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Antibiotic prescribing principles

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https://www.readbyqxmd.com/read/29122393/how-do-professional-relationships-influence-surgical-antibiotic-prophylaxis-decision-making-a-qualitative-study
#1
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/29063877/optimisation-of-antimicrobial-dosing-based-on-pharmacokinetic-and-pharmacodynamic-principles
#2
REVIEW
Grace Si Ru Hoo, Yi Xin Liew, Andrea Lay-Hoon Kwa
While suboptimal dosing of antimicrobials has been attributed to poorer clinical outcomes, clinical cure and mortality advantages have been demonstrated when target pharmacokinetic (PK) and pharmacodynamic (PD) indices for various classes of antimicrobials were achieved to maximise antibiotic activity. Dosing optimisation requires a good knowledge of PK/PD principles. This review serves to provide a foundation in PK/PD principles for the commonly prescribed antibiotics (β-lactams, vancomycin, fluoroquinolones and aminoglycosides), as well as dosing considerations in special populations (critically ill and obese patients)...
July 2017: Indian Journal of Medical Microbiology
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
#3
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/29027242/optimal-dose-and-duration-of-amoxicillin-plus-metronidazole-as-an-adjunct-to-non-surgical-periodontal-therapy-a-systematic-review-and-meta-analysis-of-randomized-placebo-controlled-trials
#4
REVIEW
Kelly McGowan, Troy McGowan, Saso Ivanovski
AIM: This systematic review aimed to determine the optimum dose and duration of amoxicillin-plus-metronidazole prescribed as an adjunct to non-surgical treatment of periodontitis. METHODS: Electronic searching identified 376 records, of which 18 were eligible blinded, randomized placebo-controlled trials. The primary outcomes assessed were periodontal pocket depth and clinical attachment level at 3-months, and secondary outcomes were adverse events and compliance...
October 13, 2017: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/29020166/long-term-impact-of-an-educational-antimicrobial-stewardship-program-on-hospital-acquired-candidemia-and-multidrug-resistant-bloodstream-infections-a-quasi-experimental-study-of-interrupted-time-series-analysis
#5
José Molina, Germán Peñalva, María V Gil-Navarro, Julia Praena, José A Lepe, María A Pérez-Moreno, Carmen Ferrándiz, Teresa Aldabó, Manuela Aguilar, Peter Olbrich, Manuel E Jiménez-Mejías, María L Gascón, Rosario Amaya-Villar, Olaf Neth, María J Rodríguez-Hernández, Antonio Gutiérrez-Pizarraya, José Garnacho-Montero, Cristina Montero, Josefina Cano, Julián Palomino, Raquel Valencia, Rocío Álvarez, Elisa Cordero, Marta Herrero, José M Cisneros
Background: The global crisis of bacterial resistance urges the scientific community to implement intervention programs in healthcare facilities to promote an appropriate use of antibiotics. However, the clinical benefits or the impact on resistance of these interventions has not been definitively proven. Methods: We designed a quasi-experimental intervention study with an interrupted time-series analysis. A multidisciplinary team conducted a multifaceted educational intervention in our tertiary-care hospital over a five-year period...
August 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28950814/optimising-%C3%AE-lactam-dosing-in-neonates-a-review-of-pharmacokinetics-drug-exposure-and-pathogens
#6
Aline Fuchs, Grace Li, Johannes Van Den Anker, Julia Bielicki
BACKGROUND: β-lactams are among the most frequently prescribed antibiotics for the treatment of neonatal sepsis. Survival of extremely preterm neonates necessitates an improved understanding of how β-lactams should be used in this vulnerable population. Appropriate dosing regimens for neonates remain unclear. We reviewed available data on the pharmacokinetics (PK) of β-lactam drugs in neonates. Pharmacokinetic/pharmacodynamic (PK/PD) efficacy index surrogates and minimum inhibitory concentrations (MICs) used to support dosing regimens recommendation in the studies were also investigated...
