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Antimicrobial stewardship program

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https://www.readbyqxmd.com/read/28089673/the-value-of-participatory-development-to-support-antimicrobial-stewardship-with-a-clinical-decision-support-system
#1
Nienke Beerlage-de Jong, Jobke Wentzel, Ron Hendrix, Lisette van Gemert-Pijnen
BACKGROUND: Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily practice. Our aim was to demonstrate why and how participatory development (involving end-users and other stakeholders) can contribute to the success of CDSSs in ASPs. METHODS: A mixed-methods approach was applied, combining scenario-based prototype evaluations (to support verbalization of work processes and out-of-the-box thinking) among 6 medical resident physicians with an online questionnaire (to cross-reference findings of the prototype evaluations) among 54 Dutch physicians...
January 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28089415/antimicrobial-stewardship-in-the-federal-bureau-of-prisons-approaches-from-the-national-and-local-levels
#2
Michael J Long, Brian N LaPlant, Justin C McCormick
OBJECTIVES: To determine the impact of national and local antimicrobial stewardship measures on overall antibiotic prescribing in the Federal Bureau of Prisons (BOP). SETTING: Care was delivered to more than 160,000 inmates in 122 BOP facilities in the United States and Puerto Rico. PRACTICE DESCRIPTION: Medical centers and health services clinics staffed by in-house medical staff, consultants, and specialists. Staffs include a variety of disciplines, including physicians, pharmacists, dentists, nurses, infection control personnel, therapists, health services administrators, and institution executive staff...
January 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28079629/duration-of-pneumonia-therapy-and-the-role-of-biomarkers
#3
Katerina Kaziani, Adamantia Sotiriou, George Dimopoulos
PURPOSE OF REVIEW: Increasing antimicrobial resistance is a worldwide phenomenon that is threatening public health. Lower respiratory infections are one of the leading causes of morbidity that contribute to antibiotic consumption and thus the emergence of multidrug-resistant microbial strains. The goal of shortening antibiotic regimens' duration in common bacterial infections has been prioritized by antimicrobial stewardship programs as an action against this problem. RECENT FINDINGS: Data coming from randomized controlled trials, meta-analyses, and systematic reviews support the shortening of antimicrobial regimens in community-acquired, hospital-acquired, and ventilator-associated pneumonia...
January 12, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28065331/antimicrobial-stewardship-in-kansas-results-from-a-statewide-survey
#4
Carrie Poteete, Joseph M Scaletta
BACKGROUND: The availability of effective antibiotics is considered one of the most important developments in medicine. However, many organisms that were once susceptible to common antibiotics are becoming resistant. Antimicrobial stewardship programs (ASPs) are considered to be vital for combating the emergence of resistance. To understand current antimicrobial stewardship practices in Kansas, the authors designed a 36-question survey. Results of this survey will be used to develop a coordinated, public health strategy for improving current practices...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28035690/%C3%AE-lactam-therapy-for-methicillin-susceptible-staphylococcus-aureus-bacteremia-a-comparative-review-of-cefazolin-versus-antistaphylococcal-penicillins
#5
Julius Li, Kelly L Echevarria, Kristi A Traugott
Methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia is associated with high morbidity and mortality. Traditionally, antistaphylococcal penicillins (ASPs) have been considered the agents of choice for the treatment of MSSA bacteremia. Vancomycin has been demonstrated to have poorer outcomes in several studies and is only recommended for patients with severe penicillin allergies. Although cefazolin is considered as an alternative to the ASPs for patients with nonsevere penicillin allergies, cefazolin offers several pharmacologic advantages over ASPs, such as more convenient dosing regimens, and antimicrobial stewardship programs are increasingly using cefazolin as the preferential agent for MSSA infections as part of cost-saving initiatives...
December 30, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28034534/antimicrobial-stewardship-practices-in-virginia
#6
Kimberly B Lee, Jesus Aaron Ramirez, Rebeccah Collins, John Bucheit, Kakotan Sanogo, Michael P Stevens
The Society of Healthcare Epidemiology of America, the Centers for Disease Control and Prevention, and the President's Council of Advisors on Science and Technology recognize the need to combat antimicrobial resistance through the promotion of antimicrobial stewardship programs. Health care facilities in Virginia were surveyed using a 23-item survey focused on facility characteristics and antimicrobial stewardship strategies. Antimicrobial stewardship activities were highly variable and many are missing key personnel and resources...
