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https://www.readbyqxmd.com/read/29149338/multiplex-respiratory-virus-testing-for-antimicrobial-stewardship-a-prospective-assessment-of-antimicrobial-use-and-clinical-outcomes-among-hospitalized-adults
#1
Makeda Semret, Ian Schiller, Barbara Ann Jardin, Charles Frenette, Vivian G Loo, Jesse Papenburg, Shelly A McNeil, Nandini Dendukuri
Background: Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults. Methods: Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada...
November 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29122393/how-do-professional-relationships-influence-surgical-antibiotic-prophylaxis-decision-making-a-qualitative-study
#2
Jennifer K Broom, Alex F Broom, Emma R Kirby, Jeffrey J Post
BACKGROUND: Surgical antibiotic prophylaxis (SAP) is a critical area to optimize to reduce the escalation of antimicrobial resistance. This article explores the ways by which interpersonal relationships influence SAP decision making. METHODS: Twenty surgeons and anesthetists participated in in-depth semistructured interviews on SAP prescribing. Results were analyzed using the framework approach. RESULTS: Analysis revealed 3 ways by which interpersonal relationships influence SAP: relationship dynamics between the surgeon and the anesthetist determine appropriateness of SAP, particularly operative risk ownership; perceived hierarchies within, and between, surgical and anesthetist specialties influence antibiotic prescribing decisions; and surgical distance from the antimicrobial stewardship team, which influences use of antimicrobial stewardship principles...
November 7, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29074435/the-natural-compound-magnolol-affects-growth-biofilm-formation-and-ultrastructure-of-oral-candida-isolates
#3
Jawad Behbehani, Sheikh Shreaz, Mohammad Irshad, Maribassapa Karched
The incidence of oral candidosis has increased in recent years due to the escalation in HIV-infection, cancer treatments, organ transplantation, and diabetes. In addition, corticosteroid use, dentures, and broad-spectrum antibiotic use have also contributed to the problem. Treatment of oral candidosis has continued to be problematic because of the potential toxicity of antifungals in clinical use, and, above all, development of drug resistance among patients. In this study, the antifungal effect of magnolol was investigated against 64 strains of Candida spp...
October 23, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29067203/prospective-study-evaluating-the-incidence-of-bacteraemia-and-bacteruria-in-afebrile-and-febrile-neutropaenic-dogs-undergoing-chemotherapy
#4
Kimberly Shaffer, Jonathan Bach, Ruthanne Chun
The purpose of this prospective study was to determine the incidence and character of bacteraemia and bacteruria in afebrile and febrile neutropaenic dogs undergoing cytotoxic chemotherapy. Fifty-five neutropaenic dogs presenting to the University of Wisconsin Veterinary Medical Teaching Hospital were enrolled for a total of 57 neutropaenic episodes. The overall incidence of bacteraemia was 12.3% (n = 7/57). Three afebrile dogs and four febrile dogs were bacteraemic; this difference was not significant (P = 0...
November 2016: Veterinary Medicine and Science
https://www.readbyqxmd.com/read/29052092/a-72-h-intervention-for-improvement-of-the-rate-of-optimal-antibiotic-therapy-in-patients-with-bloodstream-infections
#5
R Murri, F Taccari, T Spanu, T D'Inzeo, I Mastrorosa, F Giovannenze, G Scoppettuolo, G Ventura, C Palazzolo, M Camici, S Lardo, B Fiori, M Sanguinetti, R Cauda, M Fantoni
Antimicrobial stewardship programs are implemented to optimize the use of antibiotics and control the spread of antibiotic resistance. Many antimicrobial stewardship interventions have demonstrated significant efficacy in reducing unnecessary prescriptions of antibiotics, the duration of antimicrobial therapy, and mortality. We evaluated the benefits of a combination of rapid diagnostic tests and an active re-evaluation of antibiotic therapy 72 h after the onset of bloodstream infection (BSI). All patients with BSI from November 2015 to November 2016 in a 1100-bed university hospital in Rome, where an Infectious Disease Consultancy Unit (Unità di Consulenza Infettivologica, UDCI) is available, were re-evaluated at the bedside 72 h after starting antimicrobial therapy and compared to two pre-intervention periods: the UDCI was called by the ward physician for patients with BSI and the UDCI was called directly by the microbiologist immediately after a pathogen was isolated from blood cultures...