September 25, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28748196/developing-interactive-antimicrobial-stewardship-and-infection-prevention-curricula-for-diverse-learners-a-tailored-approach
#7
Priya Nori, Theresa Madaline, Iona Munjal, Shubha Bhar, Yi Guo, Susan K Seo, Andrea Porrovecchio, Elizabeth Gancher, Joshua Nosanchuk, Liise-Anne Pirofski, Belinda Ostrowsky
BACKGROUND: To impart principles of antimicrobial stewardship (AS) and infection prevention and control (IPC), we developed a curriculum tailored to the diverse aptitudes of learners at our medical center. METHODS: We integrated case-based modules, group learning activities, smartphone applications (apps), decision support tools, and prescription audit and feedback into curricula of the medical school, medicine residency program, infectious diseases (ID) fellowship program, and hospital medicine program operations...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28748178/community-based-prescribing-for-impetigo-in-remote-australia-an-opportunity-for-antimicrobial-stewardship
#8
Stefanie Jane Oliver, James Cush, Jeanette E Ward
BACKGROUND: To support antibiotic prescribing for both hospital and community-based health professionals working in remote North Western Australia, a multidisciplinary Antimicrobial Stewardship (AMS) Committee was established in 2013. This Committee is usually focused on hospital-based prescribing. A troubling increase in sulfamethoxazole/trimethoprim resistance in Staphylococcus aureus antibiograms from 9 to 18% over 1 year prompted a shift in gaze to community prescribing. WHAT WE DID: Finding a paucity of relevant research, we first investigated contextual factors influencing local prescribing...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28128095/antimicrobial-prescribing-patterns-in-a-large-tertiary-hospital-in-shanghai-china
#9
Yuan-Yuan Wang, Ping Du, Fang Huang, Dong-Jie Li, Jun Gu, Fu-Ming Shen, Yuan-Ying Jiang
Whilst the 'Principles of clinical use of antibiotics' was released by the Ministry of Health of the People's Republic of China in 2004, limited research has been conducted to evaluate the quality of antibiotic use in real-world practice. In this study, we sought to examine antimicrobial prescribing patterns in a large tertiary hospital in Shanghai, China. De-identified outpatient and emergency department pharmacy records containing antimicrobials were extracted from the hospital electronic health records system...
December 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27614913/principles-of-anti-infective-dosing-in-pregnancy
#10
REVIEW
Avinash S Patil, Jessica S Sheng, Sarah K Dotters-Katz, Maria S Schmoll, Mitchell L Onslow
PURPOSE: Anti-infectives are among the most commonly prescribed medications in pregnancy. However, detailed information on the pharmacokinetics and pharmacodynamics of these medications in pregnancy is limited, leading to uncertainty among clinicians regarding the tolerability and efficacy of treatments. The purposes of this review were to highlight key physiologic changes during pregnancy that influence drug behavior, and to discuss areas of active research related to anti-infective drugs in pregnancy...
September 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27576784/a-needs-assessment-study-for-optimising-prescribing-practice-in-secondary-care-junior-doctors-the-antibiotic-prescribing-education-among-doctors-aped
#11
Myriam Gharbi, Luke S P Moore, Enrique Castro-Sánchez, Elpiniki Spanoudaki, Charlotte Grady, Alison H Holmes, Lydia N Drumright
BACKGROUND: Appropriate antimicrobial prescribing is essential for patient care, yet up to half of antimicrobial prescriptions written in the UK are sub-optimal. Improving prescriber education has recently been promoted as a mechanism to optimise antimicrobial use, but identification of key learning objectives to facilitate this is so far lacking. Using qualitative methods we investigated junior doctor knowledge, attitudes, and behaviours around antimicrobial prescribing to identify key areas to address in future educational programmes...
August 30, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27538503/antimicrobial-stewardship-in-paediatrics
#12
REVIEW
Nicola Principi, Susanna Esposito
BACKGROUND: Antibiotics are among the drugs most commonly prescribed to children in hospitals and communities. Unfortunately, a great number of these prescriptions are unnecessary or inappropriate. Antibiotic abuse and misuse have several negative consequences, including drug-related adverse events, the emergence of multidrug resistant bacterial pathogens, the development of Clostridium difficile infection, the negative impact on microbiota, and undertreatment risks. In this paper, the principle of and strategies for paediatric antimicrobial stewardship (AS) programs, the effects of AS interventions and the common barriers to development and implementation of AS programs are discussed...
August 18, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27494918/antimicrobial-stewardship-in-wound-care-a-position-paper-from-the-british-society-for-antimicrobial-chemotherapy-and-european-wound-management-association
#13
REVIEW
Benjamin A Lipsky, Matthew Dryden, Finn Gottrup, Dilip Nathwani, Ronald Andrew Seaton, Jan Stryja
BACKGROUND: With the growing global problem of antibiotic resistance it is crucial that clinicians use antibiotics wisely, which largely means following the principles of antimicrobial stewardship (AMS). Treatment of various types of wounds is one of the more common reasons for prescribing antibiotics. OBJECTIVES: This guidance document is aimed at providing clinicians an understanding of: the basic principles of why AMS is important in caring for patients with infected wounds; who should be involved in AMS; and how to conduct AMS for patients with infected wounds...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27412043/what-do-i-need-to-know-about-penicillin-antibiotics
#14
REVIEW
Charlotte I Barker, Eva Germovsek, Mike Sharland
The penicillins remain the class of antibiotics most commonly prescribed to children worldwide. In an era when the risks posed by antimicrobial resistance are growing, an understanding of antibiotic pharmacology and how to apply these principles in clinical practice is increasingly important. This paper provides an overview of the pharmacology of penicillins, focusing on those aspects of pharmacokinetics, pharmacodynamics and toxicity that are clinically relevant in paediatric prescribing. Penicillin allergy is frequently reported but a detailed history of suspected adverse reactions is essential to identify whether a clinically relevant hypersensitivity reaction is likely or not...
