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Adherence guidelines antimicrobial

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
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
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
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
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
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
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
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
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
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
Pankaj Dhaka, Deepthi Vijay, Jess Vergis, Mamta Negi, Manesh Kumar, Vysakh Mohan, Swapnil Doijad, Krupali V Poharkar, Satyaveer Singh Malik, Sukhadeo Baliram Barbuddhe, Deepak B Rawool
INTRODUCTION: Infectious diarrhoea particularly due to pathogenic bacteria is a major health problem in developing countries, including India. Despite significant reports of diarrhoeagenic Escherichia coli (DEC) pathotypes around the globe, studies which address genetic relatedness, antibiogram profile and their correlation with respect to their isolation from different sources are sparse. The present study determines isolation and identification of DEC pathotypes from different sources, their genetic characterisation, antibiogram profile and their correlation if any...
2016: Infection Ecology & Epidemiology
S Sukumar, A P Roberts, F E Martin, C J Adler
Antibiotic resistance is considered one of the greatest threats to global public health. Resistance is often conferred by the presence of antibiotic resistance genes (ARGs), which are readily found in the oral microbiome. In-depth genetic analyses of the oral microbiome through metagenomic techniques reveal a broad distribution of ARGs (including novel ARGs) in individuals not recently exposed to antibiotics, including humans in isolated indigenous populations. This has resulted in a paradigm shift from focusing on the carriage of antibiotic resistance in pathogenic bacteria to a broader concept of an oral resistome, which includes all resistance genes in the microbiome...
August 2016: Journal of Dental Research
A J Boyajian, M Murray, M Tucker, N Neu
OBJECTIVE: Neisseria gonorrhoeae is identified as a national challenge due to emerging antimicrobial resistance. The Centers for Disease Control and Prevention (CDC) sexually transmitted diseases (STD) Treatment guidelines are updated to address emerging concerns. The aims of this study were 1) to determine the proportion of cases that were adherent to two aspects of the treatment guidelines: antimicrobial treatment and follow-up recommendations and 2) to evaluate differences in adherence based on clinical location...
July 2016: Public Health
Hazel M Parker, Karen Mattick
AIM: Little is known about the determinants of antimicrobial prescribing behaviour (APB), how they vary between hospital prescribers or the mechanism by which interventions are effective. Yet, interventions based on a sound theoretical understanding of APB are more likely to be successful in changing outcomes. This study sought to quantify the potential determinants of APB among hospital doctors in south-west England. METHODS: This multicentre, quantitative study employed a closed answer questionnaire to garner hospital doctors' views on factors influencing their APB...
August 2016: British Journal of Clinical Pharmacology
Atieh Samanipour, Simin Dashti-Khavidaki, Mohammad-Reza Abbasi, Alireza Abdollahi
OBJECTIVE: Antibiotic use pattern and emergence of resistant bacteria are major concerns in clinical settings. This study aimed to detect common bacteria and their antibiotic sensitivity patterns in nephrology and kidney transplant wards. METHODS: This 1-year, observational study was performed in the nephrology and kidney transplant wards of Imam Khomeini Hospital Complex, Tehran, Iran. All patients treated with antimicrobial agents for confirmed or suspected infections were included...
January 2016: Journal of Research in Pharmacy Practice
Candela Solé-Lleonart, Jean-Jacques Rouby, Jean Chastre, Garyfallia Poulakou, Lucy B Palmer, Stijn Blot, Tim Felton, Matteo Bassetti, Charles-Eduard Luyt, Joao Manuel Pereira, Jordi Riera, Tobias Welte, Jason A Roberts, Jordi Rello
BACKGROUND: Intratracheal antibiotic administration is increasingly used for treating respiratory infections. Limited information is available on delivery devices, techniques, and safety. METHODS: An online survey on intratracheal administration of anti-infective agents in mechanically ventilated adults was answered by health-care workers from 192 ICUs to assess the most commonly used devices, current delivery practices, and safety issues. We investigated whether ICU usage experience (≥3 y) impacted its performance...
August 2016: Respiratory Care
Tracy N Zembles, Katherine M Gaertner, Michael F Gutzeit, Rodney E Willoughby
PURPOSE: One hospital's implementation of revised American Academy of Pediatrics (AAP) guidelines for palivizumab prophylaxis of respiratory syncytial virus (RSV) infection is described. METHODS: Revised AAP guidelines for RSV prophylaxis in infants and young children at increased risk for RSV infection recommend that up to five doses of palivizumab be administered during the RSV season. The guidelines also recommend that inpatients not receive monthly palivizumab prophylaxis and that infants and young children eligible for prophylaxis during the RSV season receive a dose of palivizumab two or three days before discharge or promptly after discharge...
March 15, 2016: American Journal of Health-system Pharmacy: AJHP
Emelie C Schuts, Marlies E J L Hulscher, Johan W Mouton, Cees M Verduin, James W T Cohen Stuart, Hans W P M Overdiek, Paul D van der Linden, Stephanie Natsch, Cees M P M Hertogh, Tom F W Wolfs, Jeroen A Schouten, Bart Jan Kullberg, Jan M Prins
BACKGROUND: Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes: clinical outcomes, adverse events, costs, and bacterial resistance rates. METHODS: We identified 14 stewardship objectives and did a separate systematic search for articles relating to each one in Embase, Ovid MEDLINE, and PubMed...
July 2016: Lancet Infectious Diseases
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
Héctor A Rincón-León, Karla R Navarro-Fuentes
BACKGROUND: The treatment of nosocomial infections is hindered by the increasing antimicrobial resistance pattern of germs that cause them. The objective was to assess trends in resistance of bacteria isolated from nosocomial infections. METHODS: Retrospective study from 2009 to 2012 on a third level hospital in Chiapas. RESULTS: 1300 germs were obtained, 62.3 % Gram negative bacteria, 22.8 % Gram positive and 14.9 % yeasts; imipenem resistance of P...
January 2016: Revista Médica del Instituto Mexicano del Seguro Social
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