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Antimicrobial stewardship in emergency

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https://www.readbyqxmd.com/read/29164361/bacteraemia-in-emergency-departments-effective-antibiotic-reassessment-is-associated-with-a-better-outcome
#1
Charlotte Aillet, Didier Jammes, Agnès Fribourg, Sophie Léotard, Olivier Pellat, Patricia Etienne, Dominique Néri, Djamel Lameche, Olivier Pantaloni, Serge Tournoud, Pierre-Marie Roger
Patients with bacteraemia constitute an useful population for an audit of antibiotic treatments. Empirical antibiotic therapy (EAT) and its reassessment must take into account clinical data and microbiological results. Our aim was to determine the impact of these sequential steps of the therapy on survival. This was a retrospective multicentre study which included patients admitted to emergency departments (ED) for whom blood cultures were positive over a 4-month period. Microbial results were compiled from the database of the laboratories...
November 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29102325/surveillance-for-control-of-antimicrobial-resistance
#2
REVIEW
Evelina Tacconelli, Frangiscos Sifakis, Stephan Harbarth, Remco Schrijver, Maaike van Mourik, Andreas Voss, Mike Sharland, Nithya Babu Rajendran, Jesús Rodríguez-Baño
Antimicrobial resistance poses a growing threat to public health and the provision of health care. Its surveillance should provide up-to-date and relevant information to monitor the appropriateness of therapy guidelines, antibiotic formulary, antibiotic stewardship programmes, public health interventions, infection control policies, and antimicrobial development. In Europe, although the European Antimicrobial Resistance Surveillance Network provides annual reports on monitored resistant bacteria, national surveillance efforts are still fragmented and heterogeneous, and have substantial structural problems and issues with laboratory data...
October 25, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29102103/frequency-antimicrobial-susceptibility-and-clonal-distribution-of-methicillin-resistant-staphylococcus-pseudintermedius-in-canine-clinical-samples-submitted-to-a-veterinary-diagnostic-laboratory-in-italy-a-3-year-retrospective-investigation
#3
G Ventrella, A Moodley, E Grandolfo, A Parisi, M Corrente, D Buonavoglia, L Guardabassi
In the last decade there has been a rapid global spread of methicillin-resistant Staphylococcus pseudintermedius (MRSP) clones displaying multidrug resistance in dogs. We investigated prevalence, antimicrobial susceptibility and clonal distribution of MRSP isolated from clinical canine samples between during 2011-2014. Following species identification by nuc PCR, MRSP were confirmed by the presence of mecA and characterized by antimicrobial susceptibility testing, Pulsed Field Gel Electrophoresis (PFGE), SCCmec typing, and Multi-Locus Sequence Typing (MLST) of a few isolates having distinct PFGE profiles...
November 2017: Veterinary Microbiology
https://www.readbyqxmd.com/read/29091191/building-a-national-infection-intelligence-platform-to-improve-antimicrobial-stewardship-and-drive-better-patient-outcomes-the-scottish-experience
#4
Marion Bennie, William Malcolm, Charis A Marwick, Kimberley Kavanagh, Jean Sneddon, Dilip Nathwani
Background: The better use of new and emerging data streams to understand the epidemiology of infectious disease and to inform and evaluate antimicrobial stewardship improvement programmes is paramount in the global fight against antimicrobial resistance. Objectives: To create a national informatics platform that synergizes the wealth of disjointed, infection-related health data, building an intelligence capability that allows rapid enquiry, generation of new knowledge and feedback to clinicians and policy makers...
October 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29063523/evaluation-of-existing-and-desired-antimicrobial-stewardship-activities-and-strategies-in-swiss-hospitals
#5
M Osthoff, Julia Belicki, Andreas F-X Widmer, For Swissnoso
Antimicrobial stewardship (AMS) is an important component in the fight against antimicrobial resistance. Currently, few hospitals have an ongoing institutional AMS programme. Swissnoso - the national centre for infection prevention - has launched a national Swiss AMS initiative supported by the office of public health. To guide AMS priorities and resources, current AMS activities in Switzerland were assessed. We distributed an internet-based questionnaire directed mainly to board-certified infectious diseases specialists and, if not available, senior internal medicine staff...
