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Antimicrobial stewardship in emergency

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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
#1
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
#2
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
#3
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
#4
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
#5
REVIEW
Oliver J Dyar, Benedikt Huttner, Jeroen Schouten, Céline Pulcini
BACKGROUND: The use of the term "antimicrobial stewardship" (AMS) has grown exponentially in recent years, typically referring to programmes and interventions that aim to optimise antimicrobial use. Although AMS originated within human healthcare, it is increasingly applied in broader contexts including animal health and One Health. As the use of the term AMS becomes more common, it is important to consider what AMS is, as well as what it is not. AIMS: To review the emergence and evolution of the term "antimicrobial stewardship"...
September 4, 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
#6
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)...
August 29, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28852476/resistance-of-staphylococcus-aureus-to-antimicrobial-agents-in-ethiopia-a-meta-analysis
#7
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
#8
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-enterococci-three-major-threats-to-hematopoietic-stem-cell-transplant-recipients
#9
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
#10
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...
August 9, 2017: Foodborne Pathogens and Disease
https://www.readbyqxmd.com/read/28790988/non-antibiotic-isotretinoin-treatment-differentially-controls-propionibacterium-acnes-on-skin-of-acne-patients
#11
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
https://www.readbyqxmd.com/read/28774865/shifts-in-antimicrobial-consumption-and-infection-rates-before-and-during-a-piperacillin-tazobactam-shortage
#12
S Travis King, Katie E Barber, Jason J Parham, Kayla R Stover
BACKGROUND: Anti-infective shortages represent a growing threat to the optimal management of the infected patient and alter the institutional selective pressure against hospital-acquired infections. The objective of this analysis was to assess the impact that a shortage of piperacillin-tazobactam had on the overall antibacterial use and HAI rates at an academic institution. METHODS: Antimicrobial use and infection data were extracted from TheraDoc Clinical Surveillance Software (Premier, Inc...
July 31, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28768593/staff-nurses-as-antimicrobial-stewards-an-integrative-literature-review
#13
REVIEW
Elizabeth Monsees, Jennifer Goldman, Lori Popejoy
BACKGROUND: Guidelines on antimicrobial stewardship emphasize the importance of an interdisciplinary team, but current practice focuses primarily on defining the role of infectious disease physicians and pharmacists; the role of inpatient staff nurses as antimicrobial stewards is largely unexplored. METHODS: An updated integrative review method guided a systematic appraisal of 13 articles spanning January 2007-June 2016. Quantitative and qualitative peer-reviewed publications including staff nurses and antimicrobial knowledge or stewardship were incorporated into the analysis...
August 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28750918/susceptibilities-of-clinical-clostridium-difficile-isolates-to-antimicrobials-a-systematic-review-and-meta-analysis-of-studies-since-1970
#14
REVIEW
Nagham Khanafer, Nick Daneman, Tom Greene, Andrew Simor, Philippe Vanhems, Matthew Samore, Kevin Antoine Brown
OBJECTIVES: Although exposure to antibiotics can cause C. difficile infection, certain antibiotics are used to treat C. difficile. The measurements of antimicrobial Clostridium difficile activity could help identifying antibiotic risk and emergent resistance. Here, we describe publication patterns relating to C. difficile susceptibilities and estimate minimum inhibitory concentrations (MIC) for antibiotic classes in the published literature between January, 1970 and June, 2014. METHODS: We queried PUBMED and EMBASE for studies reporting antibiotic C...
July 24, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28711429/-appropriateness-of-antibiotic-prescribing-in-paediatric-patients-in-a-hospital-emergency-department
#15
Borja Croche Santander, Elena Campos Alonso, Adela Sánchez Carrión, Laura Marcos Fuentes, Isabel Diaz Flores, Juan Carlos Vargas, Bárbara Fernández Domínguez, Cristóbal Toro Ibañez
INTRODUCTION: Antibiotics represent one of the most widely prescribed therapeutic agents in children. It has been estimated that 30-50% of antibiotic prescriptions for this population are inappropriate. In this scenario, analysis of prescription data provides an invaluable source of information as a basis for implementing strategies for improvement in this field. OBJECTIVE: To assess the appropriateness of antibiotic prescriptions in a paediatric population at an emergency department...