October 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29031431/implementing-an-antibiotic-stewardship-program-at-a-long-term-acute-care-hospital-in-detroit-michigan
#6
Ammara Mushtaq, Reda A Awali, Suganya Chandramohan, Amar Krishna, Caitlin Biedron, Olufemi Jegede, Teena Chopra
BACKGROUND: The objective of the study was to assess health care providers' (HCPs) knowledge and attitude toward antimicrobial resistance (AMR) and implement an antimicrobial stewardship program (ASP) in a long-term acute care hospital (LTACH). METHODS: A questionnaire on antibiotic use and resistance was administered to HCP in an LTACH in Detroit, Michigan, between August 2011 and October 2011. Concurrently, a retrospective review of common antibiotic prescription practices and costs was conducted...
October 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29026666/bedside-twist-drill-aspiration-of-cerebral-abscess-less-than-2-5-cm-in-size-a-case-series-and-discussion
#7
Tyler Carson, Dan Miulli
BACKGROUND: Intracranial abscess remains a potentially deadly condition despite development of newer antibiotics and improved surgical methods. Many studies have evaluated the surgical indications for abscess drainage, and it has been generally accepted that intracranial abscesses greater than 2.5 cm may best be treated with surgical intervention followed by antibiotic therapy. More recently, studies have shown good results with stereotactic aspiration of abscesses to 1 cm in size. Furthermore, a recent case series in 2014 of 103 cases of bedside twist drill aspiration of cerebral abscess >2...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29018966/safety-and-cost-benefit-of-an-ambulatory-program-for-patients-with-low-risk-neutropenic-fever-at-an-australian-centre
#8
Benjamin W Teh, Christine Brown, Trish Joyce, Leon J Worth, Monica A Slavin, Karin A Thursky
BACKGROUND: Neutropenic fever (NF) is a common complication of cancer chemotherapy. Patients at low risk of medical complications from NF can be identified using a validated risk assessment and managed in an outpatient setting. This is a new model of care for Australia. This study described the implementation of a sustainable ambulatory program for NF at a tertiary cancer centre over a 12-month period. METHODS: Peter MacCallum Cancer Centre introduced an ambulatory care program in 2014, which identified low-risk NF patients, promoted early de-escalation to oral antibiotics, and early discharge to a nurse-led ambulatory program...
October 10, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28980026/-bacterial-sepsis-diagnostics-and-calculated-antibiotic-therapy
#9
REVIEW
D C Richter, A Heininger, T Brenner, M Hochreiter, M Bernhard, J Briegel, S Dubler, B Grabein, A Hecker, W A Krüger, K Mayer, M W Pletz, D Störzinger, N Pinder, T Hoppe-Tichy, S Weiterer, S Zimmermann, A Brinkmann, M A Weigand, Christoph Lichtenstern
The mortality of patients with sepsis and septic shock is still unacceptably high. An effective antibiotic treatment within 1 h of recognition of sepsis is an important target of sepsis treatment. Delays lead to an increase in mortality; therefore, structured treatment concepts form a rational foundation, taking relevant diagnostic and treatment steps into consideration. In addition to the assumed focus and individual risks of each patient, local resistance patterns and specific problem pathogens must be taken into account for selection of anti-infection treatment...