October 24, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29052109/assessments-of-opportunities-to-improve-antibiotic-prescribing-in-an-emergency-department-a-period-prevalence-survey
#6
Tristan T Timbrook, Aisling R Caffrey, Anais Ovalle, Maya Beganovic, William Curioso, Melissa Gaitanis, Kerry L LaPlante
INTRODUCTION: Approximately 30% of all outpatient antimicrobials are inappropriately prescribed. Currently, antimicrobial prescribing patterns in emergency departments (ED) are not well described. Determining inappropriate antimicrobial prescribing patterns and opportunities for interventions by antimicrobial stewardship programs (ASP) are needed. METHODS: A retrospective chart review was performed among a random sample of non-admitted, adult patients who received an antimicrobial prescription in the ED from January 1 to December 31, 2015...
October 19, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29048511/impact-of-implementing-national-guidelines-on-antibiotic-prescriptions-for-acute-respiratory-tract-infections-in-pediatric-emergency-departments-an-interrupted-time-series-analysis
#7
Naïm Ouldali, Xavier Bellêttre, Karen Milcent, Romain Guedj, Loïc de Pontual, Bogdan Cojocaru, Valérie Soussan-Banini, Irina Craiu, David Skurnik, Vincent Gajdos, Gérard Chéron, Robert Cohen, Corinne Alberti, François Angoulvant
Background: Many antibiotics are prescribed inappropriately in pediatric emergency departments (PEDs), but little data are available in these settings about effective interventions based on guidelines that follow the antimicrobial stewardship principle. Our aim was to assess the impact of implementing the 2011 national guidelines on antibiotic prescriptions for acute respiratory tract infection (ARTI) in PEDs. Method: We conducted a multicentric, quasiexperimental, interrupted time series analysis of prospectively collected electronic data from 7 French PEDs...
October 16, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29047423/antimicrobial-nonsusceptibility-of-gram-negative-bloodstream-isolates-veterans-health-administration-system-united-states-2003-2013-1
#8
Michihiko Goto, Jennifer S McDanel, Makoto M Jones, Daniel J Livorsi, Michael E Ohl, Brice F Beck, Kelly K Richardson, Bruce Alexander, Eli N Perencevich
Bacteremia caused by gram-negative bacteria is associated with serious illness and death, and emergence of antimicrobial drug resistance in these bacteria is a major concern. Using national microbiology and patient data for 2003-2013 from the US Veterans Health Administration, we characterized nonsusceptibility trends of community-acquired, community-onset; healthcare-associated, community-onset; and hospital-onset bacteremia for selected gram-negative bacteria (Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Acinetobacter spp...
November 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28971864/multicenter-study-of-the-risk-factors-for-colonization-or-infection-with-carbapenem-resistant-enterobacteriaceae-in-children
#9
Kathleen Chiotos, Pranita D Tamma, Kelly B Flett, Matthew Naumann, Manjiree V Karandikar, Warren B Bilker, Theoklis Zaoutis, Jennifer H Han
Carbapenem-resistant Enterobacteriaceae (CRE) are increasingly identified in children in the United States, but data on the epidemiology of CRE in this population are limited. The objectives of this study were to characterize the risk factors for colonization or infection with CRE and describe the microbiologic characteristics of pediatric CRE isolates. We performed a multicenter matched case-control study from January 2011 to October 2015 at three tertiary care pediatric centers. Case patients were hospitalized children with CRE isolated from clinical cultures and were matched in a 2:1 ratio to control patients with carbapenem-susceptible Enterobacteriaceae (CSE)...