December 26, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27997675/compliance-with-procalcitonin-algorithm-antibiotic-recommendations-for-patients-in-medical-intensive-care-unit
#7
Abdalla A Ammar, Simon W Lam, Abhijit Duggal, Elizabeth A Neuner, Stephanie N Bass, Jorge A Guzman, Xiao-Feng Wang, Xiaozhen Han, Seth R Bauer
STUDY OBJECTIVES: To describe compliance with antibiotic recommendations based on a previously published procalcitonin (PCT)-guided algorithm in clinical practice, to compare PCT algorithm compliance rates between PCT assays ordered in the antibiotic initiation setting (PCT concentration measured < 24 hours after antibiotic initiation or prior to antibiotic initiation) with those in the antibiotic continuation setting (PCT concentration measured ≥ 24 hours after antibiotic initiation), and to evaluate patient- and PCT-related factors independently associated with algorithm compliance in patients in the medical intensive care unit...
December 20, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27994621/antimicrobial-stewardship-a-cross-sectional-survey-assessing-the-perceptions-and-practices-of-community-pharmacists-in-ethiopia
#8
Daniel Asfaw Erku
Background. Community pharmacists are key healthcare professionals for antimicrobial stewardship programs owing to their role in dispensing of antimicrobials. The aim of the present study was to assess the perception and practices of community pharmacists towards antimicrobial stewardship (AMS) in Ethiopia. Methods. A cross-sectional survey was conducted by selecting pharmacy sites through stratified simple random sampling technique. Descriptive and inferential statistics were used to analyze the data. Results...
2016: Interdisciplinary Perspectives on Infectious Diseases
https://www.readbyqxmd.com/read/27986824/the-intersection-of-antimicrobial-stewardship-and-microbiology-educating-the-next-generation-of-health-care-professionals
#9
Lauren A O'Donnell, Anthony J Guarascio
With the alarming rise of antibiotic resistance, clinical professionals are called upon to manage antibiotic therapies using the most relevant and recent clinical and laboratory data. To this end, antimicrobial stewardship (AMS) programs aim to reduce unnecessary or suboptimal use of antibiotics while maximizing outcomes for the patient. For AMS programs to succeed, the active participation of clinical professionals at all levels of patient care is required. Although programs exist to train established clinicians in AMS, there is a paucity of literature on how and when to integrate AMS concepts and skills in pre-clinical and clinical coursework...
January 2017: FEMS Microbiology Letters
https://www.readbyqxmd.com/read/27974411/antimicrobial-stewardship-how-the-microbiology-laboratory-can-right-the-ship
#10
REVIEW
Philippe Morency-Potvin, David N Schwartz, Robert A Weinstein
SUMMARYAntimicrobial stewardship is a bundle of integrated interventions employed to optimize the use of antimicrobials in health care settings. While infectious-disease-trained physicians, with clinical pharmacists, are considered the main leaders of antimicrobial stewardship programs, clinical microbiologists can play a key role in these programs. This review is intended to provide a comprehensive discussion of the different components of antimicrobial stewardship in which microbiology laboratories and clinical microbiologists can make significant contributions, including cumulative antimicrobial susceptibility reports, enhanced culture and susceptibility reports, guidance in the preanalytic phase, rapid diagnostic test availability, provider education, and alert and surveillance systems...
January 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/27973295/evaluation-of-antimicrobial-stewardship-programs-in-hainan-china
#11
H Zhou
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27955625/frequency-of-empiric-antibiotic-de-escalation-in-an-acute-care-hospital-with-an-established-antimicrobial-stewardship-program
#12
Peter Liu, Christopher Ohl, James Johnson, John Williamson, James Beardsley, Vera Luther
BACKGROUND: Expanding antimicrobial resistance patterns in the face of stagnant growth in novel antibiotic production underscores the importance of antibiotic stewardship in which de-escalation remains an integral component. We measured the frequency of antibiotic de-escalation in a tertiary care medical center with an established antimicrobial stewardship program to provide a plausible benchmark for de-escalation. METHODS: A retrospective, observational study was performed by review of randomly selected electronic medical records of 240 patients who received simultaneous piperacillin/tazobactam and vancomycin from January to December 2011 at an 885-bed tertiary care medical center...
December 12, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27934622/-antibioticscout-online-tool-for-antimicrobial-stewardship-in-veterinary-medicine
#13
R Peter, C Müntener, D Demuth, D Heim, M Mevissen, G Schüpbach-Regula, S Schuller, F Stucki, B Willi, H Naegeli
Resistances to antimicrobials pose serious public health challenges. This issue concerns both human and veterinary medicine and can only be solved by a multidisciplinary approach. A comprehensive concept is, therefore, being worked out within the StAR (strategy antibiotic resistance) program in order to preserve the effectiveness of antibiotics for humans as well as animals. In this context, the AntibioticScout (www.AntibioticScout. ch) offers a new online tool for the prudent use of antibiotics in veterinary medicine...