October 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28974331/major-publications-in-the-critical-care-pharmacotherapy-literature-january-december-2016
#10
REVIEW
Deanna Horner, Diana Altshuler, Chris Droege, Joel Feih, Kevin Ferguson, Mallory Fiorenza, Kasey Greathouse, Leslie Hamilton, Caitlin Pfaff, Lauren Roller, Joanna Stollings, Adrian Wong
PURPOSE: To summarize select critical care pharmacotherapy guidelines and studies published in 2016. SUMMARY: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 31 journals monthly for relevant pharmacotherapy articles and selected 107 articles for review over the course of 2016. Of those included in the monthly CCPLU, three guidelines and seven primary literature studies are reviewed here. The guideline updates included are as follows: hospital-acquired pneumonia and ventilator-associated pneumonia management, sustained neuromuscular blocking agent use, and reversal of antithrombotics in intracranial hemorrhage (ICH)...
September 22, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28972874/impact-of-sequential-culture-results-on-diagnosis-and-de-escalation-of-the-antibiotic-regimen-in-joint-and-bone-infections
#11
Solen Kernéis, Cécile Leprince, Denis Archambeau, Luc Eyrolle, Philippe Leclerc, Hélène Poupet, Julien Loubinoux, Rémy Gauzit, Dominique Salmon, Odile Launay, Claire Poyart, Philippe Anract, Philippe C Morand
BACKGROUND: According to existing guidelines, orthopedic specimens collected in joint and bone infections (JBI) in our institution are cultured on several media sets and incubated for two, seven, and 14 days. The optimal timing for de-escalation of the first-line antibiotic combination according to the culture results needs to be defined. METHODS: Single-center, retrospective analysis of all adult patients with a first documented episode of JBI between May 2012 and April 2013...
October 3, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28951427/an-unexpected-complication-following-uterine-artery-embolisation
#12
Sarah Peters, Michelle Wise, Brendan Buckley
A 35-year-old nulliparous woman underwent uterine artery embolisation (UAE) for heavy menstrual bleeding and anaemia due to fibroids, refractive to medical and surgical treatment.Bilateral UAE was performed after cephazolin prophylaxis and analgesia. Postoperatively, pain and abdominal bloating were prominent. Symptoms were initially treated as postembolisation syndrome, and analgesia was escalated. By the third day, pain was worsening and the woman developed marked tachypnoea and tachycardia, with raised inflammatory markers and lactate...
September 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28885936/vancomycin-vs-vancomycin-piperacillin-tazobactam-associated-acute-kidney-injury-in-noncritically-ill-patients-at-a-tertiary-care-military-treatment-facility
#13
Caleb W Anderson, Kathy S Cazares, Michael B Lustik, Shivam M Patel, Troy M Denunzio
BACKGROUND: Broad-spectrum antibiotics are often used as initial empiric therapy in patients at risk for infections by multidrug-resistant organisms. Emerging literature and anecdotal reports within Tripler Army Medical Center indicate an increased incidence of vancomycin-associated acute kidney injury when used in combination with piperacillin-tazobactam. This is a retrospective, single-center study comparing the incidence of acute kidney injury in noncritically ill patients receiving either vancomycin or vancomycin in combination with piperacillin-tazobactam in a 206-bed tertiary care military training facility...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28855980/pseudomonas-endocarditis-with-an-unstable-phenotype-the-challenges-of-isolate-characterization-and-carbapenem-stewardship-with-a-partial-review-of-the-literature
#14
Emil Lesho, Erik Snesrud, Yoon Kwak, Ana Ong, Rosslyn Maybank, Maryrose Laguio-Vila, Ann R Falsey, Mary Hinkle
BACKGROUND: Pseudomonas endocarditis is exceedingly rare, especially in patients without predisposing risks. We present such a case that included unexpected switches in antibacterial resistance profiles in two Pseudomonas aeruginosa (PA) strains with the same whole-genome sequence. The case also involved diagnostic and treatment challenges, such as issues with automated testing platforms, choosing the optimal aminoglycoside, minimizing unnecessary carbapenem exposure, and the need for faster, more informative laboratory tests...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28841096/unmet-needs-in-the-management-of-intra-abdominal-infections
#15
Philippe Montravers, Parvine Tashk, Alexy Tran Dinh
Intra-abdominal infections remain a leading cause of death, morbidity and resource use in surgical wards and intensive care units. The growing complexity of their management has led to new paradigms and unresolved issues in anti-infective therapy described in the current review. Areas covered: We analyzed the literature, recent guidelines, and expert opinions published over the last decade. Expert commentary: Prospective randomized trials are difficult to perform and observational studies or database analyses should be encouraged...
