016: Infectious Diseases
https://www.readbyqxmd.com/read/27366076/prescription-of-antibiotics-in-community-acquired-pneumonia-in-children-are-we-following-the-recommendations
#16
Eduardo Jorge da Fonseca Lima, Débora Ellen Pessoa Lima, George Henrique Cordeiro Serra, Maria Anaide Zacche S Abreu E Lima, Maria Júlia Gonçalves de Mello
OBJECTIVE: To assess the adequacy of antibiotic prescription in children hospitalized for pneumonia in a reference pediatric hospital in Brazil. METHODS: This was a cross-sectional study involving children aged between 1 month and 5 years who were hospitalized between October 2010 and September 2013. The classification of community-acquired pneumonia (CAP) was based on the clinical and radiological criteria of the World Health Organization (WHO). The analysis of antibiotic adequacy was performed according to the main guidelines on CAP treatment, which include the WHO guidelines, Brazilian Society of Pediatrics guidelines, and international guidelines (Pediatrics Infectious Diseases Society, the Infectious Disease Society of America, British Thoracic Society, and Consenso de la Sociedad latinoamericana de Infectología)...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27283440/impact-of-antibiotic-stewardship-on-perioperative-antimicrobial-prophylaxis
#17
Rita Murri, Antonio Giulio de Belvis, Massimo Fantoni, Maria Tanzariello, Paolo Parente, Stefano Marventano, Sabina Bucci, Francesca Giovannenze, Walter Ricciardi, Roberto Cauda, Gabriele Sganga
OBJECTIVE: Antibiotic prophylaxis (AP) is useful to prevent antimicrobial overuse, misuse and abuse, as well against the occurrence of surgical site infections (SSIs). This study aimed to describe the implementation of a quality improvement intervention on AP for elective surgery, as informal interviews showed a lower than expected compliance with internal recommendations, and to evaluate intervention's effect in terms of main drug consumption. DESIGN: A quality improvement intervention on all elective cases within 14 main surgical departments was performed...
September 2016: International Journal for Quality in Health Care
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/27222092/recognising-early-onset-neonatal-sepsis-an-essential-step-in-appropriate-antimicrobial-use
#19
Wendy van Herk, Martin Stocker, Annemarie M C van Rossum
Early diagnosis and timely treatment of early onset neonatal sepsis (EOS) are essential to prevent life threatening complications. Subtle, nonspecific clinical presentation and low predictive values of biomarkers complicate early diagnosis. This uncertainty commonly results in unnecessary and prolonged empiric antibiotic treatment. Annually, approximately 395,000 neonates (7.9% of live term births) are treated for suspected EOS in the European Union, while the incidence of proven EOS varies between 0.01 and 0...
July 5, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27211208/evaluation-of-a-disease-state-management-guideline-for-urinary-tract-infection
#20
Monika T Zmarlicka, Sophia M Cardwell, Jared L Crandon, David P Nicolau, Mitchell H McClure, Michael D Nailor
A urinary tract infection (UTI) disease state management guideline, including risk-based antimicrobial recommendations, Foley catheter management and transitions of care, was implemented. This study evaluated the outcomes associated with implementation of the guideline. A retrospective study was conducted between 1 July 2013 and 30 September 2013 (pre-implementation) and between 1 July 2014 and 30 September 2014 (post-implementation). Symptomatic patients treated for UTI within 24 h with an identified pathogen were included...
June 2016: International Journal of Antimicrobial Agents
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