December 2016: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/27927866/expert-consensus-on-metrics-to-assess-the-impact-of-patient-level-antimicrobial-stewardship-interventions-in-acute-care-settings
#14
Rebekah W Moehring, Deverick J Anderson, Ronda L Cochran, Lauri A Hicks, Arjun Srinivasan, Elizabeth S Dodds Ashley
Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. An expert panel rated 90 candidate metrics on a 9-point Likert scale for association with 4 criteria: improved antimicrobial prescribing, improved patient care, utility in targeting stewardship efforts, and feasibility in hospitals with electronic health records...
February 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27917734/effective-antibiotic-conservation-by-emergency-antimicrobial-stewardship-during-a-drug-shortage
#15
Kevin Hsueh, Maria Reyes, Tamara Krekel, Ed Casabar, David J Ritchie, S Reza Jafarzadeh, Amanda J Hays, Michael A Lane, Michael J Durkin
We present the first description of an antimicrobial stewardship program (ASP) used to successfully manage a multi-antimicrobial drug shortage. Without resorting to formulary restriction, meropenem utilization decreased by 69% and piperacillin-tazobactam by 73%. During the shortage period, hospital mortality decreased (P=.03), while hospital length of stay remained unchanged. Infect Control Hosp Epidemiol 2016;1-4.
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27917707/management-of-pneumonia-in-the-pediatric-critical-care-unit-an-area-for-antimicrobial-stewardship
#16
Aimee M Dassner, David P Nicolau, Jennifer E Girotto
Pediatric pneumonia is one of the most common causes of childhood infection requiring hospitalization and is a substantial driver of antimicrobial use among hospitalized children. About 12-20% of pediatric patients hospitalized with community-acquired pneumonia (CAP) require critical care. Additionally, nosocomial pneumonias (i.e. hospital-acquired and ventilator-associated pneumonias) are responsible for 15-53% of hospital-associated infections and are the most common indication for empiric antibiotics in the pediatric intensive care unit...
December 4, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27915487/the-epidemiology-of-carbapenemases-in-latin-america-and-the-caribbean
#17
Kevin Escandón-Vargas, Sergio Reyes, Sergio Gutiérrez, María Virginia Villegas
Enterobacteriaceae, Pseudomonas spp., and Acinetobacter spp. infections are major causes of morbidity and mortality, especially due to the emergence and spread of β-lactamases. Carbapenemases, which are β-lactamases with the capacity to hydrolyze or inactivate carbapenems, have become a serious concern as they have the largest hydrolytic spectrum and therefore limit the utility of most β-lactam antibiotics. Areas covered: Here, we present an update of the current status of carbapenemases in Latin America and the Caribbean...
December 20, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27908435/antimicrobial-stewardship-programs-that-target-only-high-cost-broad-spectrum-antimicrobials-miss-opportunities-to-reduce-clostridium-difficile-infections
#18
Christine Bui, Elizabeth Zhu, Monica A Donnelley, Machelle D Wilson, Margaret Morita, Stuart H Cohen, Jennifer Brown
Antimicrobial stewardship programs are promoted as a strategy to reduce Clostridium difficile infections. We implemented an antimicrobial stewardship program comprised of formulary restriction plus prospective audit with feedback for high-cost and broad-spectrum antimicrobials. Subsequently, we reviewed all heath care facility-onset, health care facility-associated C difficile infections. We found that most of these infections were associated with the antecedent receipt of nonaudited, and often unnecessary, antimicrobials...
December 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27902375/improving-time-to-optimal-staphylococcus-aureus-treatment-using-a-penicillin-binding-protein-2a-assay
#19
Sonia N Rao, Sheila K Wang, Jose Gonzalez Zamora, Amy P Hanson, Radhika S Polisetty, Kamaljit Singh
The penicillin-binding protein 2a (PBP2a) assay is a quick, accurate and inexpensive test for determining methicillin susceptibility in Staphylococcus aureus. A pre-post-study design was conducted using a PBP2a assay with and without the impact of an antimicrobial stewardship intervention to improve time to optimal therapy for methicillin-susceptible and methicillin-resistant S. aureus isolates. Our results demonstrate significantly improved time to optimal therapy and support the use of a PBP2a assay as part of an programme for all healthcare facilities, especially those with limited resources...
December 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27895446/a-case-of-fatal-sepsis-due-to-multidrug-resistant-corynebacterium-striatum
#20
M Chatzopoulou, T Koufakis, I Voulgaridi, I Gabranis, M Tsiakalou
BACKGROUND: Although non-diphtheria corynebacteria have traditionally been regarded as avirulent members of human bacterial flora, their pathogenic potential is increasingly recognized in our time. Reasons for this include the prolonged survival of severely ill and immunocompromised patients, the development of more invasive diagnostic and therapeutic procedures and the sub-optimal use of antibiotics that disrupts normal microbial balance and favors superinfections. CASE REPORT: We present a rare case of sepsis due to multidrug-resistant Corynebacterium striatum in a 76-year-old host...
January 2016: Hippokratia
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