September 1, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28808398/mechanism-of-action-of-isolated-caffeic-acid-and-epicatechin-3-gallate-from-euphorbia-hirta-against-pseudomonas-aeruginosa
#16
Shanmugapriya Perumal, Roziahanim Mahmud, Sabariah Ismail
BACKGROUND: The escalating dominance of resistant Pseudomonas aeruginosa strains as infectious pathogen had urged the researchers to look for alternative and complementary drugs. OBJECTIVE: The objective of this study is to address the biological targets and probable mechanisms of action underlying the potent antibacterial effect of the isolated compounds from Euphorbia hirta (L.) against P. aeruginosa. MATERIALS AND METHODS: The action mechanisms of caffeic acid (CA) and epicatechin 3-gallate (ECG) on P...
July 2017: Pharmacognosy Magazine
https://www.readbyqxmd.com/read/28807478/role-of-lipid-mediators-in-the-regulation-of-oxidative-stress-and-inflammatory-responses-in-dairy-cattle
#17
REVIEW
Vengai Mavangira, Lorraine M Sordillo
Periparturient dairy cows experience an increased incidence and severity of several inflammatory-based diseases such as mastitis and metritis. Factors associated with the physiological adaptation to the onset of lactation can impact the efficiency of the inflammatory response at a time when it is most needed to eliminate infectious pathogens that cause these economically important diseases. Oxidative stress, for example, occurs when there is an imbalance between the production of oxygen radicals during periods of high metabolic demand and the reduced capabilities of the host's antioxidant defenses...
August 2, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28800092/induced-aberrant-organisms-with-novel-ability-to-protect-intestinal-integrity-from-inflammation-in-an-animal-model
#18
Helieh S Oz
Robust and balanced gut microbiota are required to support health and growth. Overgrowth of gut microbial or pathogens can change ecosystem balance, and compromise gut integrity to initiate gastrointestinal (GI) complications. There is no safe and effective modality against coccidiosis. Antibiotic additives routinely fed to food animals to protect against infection, are entered into the food chain, contaminate food products and pass to the consumers. HYPOTHESIS: induced aberrant organisms possess distinct ultrastructure and are tolerated by immunodeficient-animals yet are non-pathogenic, but immunogenic in various strains of chicks to act as a preventive (vaccine) and eliminating the needs for antibiotic additives...
August 11, 2017: Nutrients
https://www.readbyqxmd.com/read/28790283/-postoperative-atelectasis-and-pneumonia-after-general-thoracic-surgery
#19
Yasushi Hoshikawa, Daisuke Tochii
Atelectasis and pneumonia are common postoperative complications occurred in patients undergoing general thoracic surgery. Strategies to reduce the risk of postoperative pulmonary complications including these 2 disorders consist of smoking cessation, optimization of underlying chronic obstructive pulmonary disease( COPD), adequate pain control, intensive oral care, and so on. Preoperative treatments for patients with COPD are the same as those for COPD patients being not about to have surgery, which mainly consist of long-acting bronchodilators and pulmonary rehabilitation...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28781507/development-of-antibiotic-stewardship-practices-targeting-urinary-tract-infections-in-a-hospital-with-consultant-based-infectious-disease-services
#20
Kristine Sobolewski, Jennifer Costello, Lincoln Miller
PURPOSE: Ensuring proper use of antimicrobials through the development and implementation of stewardship programs translates to improved patient outcomes. This article will describe the development of an antibiotic stewardship program at a facility with consultant-based infectious disease services. METHODS: Program development involved a multifaceted approach, including identification of a physician stewardship champion, design of a retrospective analysis, development of a physician scoring card, and creation and auditing of a real-time reporting system targeting prospective de-escalation opportunities...
August 2017: P & T: a Peer-reviewed Journal for Formulary Management
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