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Antimicrobial stewardship program

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https://www.readbyqxmd.com/read/28343444/a-pilot-study-for-antimicrobial-stewardship-post-discharge
#1
Justin M Jones, Nathan D Leedahl, Ashley Losing, Paul J Carson, David D Leedahl
PURPOSE: Lack of patient follow-up is a major concern during care transitions, and the role of an antimicrobial stewardship program (ASP) in assessing antimicrobial regimens after hospital discharge is not well described. We implemented an expanded ASP to include patients recently discharged from the hospital and measured its impact on inappropriate antimicrobial therapy 72 hours after inpatient culture data were finalized. METHODS: A prospective cohort study was conducted at a 583-bed tertiary care center in the Upper Midwest of America...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28342095/-advances-in-diagnostic-microbiology-opportunities-and-limitations
#2
F P Maurer, M Hentschke, H Rohde
In the light of ever increasing problems related to the emergence of multidrug-resistant bacteria, rapid microbiological diagnostics are of growing importance. Timely pathogen detection and availability of susceptibility data are essential for optimal treatment, but are even more crucial for de-escalation of broad spectrum empiric therapies. Medical microbiology is, thus, an integral part of antimicrobial stewardship programs. Traditional microbiological techniques for species identification and susceptibility testing rely on bacterial growth and are, thus, characterized by inherent slowness...
March 24, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28339590/reducing-antimicrobial-use-in-an-academic-pediatric-institution-evaluation-of-the-effectiveness-of-a-prospective-audit-with-real-time-feedback
#3
Zachary I Willis, Jessica Gillon, Meng Xu, James C Slaughter, M Cecilia Di Pentima
Introduction: Antimicrobial use is decreasing across freestanding children's hospitals, predominantly in institutions with antimicrobial stewardship programs (ASPs) in place. A highly effective ASP should effect a greater decrease in use than predicted by existing trends. Antimicrobial stewardship programs depend on clinician adherence to program recommendations, but little is known about factors associated with adherence. Methods: Parenteral antimicrobial-use data for our institution and 43 additional freestanding children's hospitals were obtained and normalized for patient census...
October 7, 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28337086/pediatric-antimicrobial-stewardship-programs
#4
Kristen Nichols, Sylvia Stoffella, Rachel Meyers, Jennifer Girotto
The frequent use of antimicrobials in pediatric patients has led to a significant increase in multidrug-resistant bacterial infections among children. Antimicrobial stewardship programs have been created in many hospitals in an effort to curtail and optimize the use of antibiotics. Pediatric-focused programs are necessary because of the differences in antimicrobial need and use among this patient population, unique considerations and dosing, vulnerability for resistance due to a lifetime of antibiotic exposure, and the increased risk of adverse events...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28332344/impact-of-intervention-by-an-antimicrobial-stewardship-team-on-conversion-from-intravenous-to-oral-fluoroquinolones
#5
Soh Mee Park, Hyung Sook Kim, Young Mi Jeong, Jung Hwa Lee, Eunsook Lee, Euni Lee, Kyoung Ho Song, Hong Bin Kim, Eu Suk Kim
BACKGROUND: Early conversion from intravenous to oral antibiotics plays an important role in lowering the risk of catheter-associated infections, reducing the workload of nurses, decreasing direct and indirect costs, and shortening hospital stays. In August 2015, an antimicrobial stewardship program (ASP) was implemented to facilitate conversion from intravenous to oral administration of fluoroquinolones in our institute. This study evaluated the clinical and economic impact of the intervention...
March 13, 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/28291632/necessity-of-carbapenem-use-when-prescribed-per-infectious-diseases-specialists
#6
Kellie J Goodlet, Michael D Nailor
Preauthorization strategies, including restricting broad-spectrum antimicrobials such as carbapenems to infectious diseases physicians (ID) are commonly employed by stewardship programs. The appropriateness, or "necessity" of empiric carbapenem therapy by ID, defined as an isolated organism sensitive to the carbapenem and resistant to cefepime, was evaluated over a 6month span and included 84 patients. Additionally, 30 patients followed by ID who were not prescribed a carbapenem until final susceptibilities were included as a definitive therapy group...
February 27, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28283829/the-efficacy-of-the-direct-clinical-intervention-for-infectious-diseases-by-a-pediatric-infectious-disease-specialist-in-the-pediatric-ward-of-a-tertiary-medical-facility-without-a-pediatric-antimicrobial-stewardship-program
#7
T Hoshina, N Yamamoto, M Ogawa, T Nakamoto, K Kusuhara
Antimicrobial stewardship programs (ASPs) have been introduced in most hospital complexes; however, they are not always useful for pediatric patients. The aim of this study is to investigate the efficacy of direct clinical intervention for infectious diseases by a pediatric infectious disease specialist in a tertiary medical facility without pediatric ASP. This retrospective study included 1,821 patients who were hospitalized in the pediatric ward of a large metropolitan hospital from 2010 to 2015. The clinical course, the use of intravenous antimicrobial agents and the results of a microbiological analysis were compared between the period after the beginning of direct intervention by the specialist (post-intervention period) and the previous period (pre-intervention period)...