December 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28922959/compliance-to-the-primary-health-care-treatment-guidelines-and-the-essential-medicines-list-in-the-management-of-sexually-transmitted-infections-in-correctional-centres-in-south-africa-findings-and-implications
#10
Tammy B Matsitse, Elvera Helberg, Johanna C Meyer, Brian Godman, Amos Massele, Natalie Schellack
BACKGROUND: The emergence of antimicrobial resistance (AMR) is a global concern and a growing health crisis. Additionally, evidence has shown that non-compliance to treatment guidelines, especially in the management of communicable diseases such as sexually transmitted infections (STIs), has the potential of further enhancing AMR rates. Data on the extent of these challenges in Primary Health Care (PHC) facilities in correctional centres in South Africa (SA) is limited. Hence this study was conducted to determine the level of compliance with the 2008 PHC Standard Treatment Guidelines and Essential Medicines List (PHC STGs/EML) in the management of STIs, and to identify potential factors contributing to the compliance and non-compliance to guide future strategies...
September 19, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28903514/impact-of-an-antimicrobial-stewardship-program-on-antibiotic-use-at-a-nonfreestanding-children-s-hospital
#11
R Brigg Turner, Elena Valcarlos, Ann M Loeffler, Michael Gilbert, Dominic Chan
Background: Pediatric stewardship programs have been successful at reducing unnecessary antibiotic use. Data from nonfreestanding children's hospitals are currently limited. This study is an analysis of antibiotic use after implementation of an antimicrobial stewardship program at a community nonfreestanding children's hospital. Methods: In April 2013, an antimicrobial stewardship program that consisted of physician-group engagement and pharmacist prospective auditing and feedback was initiated...
September 1, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28901726/antimicrobial-stewardship-in-paediatric-oncology-impact-on-optimising-gentamicin-use-in-febrile-neutropenia
#12
Stefanie Hennig, Christine E Staatz, Daniel Natanek, Sabina Bialkowski, Carolina Consuelo Llanos Paez, Rachael Lawson, Julia Clark
OBJECTIVES: To evaluate the impact of an antimicrobial stewardship (AMS) intervention, involving introduction of new guidelines on the treatment of febrile neutropenia (FN), on improving the use of gentamicin in paediatric oncology patients. DESIGN AND INTERVENTION: Updated guidelines for gentamicin usage in paediatrics with FN were implemented at a tertiary children's teaching hospital, in Brisbane, Australia. Data on gentamicin usage before and after the guideline change were collected retrospectively from children with cancer admitted to hospital with FN between January 2012 and December 2013...
September 13, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28892282/diabetic-foot-infection-antibiotic-therapy-and-good-practice-recommendations
#13
Nicholas D Barwell, Marion C Devers, Brian Kennon, Helen E Hopkinson, Claire McDougall, Matthew J Young, Hannah M A Robertson, Duncan Stang, Stephanie J Dancer, Andrew Seaton, Graham P Leese
BACKGROUND: Healthcare events related to diabetic foot disease carry a burden of morbidity, mortality and economic cost. Prompt identification of clinical infection with appropriate tissue sampling limits use of broad spectrum empirical antibiotics and improves antibiotic stewardship. Staphylococcus aureus remains the commonest infecting organism and high-dose flucloxacillin remains the empirical antibiotic of choice for antibiotic naïve patients. Barriers to microbe-specific treatment include: adequate tissue sampling, delays in culture results, drug allergies and the emergence of multidrug-resistant organisms which can complicate the choice of targeted antibiotics...
September 11, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28882725/what-is-antimicrobial-stewardship
#14
REVIEW
O J Dyar, B Huttner, J Schouten, C Pulcini
BACKGROUND: The use of the term 'antimicrobial stewardship' has grown exponentially in recent years, typically referring to programmes and interventions that aim to optimize antimicrobial use. Although antimicrobial stewardship originated within human healthcare, it is increasingly applied in broader contexts including animal health and One Health. As the use of the term 'antimicrobial stewardship' becomes more common, it is important to consider what antimicrobial stewardship is, as well as what it is not...
November 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28853035/expanding-antimicrobial-stewardship-to-urgent-care-centers-through-a-pharmacist-led-culture-follow-up-program
#15
Lisa E Dumkow, Thomas S Beuschel, Kasey L Brandt
INTRODUCTION: Urgent care centers represent a high-volume outpatient setting where antibiotics are prescribed frequently but resources for antimicrobial stewardship may be scarce. In 2015, our pharmacist-led Emergency Department (ED) culture follow-up program was expanded to include two urgent care (UC) sites within the same health system. The UC program is conducted by ED and infectious diseases clinical pharmacists as well as PGY1 pharmacy residents using a collaborative practice agreement (CPA)...