February 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/27245715/the-role-of-appropriate-diagnostic-testing-in-acute-respiratory-tract-infections-an-antibiotic-stewardship-strategy-to-minimise-diagnostic-uncertainty-in-primary-care
#15
REVIEW
Adrian John Brink, Johan Van Wyk, V M Moodley, Craig Corcoran, Pieter Ekermans, Louise Nutt, Tom Boyles, Olga Perovic, Charles Feldman, Guy Richards, Marc Mendelson
Antibiotic resistance has increased worldwide to the extent that it is now regarded as a global public health crisis. Interventions to reduce excessive antibiotic prescribing to patients can reduce resistance and improve microbiological and clinical outcomes. Therefore, although improving outpatient antibiotic use is crucial, few data are provided on the key interventional components and the effectiveness of antibiotic stewardship in the primary care setting, in South Africa. The reasons driving the excessive prescription of antibiotics in the community are multifactorial but, perhaps most importantly, the overlapping clinical features of viral and bacterial infections dramatically reduce the ability of GPs to distinguish which patients would benefit from an antibiotic or not...
May 10, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27244927/-experience-of-the-rational-antibacterial-therapy-conduction-in-treatment-of-children-for-the-burn-trauma
#16
E V Ponomarenko, Ya S Skripnikova, O I Mangurenko
Abstract The principles of rational antibacterial therapy in children for the burn trauma were analyzed. The results of the completed treatment of 808 children for the burn trauma in a Combustiological Department of Municipal clinical hospital of City of Zaporozhye were studied. In 326 (40.3%) children antibacterial therapy was conducted, including one antibiotic--in 268 (82.2%), two and more--in 37 (11.3%). The preparations were prescribed empirically, taking into account bacteriological profile of the Department and the patients premorbidity background present...
February 2016: Klinichna Khirurhiia
https://www.readbyqxmd.com/read/27015776/the-clinical-relevance-of-antibiotic-resistance-thirteen-principles-that-every-dermatologist-needs-to-consider-when-prescribing-antibiotic-therapy
#17
REVIEW
James Q Del Rosso, Joshua A Zeichner
Antibiotics are commonly used by dermatologists in clinical practice, primarily because of the overall track record of favorable efficacy and safety with the most commonly used agents. During the past decade, increased attention has been given to the problems associated with antibiotic resistance. This article summarizes important principles gleaned from the continued efforts of the Scientific Panel on Antibiotic Use in Dermatology; other groups working diligently in this area, such as the Centers for Disease Control and Prevention and the Canadian Antimicrobial Resistance Alliance; and from the published literature...
April 2016: Dermatologic Clinics
https://www.readbyqxmd.com/read/26961691/the-use-and-risks-of-antibiotics-in-critically-ill-patients
#18
REVIEW
Kerina J Denny, Menino O Cotta, Suzanne L Parker, Jason A Roberts, Jeffrey Lipman
INTRODUCTION: The altered pathophysiology in critically ill patients presents a unique challenge in both the diagnosis of infection and the appropriate prescription of antibiotics. In this context, the importance of effective and timely treatment needs to be weighed against the individual and community harms associated with antibiotic collateral damage and antibiotic resistance. AREAS COVERED: We evaluate the principles of antibiotic use in critically ill patients, including dose optimisation, use of combination antibiotic therapy, therapeutic drug monitoring, appropriate antibiotic therapy duration, de-escalation, and utilisation of sepsis biomarkers...
May 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/26622268/improving-knowledge-of-general-dental-practitioners-on-antibiotic-prescribing-by-raising-awareness-of-the-faculty-of-general-dental-practice-uk-guidelines
#19
Sana Zahabiyoun, Mahasti Sahabi, Mohammad Javad Kharazi
OBJECTIVES: Cases of antimicrobial resistance are increasing, partly due to inappropriate prescribing practices by dentists. The purpose of this study was to investigate the prescribing practices and knowledge of dentists with regards to antibiotics. Moreover, this study aimed to determine whether the prescriptions comply with the recommended guidelines and whether clinical audit can alter the prescribing practices of dentists leading to better use of antibiotics in the dental service...
March 2015: Journal of Dentistry of Tehran University of Medical Sciences
https://www.readbyqxmd.com/read/26494344/effective-anaesthesia-of-the-acutely-inflamed-pulp-part-1-the-acutely-inflamed-pulp
#20
REVIEW
S S Virdee, D Seymour, S Bhakta
Achieving profound pulpal anaesthesia in a mandibular molar diagnosed with irreversible pulpitis can be argued to be the most testing of dental anaesthetic challenges. This can be attributed to the technical complexities of conventional techniques and the presence of pulp pathosis. Reasons for why the latter influences the ability to attain pulpal anaesthesia is not yet fully understood, but its frequent occurrence is well documented. In light of overcoming this it has become common practice to prescribe antibiotics, refer onto secondary care or to even commence treatment without appropriately anaesthetising the tooth...
October 23, 2015: British Dental Journal
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