March 10, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28274985/role-of-postgraduate-year-2-pharmacy-residents-in-providing-weekend-antimicrobial-stewardship-coverage-in-an-academic-medical-center
#8
Justin Siegfried, Cristian Merchan, Marco R Scipione, John Papadopoulos, Arash Dabestani, Yanina Dubrovskaya
PURPOSE: The integration of pharmacy residents into an antimicrobial stewardship program (ASP) is described, and data on the residents' ASP interventions and outcomes are reported. SUMMARY: ASP coverage of nighttime, holiday, and weekend shifts is often provided by infectious diseases (ID) medical fellows and staff pharmacists, potentially leading to inconsistent stewardship practices. As part of an initiative by a large urban hospital to provide around-the-clock, comprehensive ASP services 7 days a week, postgraduate year 2 (PGY2) pharmacy residents in ID or critical care were assigned to provide ASP coverage on weekends...
March 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28265870/correlation-between-antibiotic-consumption-and-resistance-of-bloodstream-bacteria-in-a-university-hospital-in-north-eastern-italy-2008-2014
#9
Marta Mascarello, Omar Simonetti, Anna Knezevich, Ludovica Ilaria Carniel, Jacopo Monticelli, Marina Busetti, Paolo Schincariol, Lucio Torelli, Roberto Luzzati
PURPOSE: The spread of multidrug-resistant bacteria is a worrisome problem worldwide. This study investigated the correlation between antibiotic consumption and antimicrobial resistance trends of the most important bacteria causing bacteremia at the University hospital of Trieste, Italy, from 2008 to 2014. METHODS: Antibiotic consumption (Defined Daily Dose-DDD-per 100 patient/days) and antibiotic resistance (percentage of antibiotic intermediate o resistant isolates) were analyzed independently with linear correlation by year...
March 6, 2017: Infection
https://www.readbyqxmd.com/read/28260148/anticipating-the-unpredictable-a-review-of-antimicrobial-stewardship-and-acinetobacter-infections
#10
REVIEW
Eric Wenzler, Debra A Goff, Romney Humphries, Ellie J C Goldstein
Acinetobacter remains one of the most challenging pathogens in the field of infectious diseases owing primarily to the uniqueness and multiplicity of its resistance mechanisms. This resistance often leads to devastatingly long delays in time to appropriate therapy and increased mortality for patients afflicted with Acinetobacter infections. Selecting appropriate empiric and definitive antibacterial therapy for Acinetobacter is further complicated by the lack of reliability in commercial antimicrobial susceptibility testing devices and limited breakpoint interpretations for available agents...
March 4, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28250702/an-evaluation-of-selected-indications-and-appropriateness-of-ampicillin-sulbactam-an-unrestricted-antimicrobial-at-a-single-center
#11
Dorothy McCoy, Rani Sebti, Arpi G Kuyumjian
BACKGROUND: With antimicrobial resistance on the rise and few new agents in development, it is important to exercise prudent judgment when utilizing antimicrobials. The Antimicrobial Stewardship Program (ASP) is responsible for facilitating the appropriate use of antimicrobials at the institution. Restricted antimicrobials and select additional antimicrobials are monitored by the ASP team to determine if the indications chosen by the ordering prescribers correspond to and are appropriate for the patients' infections...
March 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28239451/management-of-a-cluster-of-clostridium-difficile-infections-among-patients-with-osteoarticular-infections
#12
Jacqueline Färber, Sebastian Illiger, Fabian Berger, Barbara Gärtner, Lutz von Müller, Christoph H Lohmann, Katja Bauer, Christina Grabau, Stefanie Zibolka, Dirk Schlüter, Gernot Geginat
BACKGROUND: Here we describe a cluster of hospital-acquired Clostridium difficile infections (CDI) among 26 patients with osteoarticular infections. The aim of the study was to define the source of C. difficile and to evaluate the impact of general infection control measures and antibiotic stewardship on the incidence of CDI. METHODS: Epidemiological analysis included typing of C. difficile strains and analysis of possible patient to patient transmission. Infection control measures comprised strict isolation of CDI patients, additional hand washings, and intensified environmental cleaning with sporicidal disinfection...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28236547/screening-for-beta-lactam-allergy-in-joint-arthroplasty-patients-to-improve-surgical-prophylaxis-practice
#13
Deanna L McDanel, Antoine E Azar, Amy M Dowden, Samantha Murray-Bainer, Nicolas O Noiseux, Melissa Willenborg, Charles R Clark, John J Callaghan, Ambar Haleem
BACKGROUND: The reliability of patient-reported penicillin allergies has been disputed. A Drug Allergy Clinic (DAC) was established at our institution in combination with an electronic best practice alert (BPA) in the Orthopedic Clinic. Joint arthroplasty patients with a reported history of beta-lactam allergy (HOBA) were preoperatively referred via the BPA to the DAC. The purpose of this study was to determine the effectiveness of beta-lactam allergy screening in enabling the surgical team to optimize antimicrobial prophylaxis...