September 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28852476/resistance-of-staphylococcus-aureus-to-antimicrobial-agents-in-ethiopia-a-meta-analysis
#16
Serawit Deyno, Sintayehu Fekadu, Ayalew Astatkie
BACKGROUND: Emergence of antimicrobial resistance by Staphylococcus aureus has limited treatment options against its infections. The purpose of this study was to determine the pooled prevalence of resistance to different antimicrobial agents by S. aureus in Ethiopia. METHODS: Web-based search was conducted in the databases of PubMed, Google Scholar, Hinari, Scopus and the Directory of Open Access Journals (DOAJ) to identify potentially eligible published studies...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28833324/antibacterials-dispensed-in-the-community-comprise-85-95-of-total-human-antibacterial-consumption
#17
E Duffy, S Ritchie, S Metcalfe, B Van Bakel, M G Thomas
WHAT IS KNOWN AND OBJECTIVE: Interventions intended to slow the emergence and spread of antibacterial resistance through enhanced antimicrobial stewardship will be more effective if informed by an accurate knowledge of current patterns of antibacterial consumption. For example, knowledge of the relative magnitude of community antibacterial consumption in relation to hospital antibacterial consumption within each nation or region should help guide decisions about the relative importance of community and hospital antimicrobial stewardship programmes...
August 18, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28815897/multidrug-resistant-enterobacteriaceae-pseudomonas-aeruginosa-and-vancomycin-resistant-enterococcus-three-major-threats-to-hematopoietic-stem-cell-transplant-recipients
#18
REVIEW
Michael J Satlin, Thomas J Walsh
Hematopoietic stem cell transplant (HSCT) recipients are uniquely threatened by the emergence of multidrug-resistant (MDR) bacteria because these patients rely on immediate active antimicrobial therapy to combat bacterial infections. This review describes the epidemiology and treatment considerations for three challenging MDR bacterial pathogens in HSCT recipients: MDR Enterobacteriaceae, including extended-spectrum β-lactamase (ESBL)-producing and carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas aeruginosa, and vancomycin-resistant Enterococcus (VRE)...
August 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28792800/national-antimicrobial-resistance-monitoring-system-two-decades-of-advancing-public-health-through-integrated-surveillance-of-antimicrobial-resistance
#19
Beth E Karp, Heather Tate, Jodie R Plumblee, Uday Dessai, Jean M Whichard, Eileen L Thacker, Kis Robertson Hale, Wanda Wilson, Cindy R Friedman, Patricia M Griffin, Patrick F McDermott
Drug-resistant bacterial infections pose a serious and growing public health threat globally. In this review, we describe the role of the National Antimicrobial Resistance Monitoring System (NARMS) in providing data that help address the resistance problem and show how such a program can have broad positive impacts on public health. NARMS was formed two decades ago to help assess the consequences to human health arising from the use of antimicrobial drugs in food animal production in the United States. A collaboration among the Centers for Disease Control and Prevention, the U...
October 2017: Foodborne Pathogens and Disease
https://www.readbyqxmd.com/read/28790988/non-antibiotic-isotretinoin-treatment-differentially-controls-propionibacterium-acnes-on-skin-of-acne-patients
#20
Angela E Ryan-Kewley, David R Williams, Neill Hepburn, Ronald A Dixon
Emergence and potential transfer of antibiotic resistance in skin microorganisms is of current concern in medicine especially in dermatology contexts where long term treatment with antibiotics is common. Remarkably, non-antibiotic therapy in the form of isotretinoin - a non-antimicrobial retinoid is effective at reducing or eradicating the anaerobe Propionibacterium acnes which is causally involved in the complex pathogenesis of Acne vulgaris. This study measured the extent of colonization of P. acnes in patients with primary cystic or severe acne from three defined skin sites in 'non-lesion' areas before, during and after treatment with isotretinoin...
2017: Frontiers in Microbiology
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