July 12, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28711345/working-at-the-intersection-of-context-culture-and-technology-provider-perspectives-on-antimicrobial-stewardship-in-the-emergency-department-using-electronic-health-record-clinical-decision-support
#16
Phillip Chung, Jean Scandlyn, Peter S Dayan, Rakesh D Mistry
BACKGROUND: Antibiotic stewardship programs (ASPs) have not been fully developed for the emergency department (ED), in part the result of the barriers characteristic of this setting. Electronic health record-based clinical decision support (EHR CDS) represents a promising strategy to implement ASPs in the ED. We aimed to determine the cultural beliefs and structural barriers and facilitators to implementation of antimicrobial stewardship in the pediatric ED using EHR CDS. METHODS: Interviews and focus groups were conducted with hospital and ED leadership, attending ED physicians, nurse practitioners, physician assistants, and residents at a single health system in Colorado...
July 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28709439/enhanced-antimicrobial-de-escalation-for-pneumonia-in-mechanically-ventilated-patients-a-cross-over-study
#17
Tracy Trupka, Kristen Fisher, Scott T Micek, Paul Juang, Marin H Kollef
BACKGROUND: Antibiotics are commonly administered to hospitalized patients with infiltrates for possible bacterial pneumonia, often leading to unnecessary treatment and increasing the risk for resistance emergence. Therefore, we performed a study to determine if an enhanced antibiotic de-escalation practice could improve antibiotic utilization in mechanically ventilated patients with suspected pneumonia cared for in an academic closed intensive care unit (ICU). METHODS: This was a prospective cross-over trial comparing routine antibiotic management (RAM) and enhanced antimicrobial de-escalation (EAD) performed within two medical ICUs (total 34 beds) at Barnes-Jewish Hospital, an academic referral center...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28706384/antimicrobial-susceptibility-risk-factors-and-prevalence-of-bla-cefotaximase-temoneira-and-sulfhydryl-variable-genes-among-escherichia-coli-in-community-acquired-pediatric-urinary-tract-infection
#18
Kallyadan V Nisha, Shetty A Veena, Shenoy D Rathika, Shenoy M Vijaya, Shetty K Avinash
INTRODUCTION: The emergence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has become an important challenge among pediatric patients with community-acquired urinary tract infection (UTI). OBJECTIVES: The aim of this study was to assess the antimicrobial susceptibility patterns, associated risk factors and to survey the frequency of bla cefotaximase (CTX-M), bla temoneira (TEM), and bla sulfhydryl variable (SHV) genotypes in ESBL-producing E...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28698021/impact-of-an-antimicrobial-stewardship-programme-to-optimize-antimicrobial-use-for-outpatients-at-an-emergency-department
#19
A Dinh, C Duran, B Davido, F Bouchand, L Deconinck, M Matt, O Sénard, C Guyot, A-So Levasseur, J Attal, D Razazi, T Tritz, A Beauchet, J Salomon, S Beaune, J Grenet
BACKGROUND: Antimicrobial stewardship programmes (ASPs) have been effective in optimizing antibiotic use for inpatients. However, an emergency department's fast-paced clinical setting can be challenging for a successful ASP. AIM: In April 2015, an ASP was implemented in our emergency department and we aimed to determine its impact on antimicrobial use for outpatients. METHODS: This was a single-centre study comparing the quality of antibiotic prescriptions between a one-year period before ASP implementation (November 2012 to October 2013) and a one-year period after its implementation (June 2015 to May 2016)...
July 8, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28697159/outpatient-parenteral-antimicrobial-therapy-and-judicious-use-of-pediatric-emergency-resources
#20
Michael Xu, Quynh Doan
BACKGROUND: Pediatric returns to the emergency department (RTED) vary between 3% and 13% of the total ED volume of visits. However, the incidence and contribution of scheduled RTED on pediatric emergency department (PED) utilization is less clear. Antimicrobial stewardship programs on inpatient wards have been shown to improve judicious use of outpatient parenteral antimicrobial therapy (OPAT) in upon discharge. The implementation of such programs in PEDs has yet to be reported. The objectives of this study are to quantify the burden of scheduled RTED for OPAT on PED utilization and to examine how frequently OPAT use are supported by published practice standards for 3 common pediatric infections-cellulitis, pneumonia, and urinary tract infections...
July 11, 2017: Pediatric Emergency Care
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