January 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28216021/prevalence-antibiotic-susceptibility-and-characterization-of-antibiotic-resistant-genes-among-carbapenem-resistant-gram-negative-bacilli-and-yeast-in-intestinal-flora-of-cancer-patients-in-north-lebanon
#14
Rima Christophy, Marwan Osman, Hassan Mallat, Marcel Achkar, Azzam Ziedeh, Walid Moukaddem, Fouad Dabboussi, Monzer Hamze
The emergence and spread of carbapenem-resistant bacteria are a significant clinical and public health concern. The aim of the study is to determine the prevalence of intestinal carriage of carbapenem-resistant bacteria and yeasts in cancer patients under chemotherapy. 41 stool samples collected from cancer patients in Nini hospital in Tripoli, North Lebanon have been analyzed. After isolating yeasts and carbapenem-resistant bacteria, a biochemical identification and antimicrobial susceptibility profile were determined...
February 15, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28203781/eight-habits-of-highly-effective-antimicrobial-stewardship-programs-to-meet-the-joint-commission-standards-for-hospitals
#15
Debra A Goff, Ravina Kullar, Karri A Bauer, Thomas M File
No abstract text is available yet for this article.
February 14, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28197223/a-multifaceted-approach-to-decrease-inappropriate-antibiotic-use-in-a-pediatric-outpatient-clinic
#16
Jaffar A Al-Tawfiq, Amel H Alawami
BACKGROUND: Inappropriate use of antimicrobial agents is the major cause for the development of resistance. Thus, it is important to include outpatient clinics in the development of antibiotic stewardship program. METHODS: We report a multifaceted approach to decrease inappropriate antibiotic use in upper respiratory tract infections (URTIs) in an outpatient pediatric clinic. The interventions included educational grand round, academic detailing, and prospective audit and feedback and peer comparison...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28182774/benefits-and-unintended-consequences-of-antimicrobial-de-escalation-implications-for-stewardship-programs
#17
Josie Hughes, Xi Huo, Lindsey Falk, Amy Hurford, Kunquan Lan, Bryan Coburn, Andrew Morris, Jianhong Wu
Sequential antimicrobial de-escalation aims to minimize resistance to high-value broad-spectrum empiric antimicrobials by switching to alternative drugs when testing confirms susceptibility. Though widely practiced, the effects de-escalation are not well understood. Definitions of interventions and outcomes differ among studies. We use mathematical models of the transmission and evolution of Pseudomonas aeruginosa in an intensive care unit to assess the effect of de-escalation on a broad range of outcomes, and clarify expectations...
2017: PloS One
https://www.readbyqxmd.com/read/28179249/penicillin-skin-testing-as-an-antimicrobial-stewardship-initiative
#18
Bruce M Jones, Christopher M Bland
PURPOSE: An initiative to determine the effects of penicillin skin testing (PST) from an antimicrobial stewardship perspective is described. SUMMARY: Penicillin allergy is one of the most frequently reported allergies; however, only about 10% of self-reports of penicillin allergy are accurate. Incorrect penicillin allergies are therefore a significant barrier to antimicrobial stewardship, with important clinical and economic implications, including increased antimicrobial resistance, an increased overall cost of care, increased length of stay, and, ultimately, increased mortality...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28173888/current-state-of-antimicrobial-stewardship-in-children-s-hospital-emergency-departments
#19
Rakesh D Mistry, Jason G Newland, Jeffrey S Gerber, Adam L Hersh, Larissa May, Sarah M Perman, Nathan Kuppermann, Peter S Dayan
BACKGROUND Antimicrobial stewardship programs (ASPs) effectively optimize antibiotic use for inpatients; however, the extent of emergency department (ED) involvement in ASPs has not been described. OBJECTIVE To determine current ED involvement in children's hospital ASPs and to assess beliefs and preferred methods of implementation for ED-based ASPs. METHODS A cross-sectional survey of 37 children's hospitals participating in the Sharing Antimicrobial Resistance Practices collaboration was conducted. Surveys were distributed to ASP leaders and ED medical directors at each institution...
February 8, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28159174/antimicrobial-therapy-for-legionnaire-s-disease-antibiotic-stewardship-implications
#20
REVIEW
Cheston B Cunha, Burke A Cunha
Legionnaire's disease is a common cause of community-acquired pneumonia (CAP). Although no single clinical feature is diagnostic, if characteristic extrapulmonary findings are present a presumptive clinical syndromic diagnosis is possible. Depending on geographic location, season, and physician awareness, Legionnaire's disease may be included in the differential diagnosis of CAP. Some antibiotics effective against Legionella sp are also effective in treating the typical bacterial causes of CAP. From an antimicrobial stewardship program (ASP) perspective, monotherapy is preferred to double-drug therapy...
March 2017: Infectious Disease Clinics of North America
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